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FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN

Year 2015, Volume: 5 Issue: 4, 226 - 233, 21.02.2016

Abstract

Objective: Idiopathic hypercalciuria ( IHC ) is very frequently seen metabolic disorder in children and causes to some symptoms as hematuria, disuria, enuresis, cholic pain and growth retardation. IHC is generally ended with urolithiasis ( 1-2 ). In this researh , we aim to notice frequency and clinically importance of hypercalciuria.

                Method: In pediatric polyclinic, 4 to 15 year old children detected for hypercalciuria by calcium, creatinine, sodium and potasium measuring in spot urine samples. we calculated the urine calcium creatinine ratio( Uca/Ucr ) and 0,20 and above accepted hypercalciuria ( 3 ). Urinary tract symptoms were recorded.

                Results: We studied 223 children in our pediatric polyclinic with an age range of 4 to 15 years (mean= 8.7 ±3,18.7 ±3,1).  124 ( %55.6) chidren were female and 99 ( %44.4 ) were male. In study group,  we found urine calcium creatinine  ratio  0,20 and above in 32 (%14.3 ). The prevalance was %18.2 in males and in females was  %11.3. 92(%41.3) children were have urinary system symptoms and hypercaluria was found in 25( %27.2 ) from these 92 symptomatic children. Of all hypercalciuric 32 children, 25( %78.1 ) children were symptomatic and the most frequently symptoms was abdominal pain with %68.8 frequency ( 22 children ). However in nonhypercaiuric 191 children abdominal pain was found 47( %24.6 ) children, from hypercalciuric children 22( %68,8 ) patients had abdominal pain ( p<0,001). The mean sodium creatinine ratio, in hypercalciuric children was 3,71±3,62 and in nonhypercaiuric was 1,70±1,28 (p<0,001).

                Conclusions: Because of the IHC frequently ended in urolithiasis, especially in urinary tract sympomatic children Uca/Ucr should be studied that is not invasive test and patients with IHC can be treated firstly with sodium restricted and potasium richly diets.

References

  • 1- Stapleton F.B., Noe H. N., Roy S., III et al. Hypercalciuria in children with urolithiasis. Am J Dis Child, 1982; 136: 675
  • 2- Roy S. III, Stapleton F. B., Noe H. N. et al. Hematuria preceding renal calculus formation in children with hypercalciuria. J Pediatr, 1981; 99: 712
  • 3- Langman C. B. Disorders of phosphorus, calcium, and vitamin D. In: Barrat T. M., Avner E. D., Harman W. E., (eds). Pediatric Nephrology. 4th edition Lippincott VVilliams and VVilkins, 1998; 529-44
  • 4- Kruse K., Kracht U., Kruse U. Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents. Eur J Pediatr, 1984; 143:25-31
  • 5- De Santo N. G., Di Iorio B., Capasso G., et al. Population based data on urinary excretion of calcium, magnesium, oxalate, phosphate, and uric acid in children from Cimitile (southern Italy). Pediatr Nephrol, 1992; 6: 149-157
  • 6- Burke J. R. Ask the expert: what is the appropriate work-up for a child with hypercalciuria? Pediatr Nephrol, Dec 1995; 9 (6): 684
  • 7- Coe F. L., Favus M. J. Disorders of stone formations. In: Brenner M., Rector J., (eds). The Kidney. 6* edition Vol. 2 Philadelphia W. B. Saunders, 2000; 1786-99
  • 8- A report of the Southwest Pediatric Nephrology hypercalciuria.-association with isolated hematuria and risk for urolithiasis in children. Kidney İnt, 1990; 37: 807-11 Group. Idiopathic
  • 9- AIconcher LF; Castro C; Quintana D and et al. Urinary calcium excretion in healthy school children. Pediatr Nephrol, Apr 1997; 11 (2): 186-8
  • 10- Coe FL, Bushinsky DA: Pathophysiology of hypercalciuria Am J Physiol, 1984; 247:1 -13 (Revievv).
  • 11- Menon M., Parulkar B. G., Drach G. W. Urinary lithiasis : Etiology, Diagnosis, and Management. In: Walsh P.C., Retik A. B., Vaughan D., Wein A. J., (eds). Campbell's Urology Volume 3. 7,th edition W. B. Saunders Company 1998; 2674-76
  • 12- Alon U., Warady B., Helerstein S. Hypercalciuria in the frequency-dysuria syndrome of cildhood. J Pediatr, 1990; 116:103-05
  • 13- Sargent JD, Stukel TA, Kresel J, Klein RZ. Normal values for random urinary calcium to creatinine ratios in infancy. J Pediatr, 1993; 123:393-7
  • 14- Vachvanichsanong P; Malagon M; Moore ES Urinary incontinence due to idiopathic hypercalciuria in children J Urol, Oct 1994; 152 (4): 1226-8
  • 15- Dumas R. Hypercalciuria: etiologies and treatment. Arch Pediatr, Apr 1997; 4 (4):351-58
  • 16- Matos V., Melle G.V., Boulat O. Urinary phosphate/creatinine, magnesium/creatinine ratios in a healthy pediatric population. J Pediatr, August 1997;131 (2):252-57
  • 17- Coe F. L. Treated and untreated recurrent calcium nephrolithiasis in patients with idiopathic hypercalciuria, hyperuricosuria, or no metabolic disorder. Ann Intern Med, 1977; 87:404-10
  • 18- Coe F.L., Parks JH, Moore ES. Familial idiopathic hypercalciuria. N Engl J Med, 1979;300:337-40
  • 19- Goodman H.O., Holmes R.P., Assimos D.G. : Generic factors in calcium oxalate stone disease. J Urol, 1995; 153:301-7
  • 20- Coe FL, Parks JH, Asplin Jr: The pathogenesis and treatment of kidney stones. N Engl J Med, 1992; 327:1141 -52.
  • 21- Aladjem M., Barr J., Lahat E., et al. Renal
  • hypercalciuria: and
  • disturbance with varying and interchanging modes
  • of expression. J Am Soc Nephrol, 1995; 5 (7): 216- 219 a metabolic
  • 22- Tekin N.. Kural N., Torun M., Renal function in children with hypercalciuria Turk J Pediatr, 1997; 39: (3):335-9
  • 23- Buyan N., Saatçi Ü., Bakkaloğlu M. A., Beşbaş N. Okul çocuklarında asemptomatik hiperkalsiüri. Epidemiyoloji ve patogenez. Çocuk Sağlığı ve Hastalıkları Dergisi, 1989; 32: 43-50
  • 24- Selimoglu MA; Alp H; Bitlisli H and et al. Urinary calcium excretion of children living in the east region of Turkey. Turk J Pediatr, Jul-Sep 1998; 40 (3): 399-404
  • 25- Berçem G ; Cevit O; Toksoy HB and et al. Asymptomatic hypercalciuria: prevalance and metabolic characteristics. Indian J Pediatr, Apr 2001; 68 (4):315-8
  • 26- Manz F; Kehrt R; Lausen B; Merkel A. Urinary calcium excretion in healthy children and adolescents. Pediatr Nephrol, Nov 1999; 13 (9): 894-9
  • 27- Stapleton FB, Roy S 3d, Noe HN, Jerkins G: Hypercalciuria in children with hematuria. N Eng J Med. 1984; 310:1345-48.
  • 28- Husmann D. A., Milliner,D.S. and Segura, J.W.: Ureteropelvic junction obstruction with concurrent renal pelvic calculi in the pediatric patient: a long-term Followup. J Urol, 1996 ; 156: 741
  • 29- Langman C. B., Moore E. S. Hypercalciuria in clinical pediatrics. A review. Clin Pediatr (Phila), 1984; 23: 135-37
  • 30- Kavukçu S., Soylu A., Türkmen M. A., et al. Hypercalciuria preceding Ig A nephropathy in a child with hematuria. Scand J Urol Nephrol, Aug 1999; 33 (4): 265-67
  • 31- Osorio A. V., Alon U. S. The relationship between urinary calcium, sodium, and potassium excretion and the role of potassium in treating idiopathic hypercalciuria. Pediatrics, 1997; 100 (4): 675-81
  • 32- Parekh DJ, Popr JC IV, Adams MC, and et al. The role of hypercalciuria in a subgroup of dysfunctional voiding syndromes of childhood. J Urol, Sep 2000; 164 (3 Pt 2): 1008-10
  • 33- Brock JW 3rd. The frequency and frequency dysuria syndromes of childhood: hypercalciuria as a possible etiology. Urology, Sep 1994; 44 (3): 411-2
  • 34- Escribano Subias J., Vicente Rodriguez M., Feliu Rovira A. idiopathic hypercalciuria: clinical manifestation, outcome and risk for urolithiasis in children. J An Esp Pediatr, Feb 1997; 46 (2): 161-6

4-15 YAŞ ARASI ÇOCUKLARDA HİPERKALSİÜRİ SIKLIĞI

Year 2015, Volume: 5 Issue: 4, 226 - 233, 21.02.2016

Abstract

                     GİRİŞ VE AMAÇ: İdyopatik Hiperkalsiüri ( İHK ) çocuklarda sık görülen bir metabolik bozukluktur.  Hematuri, dizüri, enürezis, kolik ve büyüme  geriliği gibi semptomlara sebep olur ve genellikle ürolitiazisle sonuçlanır    ( 1,2 ). İHK klinik belirtileri ve sıklığına dikkat çekmek amacıyla bu çalışma yapıldı.

                YÖNTEM : Polikliniğe başvuran 4-15 yaş arası 223  çocukta spot idrarda kalsium, kreatinin, sodyum, potasyum incelendi. İdrarda kalsiyum kreatinin oranı (İkakr ) hesaplandı, 0.20 ve üzeri hiperkalsiüri olarak kabul edildi (3 ). Hastaların şikayetleri kaydedildi.

                BULGULAR : 4-15 yaş arası 223 hastanın 124( %55.6 )’ ü kız, 99( %44.4 )’ u erkekti. Yaş ortalaması ise 8.7 ±3,1’ di. 223 hastanın 32 ( %14.3 ) ’sinde İkakr  0.20’ in üzerindeydi. Erkeklerdeki prevalans %18.2 iken kızlarda %11.3’ tü. 223 hastanın 92(%41.3)’ sinde idrar semptomu vardı. İdrar semptomu olan 92 hastanın 25( %27.2 )’ inde hiperkalsiüri tespit edildi. Hiperkalsiürili 25( %78.1 ) hasta semptomatikti, en sık rastlanan semptom %68.8( 22 hasta ) ile karın ağrısıydı. İHK olmayan 191 hastanın 47( %24.6 )’ inde karın ağrısı varken, İHK olan 32 hastanın 22( %68,8 )’ sinde karın ağrısı vardı. Hiperkalsiürili olan vakalarda karın ağrısı görülme sıklığı daha fazlaydı ( p<0,001 ). İHK olanlarda sodyumun kreatinine oran ortalaması 3,71±3,62’ di. Diğer grupta ise sodyumun kreatinine oran ortalaması 1,70±1,28’ di. İHK olan vakalarda sodyum atılımı daha fazlaydı ( p<0,001 ).

                SONUÇ: İHK ürolitiazis için en önemli risk faktörü olmasından, özellikle üriner sistem semptomları olan çocuklarda idrarda İkakr  gibi  invazif olmayan bir tetkikle taranmalı ve tedavisinde başlangıçta sodyumdan fakir potasyumdan zengin diyet denenebilir.

               

References

  • 1- Stapleton F.B., Noe H. N., Roy S., III et al. Hypercalciuria in children with urolithiasis. Am J Dis Child, 1982; 136: 675
  • 2- Roy S. III, Stapleton F. B., Noe H. N. et al. Hematuria preceding renal calculus formation in children with hypercalciuria. J Pediatr, 1981; 99: 712
  • 3- Langman C. B. Disorders of phosphorus, calcium, and vitamin D. In: Barrat T. M., Avner E. D., Harman W. E., (eds). Pediatric Nephrology. 4th edition Lippincott VVilliams and VVilkins, 1998; 529-44
  • 4- Kruse K., Kracht U., Kruse U. Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents. Eur J Pediatr, 1984; 143:25-31
  • 5- De Santo N. G., Di Iorio B., Capasso G., et al. Population based data on urinary excretion of calcium, magnesium, oxalate, phosphate, and uric acid in children from Cimitile (southern Italy). Pediatr Nephrol, 1992; 6: 149-157
  • 6- Burke J. R. Ask the expert: what is the appropriate work-up for a child with hypercalciuria? Pediatr Nephrol, Dec 1995; 9 (6): 684
  • 7- Coe F. L., Favus M. J. Disorders of stone formations. In: Brenner M., Rector J., (eds). The Kidney. 6* edition Vol. 2 Philadelphia W. B. Saunders, 2000; 1786-99
  • 8- A report of the Southwest Pediatric Nephrology hypercalciuria.-association with isolated hematuria and risk for urolithiasis in children. Kidney İnt, 1990; 37: 807-11 Group. Idiopathic
  • 9- AIconcher LF; Castro C; Quintana D and et al. Urinary calcium excretion in healthy school children. Pediatr Nephrol, Apr 1997; 11 (2): 186-8
  • 10- Coe FL, Bushinsky DA: Pathophysiology of hypercalciuria Am J Physiol, 1984; 247:1 -13 (Revievv).
  • 11- Menon M., Parulkar B. G., Drach G. W. Urinary lithiasis : Etiology, Diagnosis, and Management. In: Walsh P.C., Retik A. B., Vaughan D., Wein A. J., (eds). Campbell's Urology Volume 3. 7,th edition W. B. Saunders Company 1998; 2674-76
  • 12- Alon U., Warady B., Helerstein S. Hypercalciuria in the frequency-dysuria syndrome of cildhood. J Pediatr, 1990; 116:103-05
  • 13- Sargent JD, Stukel TA, Kresel J, Klein RZ. Normal values for random urinary calcium to creatinine ratios in infancy. J Pediatr, 1993; 123:393-7
  • 14- Vachvanichsanong P; Malagon M; Moore ES Urinary incontinence due to idiopathic hypercalciuria in children J Urol, Oct 1994; 152 (4): 1226-8
  • 15- Dumas R. Hypercalciuria: etiologies and treatment. Arch Pediatr, Apr 1997; 4 (4):351-58
  • 16- Matos V., Melle G.V., Boulat O. Urinary phosphate/creatinine, magnesium/creatinine ratios in a healthy pediatric population. J Pediatr, August 1997;131 (2):252-57
  • 17- Coe F. L. Treated and untreated recurrent calcium nephrolithiasis in patients with idiopathic hypercalciuria, hyperuricosuria, or no metabolic disorder. Ann Intern Med, 1977; 87:404-10
  • 18- Coe F.L., Parks JH, Moore ES. Familial idiopathic hypercalciuria. N Engl J Med, 1979;300:337-40
  • 19- Goodman H.O., Holmes R.P., Assimos D.G. : Generic factors in calcium oxalate stone disease. J Urol, 1995; 153:301-7
  • 20- Coe FL, Parks JH, Asplin Jr: The pathogenesis and treatment of kidney stones. N Engl J Med, 1992; 327:1141 -52.
  • 21- Aladjem M., Barr J., Lahat E., et al. Renal
  • hypercalciuria: and
  • disturbance with varying and interchanging modes
  • of expression. J Am Soc Nephrol, 1995; 5 (7): 216- 219 a metabolic
  • 22- Tekin N.. Kural N., Torun M., Renal function in children with hypercalciuria Turk J Pediatr, 1997; 39: (3):335-9
  • 23- Buyan N., Saatçi Ü., Bakkaloğlu M. A., Beşbaş N. Okul çocuklarında asemptomatik hiperkalsiüri. Epidemiyoloji ve patogenez. Çocuk Sağlığı ve Hastalıkları Dergisi, 1989; 32: 43-50
  • 24- Selimoglu MA; Alp H; Bitlisli H and et al. Urinary calcium excretion of children living in the east region of Turkey. Turk J Pediatr, Jul-Sep 1998; 40 (3): 399-404
  • 25- Berçem G ; Cevit O; Toksoy HB and et al. Asymptomatic hypercalciuria: prevalance and metabolic characteristics. Indian J Pediatr, Apr 2001; 68 (4):315-8
  • 26- Manz F; Kehrt R; Lausen B; Merkel A. Urinary calcium excretion in healthy children and adolescents. Pediatr Nephrol, Nov 1999; 13 (9): 894-9
  • 27- Stapleton FB, Roy S 3d, Noe HN, Jerkins G: Hypercalciuria in children with hematuria. N Eng J Med. 1984; 310:1345-48.
  • 28- Husmann D. A., Milliner,D.S. and Segura, J.W.: Ureteropelvic junction obstruction with concurrent renal pelvic calculi in the pediatric patient: a long-term Followup. J Urol, 1996 ; 156: 741
  • 29- Langman C. B., Moore E. S. Hypercalciuria in clinical pediatrics. A review. Clin Pediatr (Phila), 1984; 23: 135-37
  • 30- Kavukçu S., Soylu A., Türkmen M. A., et al. Hypercalciuria preceding Ig A nephropathy in a child with hematuria. Scand J Urol Nephrol, Aug 1999; 33 (4): 265-67
  • 31- Osorio A. V., Alon U. S. The relationship between urinary calcium, sodium, and potassium excretion and the role of potassium in treating idiopathic hypercalciuria. Pediatrics, 1997; 100 (4): 675-81
  • 32- Parekh DJ, Popr JC IV, Adams MC, and et al. The role of hypercalciuria in a subgroup of dysfunctional voiding syndromes of childhood. J Urol, Sep 2000; 164 (3 Pt 2): 1008-10
  • 33- Brock JW 3rd. The frequency and frequency dysuria syndromes of childhood: hypercalciuria as a possible etiology. Urology, Sep 1994; 44 (3): 411-2
  • 34- Escribano Subias J., Vicente Rodriguez M., Feliu Rovira A. idiopathic hypercalciuria: clinical manifestation, outcome and risk for urolithiasis in children. J An Esp Pediatr, Feb 1997; 46 (2): 161-6
There are 37 citations in total.

Details

Primary Language English
Journal Section Original Research
Authors

Ali Gül

İnci Arıkan This is me

Publication Date February 21, 2016
Published in Issue Year 2015 Volume: 5 Issue: 4

Cite

APA Gül, A., & Arıkan, İ. (2016). FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN. Çağdaş Tıp Dergisi, 5(4), 226-233. https://doi.org/10.16899/ctd.32012
AMA Gül A, Arıkan İ. FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN. J Contemp Med. February 2016;5(4):226-233. doi:10.16899/ctd.32012
Chicago Gül, Ali, and İnci Arıkan. “FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN”. Çağdaş Tıp Dergisi 5, no. 4 (February 2016): 226-33. https://doi.org/10.16899/ctd.32012.
EndNote Gül A, Arıkan İ (February 1, 2016) FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN. Çağdaş Tıp Dergisi 5 4 226–233.
IEEE A. Gül and İ. Arıkan, “FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN”, J Contemp Med, vol. 5, no. 4, pp. 226–233, 2016, doi: 10.16899/ctd.32012.
ISNAD Gül, Ali - Arıkan, İnci. “FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN”. Çağdaş Tıp Dergisi 5/4 (February 2016), 226-233. https://doi.org/10.16899/ctd.32012.
JAMA Gül A, Arıkan İ. FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN. J Contemp Med. 2016;5:226–233.
MLA Gül, Ali and İnci Arıkan. “FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN”. Çağdaş Tıp Dergisi, vol. 5, no. 4, 2016, pp. 226-33, doi:10.16899/ctd.32012.
Vancouver Gül A, Arıkan İ. FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN. J Contemp Med. 2016;5(4):226-33.