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Titolo:
Idiopathic hypercalciuria of childhood: 4-to 11-year outcome
Autore:
Alon, US; Berenbom, A;
Indirizzi:
Univ Missouri, Sect Pediat Nephrol, Childrens Mercy Hosp, Kansas City, MO 64108 USA Univ Missouri Kansas City MO USA 64108 cy Hosp, Kansas City, MO 64108 USA
Titolo Testata:
PEDIATRIC NEPHROLOGY
fascicolo: 10-11, volume: 14, anno: 2000,
pagine: 1011 - 1015
SICI:
0931-041X(200009)14:10-11<1011:IHOC41>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY CALCIUM EXCRETION; DIETARY-SODIUM; CHILDREN; POTASSIUM; HEMATURIA;
Keywords:
calciuria; hematuria; ultrasonography; urolithiasis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Alon, US Univ Missouri, Sect Pediat Nephrol, Childrens Mercy Hosp, 2401 Gillham Rd,Kansas City, MO 64108 USA Univ Missouri 2401 Gillham Rd Kansas City MO USA 64108 64108 USA
Citazione:
U.S. Alon e A. Berenbom, "Idiopathic hypercalciuria of childhood: 4-to 11-year outcome", PED NEPHROL, 14(10-11), 2000, pp. 1011-1015

Abstract

Apart from a minority with urolithiasis, the majority of children diagnosed with idiopathic hypercalciuria present with macro- or microhematuria, abdominal or back pain, or voiding symptoms. With dietary and pharmacological interventions, most such children become asymptomatic and are lost to follow-up, hence their long-term outcome is unclear. In the present study, we evaluated the status of 14 males and 19 females aged 8-17 years (mean 11.9 years, median 11.2 years) 4-11 years (mean 6.9 pears, median 6.5 years) afterthe initial diagnosis of idiopathic hypercalciuria not associated with urolithiasis. A questionnaire was answered and two random urine samples provided 3-4 weeks apart were analyzed for calcium (Ca), sodium (Na), potassium (K), and creatinine (Cr). Urine Ca/Cr ratio greater than or equal to 0.21 (mg/mg) was defined as hypercalciuria. At the time of the study none were under follow-up, although 7 children were still exhibiting voiding symptoms. No child developed clinical urolithiasis. Based on the first urine specimen,16 of the 33 (48.4%) were hypercalciuric. Their 2nd urinalysis showed persistent hypercalciuria in 8 and normocalciuria in 8. Urine Na/K ratio (mEq/mEq) decreased in the latter 8 from 5.08+/-2.67 to 3.03+/-2.23 (P<0.05). Of the 17 initially nonnocalciuric children, 5 did not submit a 2nd specimen, 11 remained normocalciuric, and 1 became hypercalciuric with an increase inurine Na/K ratio. Twenty-three children (all 8 persistently and 9 intermittently hypercalciuric plus 6 normocalciuric) were studied by ultrasonography. Only in 1 asymptomatic persistently hypercalciuric child was a single small renal calcification noted. Introduction of a low-Na/high-K diet in 7 persistently hypercalciuric children resulted in a decrease in UNa/K ratio from 7.34+/-2.15 to 4.14+/-3.09 (P<0.01) and UCa/Cr ratio from 0.25+/-0.04 to0.13+/-0.03 (P<0.01). We conclude that even though over time most hypercalciuric children become asymptomatic, many remain hypercalciuric. Further follow-up is required to ascertain whether these children are at risk of developing kidney stones. If they are at risk then long-term compliance with a low-Na/high-K diet might be beneficial, as it can normalize calciuria in the majority of these children.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 19:57:50