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DOI: 10.1055/s-0040-1721389
An Important Risk Factor Affecting Hypercalciuria in Children: Vesicoureteral Reflux
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Abstract
Introduction A large number of genes and environmental factors, like dietary habits, play a role in the development of hypercalciuria in children. In this study, we aimed to determine the effects of the presence and grade of vesicoureteral reflux (VUR) on hypercalciuria status in children.
Materials and Methods Data for 165 patients who admitted to the Pediatric Urology Department were retrospectively analyzed. The patients were composed of following four different groups: (1) urinary stone patients, (2) VUR patients under follow-up, (3) corrected VUR patients, and (4) control. The demographic features, clinical data, and laboratory tests for the groups were compared.
Results The mean age of the patients was 100.6 ± 54.69 months and the female/male ratio was 79:86. The mean urinary calcium/creatinine (UCa/Cr) excretion and the frequency of high UCa/Cr ratios in the corrected VUR group were similar to those in the control group (p = 0.375 and 0.965, respectively). In contrast, the mean UCa/Cr excretion and frequency of high UCa/Cr ratios in the urinary stone and follow-up VUR groups were significantly higher than those in the corrected VUR group (p < 0.001, < 0.001, 0.003, and 0.029, respectively). The mean UCa/Cr excretion and frequency of high UCa/Cr ratios in the follow-up VUR group were similar to those in the urinary stone group (p = 0.323 and 0.425, respectively). In the follow-up VUR group, although reflux laterality had no effect on the UCa/Cr ratios (p = 0.180 and 0.108, respectively), the mean and frequency of high UCa/Cr ratios were higher in high-grade reflux cases (p < 0.001 and p = 0.042, respectively).
Conclusion Both the mean UCa/Cr ratio and the rate of hypercalciuria in the corrected reflux group were significantly lower than the corresponding values in the follow-up VUR and urinary stone groups. Further, the follow-up VUR patients had similar urinary calcium excretion levels as the stone patients. VUR treatment is associated with a decrease in urinary calcium excretion to the normal population level. A positive correlation between reflux degree and calcium excretion was observed.
Keywords
hypercalciuria - pediatric stone disease - reflux in follow-up - urinary calcium creatine ratio - vesicoureteral refluxPublication History
Received: 03 June 2020
Accepted: 23 October 2020
Article published online:
22 November 2020
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References
- 1 Vachvanichsanong P, Lebel L, Moore ES. Urinary calcium excretion in healthy Thai children. Pediatr Nephrol 2000; 14 (8,9): 847-850
- 2 Alconcher LF, Castro C, Quintana D. et al. Urinary calcium excretion in healthy school children. Pediatr Nephrol 1997; 11 (02) 186-188
- 3 Srivastava T, Schwaderer A. Diagnosis and management of hypercalciuria in children. Curr Opin Pediatr 2009; 21 (02) 214-219
- 4 García-Nieto V, Siverio B, Monge M, Toledo C, Molini N. Urinary calcium excretion in children with vesicoureteral reflux. Nephrol Dial Transplant 2003; 18 (03) 507-511
- 5 Madani A, Kermani N, Ataei N. et al. Urinary calcium and uric acid excretion in children with vesicoureteral reflux. Pediatr Nephrol 2012; 27 (01) 95-99
- 6 Badeli H, Sadeghi M, Shafe O, Khoshnevis T, Heidarzadeh A. Determination and comparison of mean random urine calcium between children with vesicoureteral reflux and those with improved vesicoureteral reflux. Saudi J Kidney Dis Transpl 2011; 22 (01) 79-82
- 7 Mahyar A, Dalirani R, Ayazi P. et al. The association of hypercalciuria and hyperuricosuria with vesicoureteral reflux in children. Clin Exp Nephrol 2017; 21 (01) 112-116
- 8 Milliner DS. Urolithiasis. In: Ellis D.Avner WEH, Patrick Niaudet, Norishige Yoshikawa. eds. Pediatric Nephrology. Berlin, Germany: Springer; 2009: 1405-1430
- 9 Sönmez F, Akçanal B, Altincik A, Yenisey C. Urinary calcium excretion in healthy Turkish children. Int Urol Nephrol 2007; 39 (03) 917-922
- 10 Gül A, Özer S, Yılmaz R. et al. Prevalence of hypercalciuria and urinary calcium excretion in school-aged children in the province of Tokat. Turk Pediatri Ars 2016; 51 (04) 193-197
- 11 Keren R, Shaikh N, Pohl H. et al. Risk factors for recurrent urinary tract infection and renal scarring. Pediatrics 2015; 136 (01) e13-e21
- 12 Nacaroglu HT, Demircin G, Bülbül M, Erdogan O, Akyüz SG, Caltik A. The association between urinary tract infection and idiopathic hypercalciuria in children. Ren Fail 2013; 35 (03) 327-332
- 13 Stojanović VD, Milosević BO, Djapić MB, Bubalo JD. Idiopathic hypercalciuria associated with urinary tract infection in children. Pediatr Nephrol 2007; 22 (09) 1291-1295
- 14 Sternberg K, Greenfield SP, Williot P, Wan J. Pediatric stone disease: an evolving experience. J Urol 2005; 174 (4 Pt 2): 1711-1714
- 15 Baştuğ F, Gündüz Z, Tülpar S, Poyrazoğlu H, Düşünsel R. Urolithiasis in infants: evaluation of risk factors. World J Urol 2013; 31 (05) 1117-1122
- 16 Roberts JP, Atwell JD. Vesicoureteric reflux and urinary calculi in children. Br J Urol 1989; 64 (01) 10-12
- 17 Chand DH, Rhoades T, Poe SA, Kraus S, Strife CF. Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. J Urol 2003; 170 (4 Pt 2): 1548-1550
- 18 Miah T, Kamat D. Pediatric nephrolithiasis: a review. Pediatr Ann 2017; 46 (06) e242-e244