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Hypercalciuria is related to osmolar excretion in children with nocturnal enuresis
A Raes1, L Dossche, N Hertegonne
1Department of Pediatric Nephrology, University Hospital Ghent, Ghent, Belgium. ann.raes@ugent.be
Insights
Hypercalciuria (high urinary calcium) is common in children with nocturnal enuresis, often linked to diuresis and osmolar excretion, suggesting a comorbid factor rather than a primary cause.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Nocturnal enuresis is a common condition in children.
- Hypercalciuria, defined as urinary calcium-to-creatinine ratio > 0.21 mg/mg, has been investigated as a potential factor in enuresis.
Purpose of the Study:
- To evaluate the incidence of hypercalciuria in children with nocturnal enuresis.
- To assess the association between hypercalciuria and concurrent diuresis and osmolar excretion.
Main Methods:
- A study involving 550 children with nocturnal enuresis admitted to a tertiary university center.
- 24-hour urine collections were conducted across 8 sampling periods to measure calcium excretion, osmolality, and diuresis.
Main Results:
- 12% of children with nocturnal enuresis exhibited 24-hour hypercalciuria, with up to 29% in timed samples.
- Significant correlations were found between calcium excretion and nocturnal diuresis (polyuria), low urinary osmolality, and increased nighttime sodium and osmolar excretion (p <0.001).
Conclusions:
- Patients at a tertiary enuresis center show a high incidence of hypercalciuria.
- The correlation suggests hypercalciuria is a comorbid factor, not a primary cause of nocturnal enuresis.
- Findings suggest an association with nutritional intake rather than primary hypercalciuria as per previous Italian studies.
Purpose:
We evaluated the incidence of hypercalciuria, defined as urinary calcium-to-creatinine ratio greater than 0.21 mg/mg, in children with nocturnal enuresis, and the association with concurrent values of diuresis and osmolar excretion.
Materials And Methods:
A total of 550 children admitted to a tertiary university center were included in the study. A 24-hour urine collection was performed in 8 sampling periods for measurement of calcium excretion, osmolality and diuresis.
Results:
Of the children with nocturnal enuresis 12% had 24-hour hypercalciuria. Up to 29% of the timed urine samples exhibited hypercalciuria. There was a significant correlation between calcium excretion and nocturnal diuresis volume (polyuria), low urinary osmolality, and increased sodium and osmolar excretion of nighttime urine samples (all p <0.001).
Conclusions:
Patients referred to a tertiary enuresis center have a high incidence of hypercalciuria. However, the significant correlation between hypercalciuria and osmolar excretion and diuresis suggests that it is a comorbid factor rather than a primary pathogenic factor. As such, we cannot confirm the data from Italian studies relating nocturnal enuresis to primary hypercalciuria, and suggest instead an association with nutritional intake.
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