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Related Experiment Videos

Screening for hypercalciuria.

S Akashi1, H Motizuki

  • 1Division of Nephrology, Saitama Children's Medical Center, Japan.

Acta Paediatrica Japonica : Overseas Edition
|December 1, 1990
PubMed
Summary

Establishing reference values for urinary calcium/creatinine (Ca/Cr) ratio in children provides a screening tool for elevated calcium excretion. This study subclassified idiopathic hypercalciuria, suggesting disordered vitamin D metabolism in absorptive hypercalciuria.

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Area of Science:

  • Pediatric Nephrology
  • Clinical Biochemistry
  • Metabolic Bone Disease

Background:

  • Idiopathic hypercalciuria (IH) is a common condition in children with unclear pathogenesis.
  • Accurate reference values for urinary calcium excretion are crucial for diagnosis and management.
  • The urinary calcium/creatinine (Ca/Cr) ratio is a widely used index for assessing calcium excretion.

Purpose of the Study:

  • To establish reference values for the urinary Ca/Cr ratio in healthy children.
  • To investigate the relationship between Ca/Cr ratio, age, and sex.
  • To subclassify idiopathic hypercalciuria based on urinary Ca/Cr ratios and calciuric response.

Main Methods:

  • Cross-sectional study of 361 healthy children aged 5-15 years.
  • Measurement of urinary Ca/Cr ratio in first morning voided urine on unrestricted diets.
  • Assessment of calciuric response to calcium-restricted diets and oral calcium loading tests.

Main Results:

  • Urinary Ca/Cr ratio was independent of sex but dependent on age.
  • The first morning urinary Ca/Cr ratio on unrestricted diets served as a reliable screening test for elevated calcium excretion.
  • IH was subclassified into absorptive, renal, and dietary hypercalciuria.
  • Disordered 1,25(OH)2 vitamin D metabolism with excessive urinary phosphate excretion was suggested in absorptive hypercalciuria.

Conclusions:

  • Reference values for urinary Ca/Cr ratio in children are established.
  • First morning urinary Ca/Cr ratio is a valuable screening tool for hypercalciuria.
  • Subclassification of IH aids in understanding its diverse pathophysiology.
  • Abnormal vitamin D metabolism may contribute to absorptive hypercalciuria.

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