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Idiopathic hypercalcemia in infants with renal dysplasia

N Al Kalbani1, M Frieling, J C Teh

  • 1The Hospital for Sick Children, Division of Nephrology, Toronto, Canada.

Clinical Nephrology
|May 6, 2011
PubMed

Insights

Idiopathic hypercalcemia is common in infants with renal dysplasia, particularly in males under one month old and those with posterior urethral valves (PUV). Levels of vitamin D, phosphate, and parathyroid hormone (PTH) are typically normal.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Neonatology

Background:

  • Infants with renal dysplasia can develop sustained hypercalcemia without supplementation, a condition termed idiopathic hypercalcemia.
  • This phenomenon has not been previously described in the medical literature.

Purpose of the Study:

  • To determine the incidence, severity, and duration of idiopathic hypercalcemia in infants under 12 months with renal dysplasia.
  • To evaluate associated phosphate, parathyroid hormone (PTH), and vitamin D levels in these infants.

Main Methods:

  • A retrospective study analyzed 99 infants with renal dysplasia from June 2005 to June 2008.
  • Exclusion criteria included calcium-containing phosphate binders or vitamin D supplementation exceeding 400 IU daily.
  • Hypercalcemia was defined by at least three corrected calcium values above normal within one week.

Main Results:

  • 15% (15 of 99) of infants with renal dysplasia exhibited hypercalcemia.
  • The majority were males (100%), presented under one month of age (67%), and had posterior urethral valves (PUV) (60%).
  • Mean hypercalcemia duration was 5.2 months, with a mean corrected calcium of 3.07 mmol/l. Elevated PTH, phosphate, and 25-hydroxyvitamin D levels were infrequent.

Conclusions:

  • Idiopathic hypercalcemia is a common complication in infants with renal dysplasia.
  • Neonates and infants with PUV are at the highest risk.
  • Most affected infants present with normal 25-hydroxyvitamin D, phosphate, and PTH levels.
Abstract

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