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Is there any correlation between hypercalciuria and nocturnal enuresis?
A Nikibakhsh1, H Poostindooz, H Mahmoodzadeh
1Department of Pediatric Nephrology, Urmia University of Medical Sciences, Urmia, Iran.
Insights
Hypercalciuria, or high calcium in urine, is more common in children with nocturnal enuresis (bedwetting) than in healthy children. Measuring urine calcium may help identify causes of bedwetting.
Area of Science:
- Pediatrics
- Nephrology
- Urology
Background:
- Nocturnal enuresis is a prevalent childhood issue.
- Hypercalciuria is a potential contributing factor to bedwetting.
Purpose of the Study:
- To determine the incidence of hypercalciuria in children experiencing nocturnal enuresis.
- To compare hypercalciuria rates between enuretic children and healthy controls.
Main Methods:
- A case-control study involving 118 children with nocturnal enuresis and 100 matched healthy controls.
- Urine samples collected upon waking and 2 hours later to measure calcium/creatinine ratios.
- Serum calcium, phosphorus, electrolytes, and PTH levels assessed in hypercalciuric individuals.
Main Results:
- The mean urine calcium/creatinine ratio was significantly higher in the nocturnal enuresis group (0.070±0.06 mg/mg) compared to controls (0.050±0.046 mg/mg; P=0.008).
- Hypercalciuria was detected in 12/118 children with nocturnal enuresis versus 3/100 controls (P=0.032).
- All hypercalciuric subjects exhibited normal serum calcium, phosphorus, electrolyte, and PTH levels.
Conclusions:
- A significantly higher frequency of hypercalciuria exists in children with nocturnal enuresis.
- Measurement of urinary calcium is recommended for children presenting with nocturnal enuresis to explore potential etiologies.
Abstract:
Nocturnal enuresis is a common problem among children. Hypercalciuria has been proposed as an important etiology of bedwetting. We investigated the incidence of hypercalciuria among children with nocturnal enuresis and age- and sex-matched healthy controls. In this case-control study 118 children with nocturnal enuresis and 100 age-, sex-, and educational district-matched healthy controls were recruited. Urine samples were obtained from each subject twice: immediately after awakening and 2 hours later at school. Urinary calcium and creatinine levels were measured and the subjects with a urinary calcium/creatinine ratio more than 0.2 were considered as hypercalciuric. Serum Ca, P, Na, K, and PTH levels were measured for all hypercalciuric subjects. The mean urine calcium to creatinine ratio in the second urine sample was 0.070±0.06 mg/mg and 0.050±0.046, respectively in the case and control groups (P=0.008). There were 12/118 and 3/100 hypercalciuric subjects in the case and control groups respectively (P=0.032). The serum Ca, P, Na, K, and PTH levels were in normal range in all hypercalciuric subjects. In our study there was a significant difference in the frequency of hypercalciuria among children with nocturnal enuresis and healthy controls, so we can suggest adding the measurement of urine electrolytes especially the calcium level in patients with nocturnal enuresis.
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