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Urinary volume in children with urolithiasis
1Department of Pediatrics, University of Tennessee, Memphis.
Insights
Children with idiopathic calcium oxalate urolithiasis have significantly lower urinary volume, indicating it
Area of Science:
- Pediatric Nephrology
- Urology
- Metabolic Disorders
Background:
- Hypercalciuria and urolithiasis are significant concerns in pediatric populations.
- Idiopathic calcium oxalate urolithiasis requires understanding of contributing risk factors.
Purpose of the Study:
- To investigate urinary volume as a potential risk factor in children with hypercalciuria and urolithiasis.
- To compare urinary volume in healthy children, those with hypercalciuria, and those with idiopathic calcium oxalate urolithiasis.
Main Methods:
- 24-hour urine collections were analyzed in three groups of children: healthy controls, those with hypercalciuria, and those with idiopathic calcium oxalate urolithiasis.
- Urinary volume (ml/kg/day), sodium excretion, and urine osmolality were measured and compared between groups.
Main Results:
- Children with idiopathic calcium oxalate urolithiasis exhibited significantly lower urinary volume (12.2 ml/kg/day) compared to healthy controls (22.2 ml/kg/day) and hypercalciuric children (25.4 ml/kg/day).
- Urinary volume was not significantly different between hypercalciuric children with and without urolithiasis.
- Urinary sodium excretion and urine osmolality were similar across all studied groups.
Conclusions:
- Reduced urinary volume is a critical risk factor for idiopathic calcium oxalate urolithiasis in children.
- Increased fluid intake should be strongly recommended for pediatric patients diagnosed with idiopathic calcium oxalate urolithiasis.
Abstract:
Urinary volume in 24-hour urine collections was examined in 50 children with hypercalciuria and urolithiasis or hematuria, 12 with idiopathic calcium oxalate urolithiasis and 36 healthy children. Urinary volume was 22.2 +/- 2.0 ml. per kg. per day in healthy children and 25.4 +/- 2.0 ml. per kg. per day in children with hypercalciuria, and it was similar in children with absorptive and renal hypercalciuria, and significantly lower in children with idiopathic calcium oxalate urolithiasis (12.2 +/- 1.4 ml. per kg. per day, p less than 0.001 from controls and children with hypercalciuria). Volume was not statistically different in hypercalciuric children with and without urolithiasis. Urinary sodium excretion in children with idiopathic calculi was not statistically different from controls. Urine osmolality was similar among the groups. Urinary volume represents a risk factor in children with idiopathic calcium oxalate urolithiasis, and increased fluid intake should be emphasized in such patients.