Hypercalciuria, an Old but still Bold issue in Children

Idiopathic hypercalciuria (IH) represents a significant health concern among children. Given the influence of childhood health on adult well-being, the high levels of salt intake prevalent in the Iranian population, and the immediate and long-term effects of hypercalciuria, we have decided to assess the incidence of IH in children who are beginning their primary education, along with various related factors.

This survey was conducted on 653 children of first-degree primary school age (5-7 years old) in Isfahan, Iran from January 2018 to June 2019. A questionnaire containing demographic and laboratory data was filled out for all participants. The measurement of the fasting spot urine calcium-to-creatinine ratio was used to assess hypercalciuria.

A total of 295 out of 653 participants were male. About 56% of the pupils belonging to families who had more than 1-3 times of fast food per week, were hypercalciuric. After two times evaluation of abnormal results, 40.2% had hypercalciuria and 28.6% had hyperuricosuria. The mean values of mean platelet volume (MPV), neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio, all serving as indicators of endothelial dysfunction, were slightly elevated in hypercalciuric pupils compared to their non-hypercalciuric counterparts, P < 0.05. The average of three blood pressure measurements, ages of bladder control, and also bladder indices were not different between these two groups.

In the countries on the stone belt, hypercalciuria is a common laboratory finding in children at the age of entering primary school. In patients with not only isolated microscopic hematuria but also with lower urinary tract symptoms, hypercalciuria should be kept in mind. However, the role of hypercalciuria and its risk factors in inducing endothelial dysfunction must be investigated.