Hypercalciuria in clinical pediatrics. A review

Area of Science:

• Pediatric Nephrology
• Urology

Background:

• Idiopathic hypercalciuria (IH) is a common metabolic abnormality in children.
• IH can manifest with diverse urinary tract symptoms, including hematuria, enuresis, and renal calculi.
• Early diagnosis and management are crucial for preventing long-term complications.

Purpose of the Study:

• To review the clinical presentation and diagnostic approaches to idiopathic hypercalciuria in pediatric patients.
• To outline management strategies for IH, focusing on identified causes and renal stone management.
• To discuss the controversies surrounding pharmacotherapy for non-calculi related symptoms in pediatric IH.

Main Methods:

• Literature review of idiopathic hypercalciuria in pediatric populations.
• Analysis of diagnostic tools, including urine calcium-creatinine ratio.
• Evaluation of treatment guidelines for IH and associated urinary tract complaints.

Main Results:

• A random urine calcium-creatinine ratio serves as an effective initial screening tool for hypercalciuria.
• Specific treatment is indicated for identifiable causes of hypercalciuria.
• Thiazide diuretics are the recommended treatment for uncomplicated renal calculi in children with IH.

Conclusions:

• Idiopathic hypercalciuria presents with varied urinary symptoms in children.
• A stepwise diagnostic approach, starting with urine calcium-creatinine ratio, is recommended.
• Pharmacological treatment for IH symptoms beyond renal stones should be reserved for severe cases.