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Gluconate calcium therapy and neonatal hypercalciuria
Insights
Premature infants receiving furosemide or intravenous calcium gluconate may develop hypercalciuria, increasing nephrolithiasis risk. This study highlights the impact of these therapies on infant kidney health.
Area of Science:
- Pediatric Nephrology
- Neonatal Intensive Care
Background:
- Premature infants with bronchopulmonary dysplasia often receive furosemide and intravenous calcium gluconate.
- Hypercalciuria and nephrolithiasis have been observed in infants on these therapies.
Observation:
- This study investigated sick infants receiving calcium gluconate without furosemide.
- Urinary calcium excretion was compared between sick infants on calcium gluconate and well infants on regular formula.
Findings:
- Sick infants receiving calcium gluconate exhibited higher urinary calcium levels than healthy infants.
- Calciuria appeared to increase progressively with continued calcium gluconate therapy.
Implications:
- Prolonged use of furosemide or intravenous calcium gluconate can lead to hypercalciuria in premature infants.
- Hypercalciuria may predispose premature infants to developing nephrolithiasis (kidney stones).
Abstract:
Nephrolithiasis was present in a 2-month-old premature infant with bronchopulmonary dysplasia who had been receiving furosemide and intravenous (IV) gluconate calcium therapy. This infant was found to be hypercalciuric. Furosemide therapy is known to increase calcium excretion. In the present study, we examined sick infants who were receiving gluconate calcium without furosemide to evaluate the effect of gluconate calcium therapy on urinary calcium excretion. The sick infants receiving gluconate calcium had higher values of urinary calcium than did the well infants taking regular formula feedings. Moreover, the calciuria appeared to increase progressively with continued gluconate calcium therapy. It appears that prolonged use of either furosemide or IV gluconate calcium leads to hypercalciuria, which, in turn, may predispose the premature infant to nephrolithiasis.