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Hematuria associated with hypercalciuria and hyperuricosuria: a practical approach
1Department of Pediatrics, State University of New York at Buffalo, New York.
Insights
Painless hematuria in children can be caused by excess calcium (hypercalciuria) or uric acid (hyperuricosuria) in urine. This review examines the history, clinical features, and diagnostic criteria for these conditions.
Area of Science:
- Pediatric Nephrology
- Urology
- Clinical Biochemistry
Background:
- Hematuria is a common urinary finding in pediatric patients.
- Hypercalciuria and hyperuricosuria have been implicated as causes of painless hematuria in children.
Purpose of the Study:
- To review the historical context and clinical characteristics of hematuria associated with hypercalciuria and hyperuricosuria in children.
- To outline diagnostic criteria for excessive urinary calcium and uric acid excretion.
- To highlight age-related differences in excretion patterns.
Main Methods:
- Literature review of studies on pediatric hematuria, hypercalciuria, and hyperuricosuria.
- Analysis of clinical syndromes and diagnostic criteria.
- Comparison of urinary excretion patterns between infants and older children.
Main Results:
- Hypercalciuria and hyperuricosuria are recognized causes of hematuria in pediatric populations.
- Specific diagnostic criteria for elevated urinary calcium and uric acid levels are presented.
- Age-dependent variations in urinary calcium and uric acid excretion exist.
Conclusions:
- Hypercalciuria and hyperuricosuria are significant, though not always symptomatic, causes of pediatric hematuria.
- Long-term consequences, apart from urolithiasis, are limited, with ongoing discussion regarding bone health impacts of chronic hypercalciuria.
Abstract:
Hematuria is one of the most common urinary abnormalities found in children. When hypercalciuria was identified as a potential etiology of painless hematuria, many questions arose concerning the general importance of this observation. Subsequently, increased uric acid excretion also has been purported to cause hematuria in children. This review traces the history of these observations and describes the clinical characteristics of the clinical syndrome of hematuria associated with hypercalciuria and hyperuricosuria. Diagnostic criteria of excessive urinary excretion of calcium and uric acid are reviewed; differences in urinary calcium and uric acid excretion between infants and older children are emphasized. Aside from urolithiasis, few long-term consequences from hypercalciuria or hyperuricosuria have been identified, although some debate exists concerning the effect of chronic hypercalciuria upon bone mineralization.