FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN

Öz

Objective: Idiopathic hypercalciuria ( IHC ) is very frequently seen metabolic disorder in children and causes to some symptoms as hematuria, disuria, enuresis, cholic pain and growth retardation. IHC is generally ended with urolithiasis ( 1-2 ). In this researh , we aim to notice frequency and clinically importance of hypercalciuria.

                Method: In pediatric polyclinic, 4 to 15 year old children detected for hypercalciuria by calcium, creatinine, sodium and potasium measuring in spot urine samples. we calculated the urine calcium creatinine ratio( U_ca/U_cr ) and 0,20 and above accepted hypercalciuria ( 3 ). Urinary tract symptoms were recorded.

                Results: We studied 223 children in our pediatric polyclinic with an age range of 4 to 15 years (mean= 8.7 ±3,18.7 ±3,1).  124 ( %55.6) chidren were female and 99 ( %44.4 ) were male. In study group,  we found urine calcium creatinine  ratio  0,20 and above in 32 (%14.3 ). The prevalance was %18.2 in males and in females was  %11.3. 92(%41.3) children were have urinary system symptoms and hypercaluria was found in 25( %27.2 ) from these 92 symptomatic children. Of all hypercalciuric 32 children, 25( %78.1 ) children were symptomatic and the most frequently symptoms was abdominal pain with %68.8 frequency ( 22 children ). However in nonhypercaiuric 191 children abdominal pain was found 47( %24.6 ) children, from hypercalciuric children 22( %68,8 ) patients had abdominal pain ( p<0,001). The mean sodium creatinine ratio, in hypercalciuric children was 3,71±3,62 and in nonhypercaiuric was 1,70±1,28 (p<0,001).

                Conclusions: Because of the IHC frequently ended in urolithiasis, especially in urinary tract sympomatic children U_ca/U_cr should be studied that is not invasive test and patients with IHC can be treated firstly with sodium restricted and potasium richly diets.

Anahtar Kelimeler

• Idiopathic hypercalciuria, urine calcium creatinine ratio, urinary tract symptoms, urinary excretion of sodium.

4-15 YAŞ ARASI ÇOCUKLARDA HİPERKALSİÜRİ SIKLIĞI

Öz

                     GİRİŞ VE AMAÇ: İdyopatik Hiperkalsiüri ( İHK ) çocuklarda sık görülen bir metabolik bozukluktur.  Hematuri, dizüri, enürezis, kolik ve büyüme  geriliği gibi semptomlara sebep olur ve genellikle ürolitiazisle sonuçlanır    ( 1,2 ). İHK klinik belirtileri ve sıklığına dikkat çekmek amacıyla bu çalışma yapıldı.

                YÖNTEM : Polikliniğe başvuran 4-15 yaş arası 223  çocukta spot idrarda kalsium, kreatinin, sodyum, potasyum incelendi. İdrarda kalsiyum kreatinin oranı (İ_ka/İ_kr ) hesaplandı, 0.20 ve üzeri hiperkalsiüri olarak kabul edildi (3 ). Hastaların şikayetleri kaydedildi.

                BULGULAR : 4-15 yaş arası 223 hastanın 124( %55.6 )’ ü kız, 99( %44.4 )’ u erkekti. Yaş ortalaması ise 8.7 ±3,1’ di. 223 hastanın 32 ( %14.3 ) ’sinde İ_ka/İ_kr  0.20’ in üzerindeydi. Erkeklerdeki prevalans %18.2 iken kızlarda %11.3’ tü. 223 hastanın 92(%41.3)’ sinde idrar semptomu vardı. İdrar semptomu olan 92 hastanın 25( %27.2 )’ inde hiperkalsiüri tespit edildi. Hiperkalsiürili 25( %78.1 ) hasta semptomatikti, en sık rastlanan semptom %68.8( 22 hasta ) ile karın ağrısıydı. İHK olmayan 191 hastanın 47( %24.6 )’ inde karın ağrısı varken, İHK olan 32 hastanın 22( %68,8 )’ sinde karın ağrısı vardı. Hiperkalsiürili olan vakalarda karın ağrısı görülme sıklığı daha fazlaydı ( p<0,001 ). İHK olanlarda sodyumun kreatinine oran ortalaması 3,71±3,62’ di. Diğer grupta ise sodyumun kreatinine oran ortalaması 1,70±1,28’ di. İHK olan vakalarda sodyum atılımı daha fazlaydı ( p<0,001 ).

                SONUÇ: İHK ürolitiazis için en önemli risk faktörü olmasından, özellikle üriner sistem semptomları olan çocuklarda idrarda İ_ka/İ_kr  gibi  invazif olmayan bir tetkikle taranmalı ve tedavisinde başlangıçta sodyumdan fakir potasyumdan zengin diyet denenebilir.

               

Anahtar Kelimeler

• Hiperkalsiüri, idrar kalsiyum kreatinin oranı, idrar yolları semptomları, idrarda sodyum atılımı

Kaynakça

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