FREQUENCY OF HYPERCALCIURIA IN 4 TO 15 YEAR OLD CHILDREN

Yıl 2015, Cilt: 5 Sayı: 4, 226 - 233, 21.02.2016

Ali Gül , İnci Arıkan

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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