Doğan Cağla Serpil, Uslu-Gökçeoğlu Arife, Comak Elif, Alimoğlu Emel, Koyun Mustafa, Akman Sema
Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Turk J Pediatr. 2013 Jan-Feb;55(1):58-62.
The aim of this study was to analyze the etiology of nephrocalcinosis (NC) and whether it has any effect on growth and renal function in children. Forty-three children who were diagnosed with bilateral NC were studied retrospectively. Two neonates treated with furosemide and five premature infants were excluded from the study. The most common condition leading to NC was hereditary tubulopathies (50%). Data of 27 children who had a follow-up period of at least two years were examined in more detail. Of the 27 patients, the median age at first examination was 12 (range: 2-132) months and median follow-up time was 57 (range: 24-209) months. Thirteen of 27 (48.1%) patients had height standard deviation scores (hSDS) <-2 at presentation, and 6 (22.2%) patients who had normal glomerular function were still below -2 SDS at the last examination. Hypercalciuria was present in 25 (92.6%) patients at the first evaluation and in 6 (22.2%) patients at the last examination. The degree of NC worsened in 6 (22.2%), remained stable in 15 (55.5%) and decreased in 6 (22.2%) patients during the followup period. Chronic renal insufficiency (CRI) developed in 5 patients without there being any increase in the degree of NC. In conclusion, growth and renal function in these patients generally depend on the nature of the underlying disease but not the degree of NC.
本研究的目的是分析小儿肾钙质沉着症(NC)的病因,以及它是否对儿童的生长发育和肾功能有任何影响。对43例诊断为双侧NC的儿童进行了回顾性研究。两名接受速尿治疗的新生儿和五名早产儿被排除在研究之外。导致NC的最常见病因是遗传性肾小管病(50%)。对27例随访至少两年的儿童的数据进行了更详细的检查。在这27例患者中,首次检查时的中位年龄为12(范围:2 - 132)个月,中位随访时间为57(范围:24 - 209)个月。27例患者中有13例(48.1%)在初次就诊时身高标准差评分(hSDS)< -2,6例(22.2%)肾小球功能正常的患者在最后一次检查时仍低于 -2 SDS。首次评估时25例(92.6%)患者存在高钙尿症,最后一次检查时6例(22.2%)患者存在高钙尿症。在随访期间,6例(22.2%)患者的NC程度加重,15例(55.5%)患者的NC程度保持稳定,6例(22.2%)患者的NC程度减轻。5例患者出现慢性肾功能不全(CRI),而NC程度并未增加。总之,这些患者的生长发育和肾功能一般取决于潜在疾病的性质,而非NC的程度。