Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
Division of Pediatric Urology, Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
Eur J Pediatr Surg. 2021 Dec;31(6):530-534. doi: 10.1055/s-0040-1721389. Epub 2020 Nov 22.
A large number of genes and environmental factors, like dietary habits, play a role in the development of hypercalciuria in children. In this study, we aimed to determine the effects of the presence and grade of vesicoureteral reflux (VUR) on hypercalciuria status in children.
Data for 165 patients who admitted to the Pediatric Urology Department were retrospectively analyzed. The patients were composed of following four different groups: (1) urinary stone patients, (2) VUR patients under follow-up, (3) corrected VUR patients, and (4) control. The demographic features, clinical data, and laboratory tests for the groups were compared.
The mean age of the patients was 100.6 ± 54.69 months and the female/male ratio was 79:86. The mean urinary calcium/creatinine (UCa/Cr) excretion and the frequency of high UCa/Cr ratios in the corrected VUR group were similar to those in the control group ( = 0.375 and 0.965, respectively). In contrast, the mean UCa/Cr excretion and frequency of high UCa/Cr ratios in the urinary stone and follow-up VUR groups were significantly higher than those in the corrected VUR group ( < 0.001, < 0.001, 0.003, and 0.029, respectively). The mean UCa/Cr excretion and frequency of high UCa/Cr ratios in the follow-up VUR group were similar to those in the urinary stone group ( = 0.323 and 0.425, respectively). In the follow-up VUR group, although reflux laterality had no effect on the UCa/Cr ratios ( = 0.180 and 0.108, respectively), the mean and frequency of high UCa/Cr ratios were higher in high-grade reflux cases ( < 0.001 and = 0.042, respectively).
Both the mean UCa/Cr ratio and the rate of hypercalciuria in the corrected reflux group were significantly lower than the corresponding values in the follow-up VUR and urinary stone groups. Further, the follow-up VUR patients had similar urinary calcium excretion levels as the stone patients. VUR treatment is associated with a decrease in urinary calcium excretion to the normal population level. A positive correlation between reflux degree and calcium excretion was observed.
大量的基因和环境因素，如饮食习惯，在儿童高钙尿症的发展中起作用。本研究旨在确定膀胱输尿管反流（VUR）的存在和严重程度对儿童高钙尿症状态的影响。
回顾性分析了 165 名患儿的资料，这些患儿分别属于以下四个不同的组：（1）尿石症患者；（2）VUR 随访患者；（3）矫正 VUR 患者；（4）对照组。比较了各组的人口统计学特征、临床资料和实验室检查结果。
患者的平均年龄为 100.6±54.69 个月，男女比例为 79:86。矫正 VUR 组的平均尿钙/肌酐（UCa/Cr）排泄率和高 UCa/Cr 比值的频率与对照组相似（=0.375 和 0.965）。相比之下，尿石症和 VUR 随访组的平均 UCa/Cr 排泄率和高 UCa/Cr 比值的频率明显高于矫正 VUR 组（<0.001，<0.001，0.003 和 0.029）。VUR 随访组的平均 UCa/Cr 排泄率和高 UCa/Cr 比值的频率与尿石症组相似（=0.323 和 0.425）。在 VUR 随访组中，尽管反流侧位对 UCa/Cr 比值没有影响（=0.180 和 0.108），但高反流分级病例的平均和高 UCa/Cr 比值频率更高（<0.001 和=0.042）。
矫正反流组的平均 UCa/Cr 比值和高钙尿症发生率均明显低于 VUR 随访组和尿石症组。此外，VUR 随访患者的尿钙排泄水平与结石患者相似。VUR 治疗可导致尿钙排泄降低至正常人群水平。反流程度与钙排泄呈正相关。
