Tekin N, Kural N, Torun M
Department of Pediatrics, Osmangazi University Faculty of Medicine, Eskişehir.
Turk J Pediatr. 1997 Jul-Sep;39(3):335-9.
Hypercalciuria is a common problem causing symptoms such as abdominal pain, hematuria and enuresis, and leading to stone formation. It results from a renal tubular calcium "leak" or intestinal hyper-reabsorption of calcium. This study was performed to determine whether renal functional impairment was present in children with hypercalciuria. The study group comprised 298 children who were screened for hypercalciuria by means of urinary calcium/creatinine (UCa/UCr) ratio. The renal functions of 18 children (6.4%) detected as having hypercalciuria with Ca/Cr ratios of greater than 0.18 in their spot urines were evaluated. Results were compared with those of the healthy control group. The rate of hypercalciuria did not very significantly between the boys and girls (p > 0.05). The mean value of daily calcium excretion was 6.42 + 3.93 mg/kg/day in the children with hypercalciuria, which was significantly different from that of the control group (p < 0.01). When the values of creatinine, osmolar and free water clearances, fractional excretion of sodium and tubular reabsorption of phosphorus were compared between the patient and control groups, the difference was not significant (p > 0.05). Urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion, which was described as the creatinine ratio, was significantly higher in the children with hypercalciuria. These findings suggest that in the presence of normal renal functional studies in children with hypercalciuria, tubular injury can be detected by NAG, which is a more sensitive marker of renal tubular injury.
高钙尿症是一个常见问题，会引发腹痛、血尿和遗尿等症状，并导致结石形成。它是由肾小管钙“渗漏”或肠道对钙的过度重吸收引起的。本研究旨在确定高钙尿症患儿是否存在肾功能损害。研究组包括298名通过尿钙/肌酐（UCa/UCr）比值筛查高钙尿症的儿童。对18名尿钙/肌酐比值大于0.18被检测为患有高钙尿症的儿童的肾功能进行了评估。结果与健康对照组进行比较。高钙尿症的发生率在男孩和女孩之间没有显著差异（p>0.05）。高钙尿症患儿每日钙排泄的平均值为6.42 + 3.93毫克/千克/天，与对照组有显著差异（p<0.01）。当比较患者组和对照组之间肌酐、渗透压和自由水清除率、钠分数排泄和磷肾小管重吸收的值时，差异不显著（p>0.05）。以肌酐比值表示的尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）排泄在高钙尿症患儿中显著更高。这些发现表明在高钙尿症患儿肾功能研究正常的情况下，NAG可检测到肾小管损伤，NAG是肾小管损伤更敏感的标志物。
