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Journal of the Korean Society of Pediatric Nephrology 1998;2(1): 34-40.
혈뇨를 동반한 소아 특발성 고칼슘뇨증에 관한 장기 추적 관찰
이영석, 신원혜, 고철우, 구자훈
1경북대학교 의과대학 소아과학교실
2경북대학교 의과대학 소아과학교실
3경북대학교 의과대학 소아과학교실
4경북대학교 의과대학 소아과학교실
Long-term Follow-up of Children with Idiopathic Hypercalciuria
Young-Seok Lee, Won-Hye Shin, Cheol-Woo Ko, Ja-Hoon Koo
1Department of Pediatrics, Kyungpook National University, School of Medicine
2Department of Pediatrics, Kyungpook National University, School of Medicine
3Department of Pediatrics, Kyungpook National University, School of Medicine
4Department of Pediatrics, Kyungpook National University, School of Medicine
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ABSTRACT
Present study was conducted to determine the frequency, clinical characteristics and long-term outcome of children with idiopathic hypercalciuria. Study patients consisted of 150 children with isolated hematuria (recurrent gross or persistent microscopic), and hypercalciuria was defined as urinary calcium excretion over 4 mg/kg/day. During follow-up period up to $6{sim}8$ years, serial check-up of renal sonogram for stone formation and Dipstick examination for hematuria were done. Forty-four (29%) out of 150 cases were diagnosed as idiopathic hypercalciuria, and in hypercalciuric children compared to normocalciuric children boys were more common than girls (9:35) and gross hematuria was more common than microscopic hematuria (37:7) (P<0.05). Oral calcium loading test showed renal type in 29 cases, absorptive type in 8 cases and in 7 cases type could not be definable. Among 3 types no differences could be found in 24 hour urinary calcium excretion and in clinical or laboratory data. Urolithiasis developed in 4 out of 44 cases (2 at the time of initial diagnosis and 2 within $1{sim}2$ years of follow-up periods) and these children showed lower chronologic age ($3.7{pm}2.7;vs;7.2{pm}2.9;yr$) and more girl than boys (3:1 vs 6:34) (P<0.05) compared to the rest of the hypercalciuric children. Follow-up urinalysis showed disappearance of hematuria in 56, 50, 66 and 75% of children at $1{sim}2,;2{sim}4,;4{sim}6$ and $6{sim}8$ years after initial diagnosis respectively. In conclusion, present study demonstrates that idiopathic hypercalciuria is a major cause of isolated hematuria in children so that in these children 24 hour urinary calcium excretion test seems to be an essential test to be performed. And serial renal sonography should be done to detect development of nephrolithiasis. However, clinical significance of dividing hypercalciuric children into two pathophysiologically distinct subtypes by oral calcium loading test seems to be in doubt and further study is needed to solve this problem.
Key words: Idiopathic hypercalciuria | Isolated hematuria | Nephrolithiasis
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