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Query: UMLS:C0020438 (hypercalciuria)
 2,502 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

24-hour urinary outputs of oxalate, calcium, and magnesium have been determined in a total of 62 children aged 3 months to 17 years who fell into the following groups: (i) 16 normal controls, (ii) 3 with primary hyperoxaluria, (iii) 9 with small and/or large intestinal resections, (iv) 9 with untreated coeliac disease, (v) 5 with pancreatic dysfunction, and (vi) a miscellaneous group of 20 children with a variety of intestinal disorders. Taken as a whole, 58% of patients with intestinal disorders had hyperoxaluria, and of these 7% had urinary outputs of oxalate which fell within the range seen in primary hyperoxaluria. The proportion of children with hyperoxaluria in the different diagnostic groups was as follows: intestinal resections (78%), coeliac disease (67%), pancreatic dysfunction (80%), and miscellaneous (45%). 35% of the patients with hyperoxaluria had hypercalciuria, whereas magnesium excretion was normal in all subjects studied. In 2 patients treatment of the underlying condition was accompanied by a return of oxalate excretion to normal. These results indicate that hyperoxaluria and hypercalciuria are common in children with a variety of intestinal disorders, and that such children may be at risk of developing renal calculi without early diagnosis and treatment.
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PMID:Urinary outputs of oxalate, calcium, and magnesium in children with intestinal disorders. Potential cause of renal calculi. 100 83

In 59 out of 80 patients with recurrent renal calcium stones studied between 1977 and 1982 and followed up for 4,5 to 7 years, an index has been used to determine the activity of the disease, before and after treatment with diet, high water intake, thiazide and/or allopurinol. As estimated by variations of the "activity index", the treatment was effective in all groups studied: patients with idiopathic hypercalciuria were prescribed a low purine and oxalate diet and a large water intake associated or not with thiazide; hyperuricosuric patients were treated by the same diet and allopurinol; patients with no metabolic abnormality were submitted to diet and/or thiazide and/or allopurinol. The association of thiazide and allopurinol seems to be a more effective therapy in recurrent stone formers with primary hyperoxaluria than high diuresis and succinimide.
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PMID:[Preventive medical treatment of recurrent urinary calcium calculi]. 396 Feb 61

A 13-year-old boy with primary hyperoxaluria and a successful renal allograft developed symptomatic bone disease, hypercalcemia, and hypercalciuria. Transiliac bone biopsy revealed calcium oxalate crystals in the marrow within mononuclear phagocytes and multinucleated giant cells. Deep resorption bays were seen adjacent to these crystal-cell aggregates. Serum 1,25-(OH)2-vitamin D (calcitriol) and iPTH concentrations were low or normal. We suggest that hypercalcemia results from macrophage-mediated bone resorption initiated by Ca oxalate crystal deposition.
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PMID:Calcium-oxalate-crystal-induced bone disease. 704 38

The analysed material includes 100 children with urolithiasis treated in the Pediatric Clinic of the National Research Institute of Mother and Child in Warsaw between 1976 and 1978. Patients' age was from 3 months to 18 years. The analysed group included 51 boys and 49 girls. Urinary tract infection was found in 54 cases, i.e. 57,4% of the analysed material. The most common bacterial strains were those producing urease. They were detected in 48 children i.e. 88,9% of cases with urinary tract infection. Mostly these were bacteria of Proteus group--sporadically Pseudomonas aeruginosa and Staphylococcus albus. In the analysed patients urinary tract obstruction was observed in 36 children, i.e. 36% of cases. In 77% of the analysed material, localization of concrements was in upper urinary tract in 19% in the ureters and in 4% in the lover urinary tract. While in adult patients the most common compound of urinary stones was calcium oxalate, in children the most common stone compounds were phosphates (found in 38 cases i.e. 58,4% of the analysed material). The second frequent compound was oxalate found in 20 cases (30,7%). Less frequent compounds were uric acid and cystine. Performed study allowed to establish the cause of urolithiasis in 93 out of 100 examined children. Metabolic reasons of urolithiasis were found in 26 cases, i.e. 26% of the analysed material. They were as follows: idiopathic hypercalciuria--12 cases, uric acid urolithiasis--8 cases, primary hyperoxaluria--3 cases, cystinuria--2 cases, and incomplete acidosis of distal renal tubuli--1 case. Urolithiasis of probably metabolic origin was detected in 13 children (13%). Other reasons of urolithiasis in children were: infection (31%), idiopathic urolithiasis (17%) and others (6%). In 7 cases the reason of urolithiasis was not established.
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PMID:[Metabolic etiology of urinary calculi in children]. 717 91

59 children with urolithiasis were seen between 1969 and 1977 (8 1/2 years). Calculi from 50 patients were analyzed by X-ray diffraction. Half of the patients were 0-4 years old, and in this age group males greatly predominated (76%). Calculi in 26 patients were of infectious, and in 15 patients of metabolic origin (cystinuria 7, idiopathic hypercalciuria 5, primary hyperoxaluria 3), whereas 18 were idiopathic. Most infectious stones contained struvite, and most idiopathic stones contained calcium oxalate. An infectious etiology was observed in 55% of the 0-5-year-old children (n = 33), but in only 20% of the 10-16-year-old ones. In contrast, the percentage of idiopathic stones rose from 18% in the youngest to 70% in the oldest age group, although the absolute numbers were similar in all age groups, Childhood urolithiasis in Switzerland is thus primarily observed in young male patients and is usually secondary to a definable cause.
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PMID:Childhood urolithiasis. 745 Dec 34

The introduction of renal ultrasound technology has shown renal calcification to be more common in infancy than was previously believed. Understanding the role of inhibitors and promoters in crystal formation helps elucidate the pathophysiology of nephrocalcinosis. Identification of the presence or absence of hypercalcemia and hypercalciuria is an effective way to direct the diagnostic work-up of infants with nephrocalcinosis. The sonographic image of renal calcification resolves spontaneously in many infants. Whether microscopic nephrocalcinosis persists below the threshold of ultrasonographic detection is unknown. Renal calcification can be associated with persistent renal function abnormalities if hypercalciuria continues, such as in VLBW infants who receive long-term furosemide therapy after discharge from the hospital. Renal calcification may also progress to renal failure, such as in infants with primary hyperoxaluria, owing to the persistence of hyperoxaluria, a potent promoter of calcium crystal formation.
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PMID:Renal calcification in the first year of life. 861 92

Genetic factors are important determinants for kidney stone formation. Cystinuria, primary hyperoxaluria, and X-linked nephrolithiasis (Dent's disease) are monogenic kidney stone diseases for which responsible genes have been identified. Familial stone disease with hyperuricosuria or renal tubular acidosis has been described in several clinical settings. Idiopathic hypercalciuria is the most common stone risk factor, and evidence in humans and in a rat model indicates that hypercalciuria is a complex, polygenic trait. Some candidate genes for idiopathic hypercalciuria are suggested by the known physiology, including those encoding the vitamin D receptor, the 1 alpha-hydroxylase of vitamin D, the calcium-sensing receptor, the renal sodium-dependent phosphate transporter, and chloride channels, but others remain to be identified. The multifaceted physiology of hypercalciuria may reflect the combined effects of polymorphisms in several genes.
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PMID:Nephrolithiasis. 1043 76

The composition of urinary stones in children depends on socioeconomic conditions and hygiene, geographical area, and dietary habits. We analyzed urinary stones from 120 consecutive Tunisian children (81 males, 39 females) aged 5 months to 15 years. The stone was located in the upper urinary tract in 91 cases (76%). Stone analysis included both a morphological examination and an infrared analysis of the nucleus and the inner and peripheral layers. The main components of bladder calculi were whewellite (69%) and struvite (22%), whereas the main component of upper urinary tract calculi was whewellite (67%). The nucleus of bladder stones was composed of ammonium urate (45%), struvite (28%), cystine (10%), and carbapatite (7%). The nucleus of kidney and ureteral calculi was mainly composed of ammonium urate (38%), whewellite (24%), carbapatite (13%), or struvite (11%). Based on stone composition, urinary tract infection was involved in the nucleation or growth of a third of calculi. Endemic urolithiasis involving simultaneous nutritional, metabolic, and infectious factors, and defined by its nucleus composed of ammonium urate without struvite, represented 40% of cases. Exclusive metabolic factors - including genetic diseases such as primary hyperoxaluria, cystinuria, and hypercalciuria - were responsible for less than 25% of cases.
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PMID:Urolithiasis in Tunisian children: a study of 120 cases based on stone composition. 1060 49

The potential risk of recurrence and degradation of renal function justifies the etiological investigation of all lithiasis-associated pathologies. Therefore calculus analysis of the crystalline phases and morphological characteristics is an important factor in the etiological diagnosis of the disease. Microscopic examination and infrared spectroscopy of calculi from 727 children showed that calcium oxalate was the main component in 36.7% of cases, followed by calcium phosphate (31%), struvite (9.9%) and purine groups (7.7%). The most frequently observed crystalline from was carbapatite (26%), then whewellite (21%) and weddellite (15.7%). As regards the etiopathogenic aspect in adults, the relations between hypercalciuria and weddellite, and between hyperoxaluria and whewellite are also found in the child: in subjects with hypercalciuria, 82% of the calculi contained over 20% weddellite; and in subjects with hyperoxaluria, whewellite was the major constituent in 79% of cases (or 95% in the absence of associated hypercalciuria). In 27 calculi mainly composed of whewellite, the morphological analysis indicated primary hyperoxaluria; this diagnosis was confirmed in 25 cases by specific biological investigation. Urinary tract infection is frequently associated with lithiasis, but its lithogenic role cannot be confirmed without calculus analysis. Several criteria can be used as markers to determine the lithogenic etiology of the infection, i.e., the presence of struvite, the carbonate rate of carbapatite, and the whitlockite and/or protein content of the calculus.
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PMID:[Component analysis of urinary calculi in the etiologic diagnosis of urolithiasis in the child]. 1098 88

Crystalluria is a marker of urine supersaturation present in both normal and pathological conditions. Indeed, nature and characteristics of the spontaneous crystalluria are of clinical interest for detecting and following biological disorders involved in renal diseases. Method. Crystalluria examination should preferably be performed on first morning urine or fresh fasting voiding samples by polarised microscopy in a Malassez cell. Urine samples must be stored at 37 degrees C or at room temperature and examined within two hours following voiding. Results and discussion. Crystalluria should be interpreted according to various criteria: 1) chemical nature of crystals for abnormal crystals such as struvite, ammonium urate, cystine, dihydroxyadenine, xanthine or drugs; 2) crystalline phase of common chemical species as calcium oxalates, calcium phosphates and uric acids; 3) crystal morphology (calcium oxalates); 4) crystal size (calcium oxalates); 5) crystal abundance (calcium oxalates, calcium phosphates, uric acids, cystine); 6) crystal aggregation (calcium oxalates); 7) frequency of crystalluria assessed on serial first morning urine samples, a very useful tool for long-term surveillance of patients. Within calcium oxalate crystalluria, presence of whewellite is a marker of elevated oxalate concentration (urine oxalate > 0.3 mmol/L); a crystal number > 200/mm 3 is highly suggestive of heavy hyperoxaluria of genetic or absorptive origin. Predominant weddellite crystalluria is most often indicative of an excessive urine calcium concentration (> 3.8 mmol/L); a dodecahedric aspect of the crystals is a marker for heavy hypercalciuria (> 6 mmol/L) while an increased crystal size (>or= 35 microm) is indicative of simultaneous hypercalciuria and hyperoxaluria. Calculation of the global crystal volume, especially when applied to calcium oxalates or cystine, is a clinically useful tool for the monitoring of patients suffering from primary hyperoxaluria or cystinuria. Lastly, presence of crystalluria in more than 50% of serial first voided morning urine samples is in our experience the most reliable biological marker for detecting the risk of stone recurrence in lithiasic patients. Conclusion. Crystalluria examination is an essential laboratory test for detecting and following pathological conditions, which may induce renal stone disease or alter kidney function due to urine crystals.
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PMID:[Clinical value of crystalluria study]. 1529 32


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