Altai State Medical University РЕФЕРАТ ЦЕЛЬ ИССЛЕДОВАНИЯ: анализ клинико-лабораторных проявлений гиперкальциурии у детей г. Барнаула, проживающих в зоне резко континентального климата Юга Западной Сибири. ПАЦИЕНТЫ И МЕТОДЫ. В исследование включены 239 детей в возрасте от 1 мес до 16 лет (средний возраст 6,6±2,72 года) с идиопатической гиперкальциурией (ИГ), диагностированной по уровню кальций/креатининового коэффициента (ККК) более 0,6 ммоль/ммоль и нормального плазменного содержания кальция и паратгормона. Проводилось общеклиническое обследование, а также биохимическое исследование крови и мочи с определением уровня кальция, фосфора, креатинина, мочевины и мочевой кислоты, ультразвуковое исследование почек и мочевого пузыря, рентгеноконтрастные методы исследования по показаниям. РЕЗУЛЬТАТЫ. Отягощенная наследственность по мочекаменной болезни (МКБ) была зарегистрирована у 56,1% детей с гиперкальциурией. Анализ сопутствующей патологии показал сочетание ИГ с МКБ у 15,1% пациентов, с инфекциями мочевой системы (ИМС) -у 38,5%, с аномалиями органов мочевой системы -у 27,2% и нейрогенными расстройствами мочеиспускания -у 9,2% детей. В клинической картине заболевания преобладали дизурические расстройства (48,5%) и умеренно выраженный отечный синдром (45,6%). В мочевом осадке у детей с гиперкальциурией наиболее часто регистрировались кристаллурия (31,8%), микрогематурия (19,2%) и лейкоцитурия (13,8%). ЗАКЛЮ-ЧЕНИЕ. Идиопатическая гиперкальциурия у детей нередко сочетается с такими патологическими состояниями, как ИМС, нейрогенные расстройства мочеиспускания, аномалии органов мочевой системы, и является причиной развития МКБ уже в детском возрасте.Ключевые слова: дети, идиопатическая гиперкальциурия, клинико-лабораторные проявления.ABSTRACT THE AIM: to study clinical and laboratory manifestations of hypercalciuria in children of Barnaul, living in the zone of sharply continental climate of the South of Western Siberia. PATIENTS AND METHODS. The study included 239 children aged from 1 month to 16 years (mean age of 6.6±2,72 years) with idiopathic hypercalciuria (IH), diagnosed according to the level of calcium/creatininemia coefficient (CCC), more than 0.6 mmol/mmol and normal plasma calcium and parathyroid hormone. Conducted physical examination and biochemical blood and urine determination of calcium, phosphorus, creatinine, urea and uric acid, ultrasound of the kidneys and bladder, radiopaque research methods indicated. RESULTS. Family history of urolithiasis have been reported in 56.1% children with hypercalciuria. Analysis of comorbidity showed a combination of IH with urolithiasis in 15.1% patients with urinary system infections(USI) -in 38.5%, with anomalies of the urinary system -27,2% children with neurogenic disorders of urination -at 9.2 percent. The clinical picture of the disease prevailed dysuric disorders (48,5%) and moderately pronounced edema syndrome (45,6%). In the urinary sediment of children with hypercalciuria, the most frequently recorded crystalluria (31,8%), microhematuria (19,2%) and leukocyturia ...

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THE AIM: To study the characteristics of phosphorus-calcium metabolism in patients with neurogenic disorders of urination, taking into account the severity of the manifestations of connective tissue dysplasia. PATIENTS AND METHODS. The study included 90 children, including 60 children with neuro-muscular dysfunction of the bladder (NMDB) and 30 children with enuresis from the age of 5 to 15 years. The diagnosis was established based on a comprehensive examination and according to industry standards. Connective tissue dysplasia was diagnosed in children with the detection of 6 or more small external or visceral manifestations involving 3 or more organs from different systems. Assessment of the severity (severity) of connective tissue dysplasia was carried out according to the point system proposed by T.I. Kadurina et al. Each group was divided into subgroups depending on the severity of the manifestations of connective tissue dysplasia. The determination of the level of calcium and phosphorus in the blood and urine, as well as the calculation of the calcium-creatinine coefficient followed by a comparison of the results in these groups and subgroups. To assess the significance of differences, the Mann-Whitney test was calculated, p <0.05 was considered significant. RESULTS. he level of calcium and phosphorus in the urine was slightly higher in children with enuresis, especially in the morning portion of urine, where the concentration of calcium was 26% higher than in patients with NMDB. At the same time, the value of calcium /creatinine coefficient was significantly higher in the group of patients with enuresis and was 2 times higher than the normative indicators, which indicates the importance of hypercalciuria in the development of enuresis. СONCLUSION. According to the obtained data, the severity of calciuria, determined by the value of the calcium-creatinine coefficient, is significantly higher in patients with enuresis than with NMDB.

Idiopathic hypercalciuria (IHC) is referred to a common metabolic disorders and considered to be the one of the main reasons for the development of nephrolithiasis. The aim of the study is to develop and evaluate the effectiveness of such adequate diet for the use in IHC children. Materials and Methods. The study included 44 children aged from 1 year to 14 years (10 boys and 34 girls, mean age: 5,1 ± 0,4 years) with revealed IHC at the level when calcium/creatinine ratio exceeded 0.6 mmol/mmol at normal levels of calcium and PTH in the blood plasma. Children with diagnosed ICH were prescribed a low sodium and high potassium diet with increased fluid intake for 3 months without additional medication. Results. Against the background of diet therapy 55,6% of children (10 people) reported a decrease in the face pastosity. In 10 out of 13 children (76,9%) with the previous oliguria the daily amount of urine increased significantly, which was accompanied by a decrease in urine specific gravity. Dysuric disorders were eliminated in 4 patients. In 3 months hematuria was not detected in the analysis of urine in 5 (50%) of children. Among the children who had a combination of some clinical and laboratory signs of the IHC, the complete elimination occurred in 71% of cases. The value of calcium/ creatinine ratio was normalized in 26 (59%) patients. Conclusion. Thus, the use of a diet with low sodium and elevated potassium content in conjunction with the increase in volume of consumed liquid within 3 months promotes both the disappearance of symptoms of IHC and normalization of calcium excretion in over 50% of children without prescription ofpharmaceuticals.

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