Hypercalciuria and recurrent urinary tract infections: incidence and symptoms in children over 5 years of age

Abstract

Hypercalciuria is an important and common risk factor in the formation of renal stones. In this study we evaluated the incidence and the clinical presentation of hypercalciuria in 75 children over 5 years of age with the diagnosis of recurrent urinary tract infection (UTI). We measured random urinary calcium/creatinine value (three times), 24-h urinary calcium excretion, serum calcium, phosphorus, electrolytes, blood gas, blood urea nitrogen and creatinine levels. Hypercalciuria was found in 32 patients (43%). The mean urinary calcium/creatinine ratio for hypercalciuric patients was 0.50+/-0.21 mg/mg (min: 0.24, max: 2.60). The mean urinary calcium/creatinine ratio for the rest of the study population--those without hypercalciuria--was 0.10+/-0.04 mg/mg (min: 0.01, max: 0.18). Presenting symptoms of the hypercalciuric patients and normocalciuric patients were similar. History of familial urolithiasis was positive in 19 patients (59%). Predisposing urinary tract abnormalities in recurrent UTI was shown in 12 of the hypercalciuric patients (12/32, 37.5%) and 8 of the normocalciuric patients (8/43, 19%) without a statistically significant difference between. We conclude that hypercalciuria is not a rare finding among recurrent UTI cases in Turkish children. Hypercalciuria does not modify the clinical presentation of UTI, and we suggest the investigation of urinary calcium excretion in children with recurrent UTI.

The Association between Urinary Tract Infection and Idiopathic Hypercalciuria in Children

“…The prevalence of urolithiasis in the families of these patients has been reported between 34% and 59%. 17,18,31,32 In our study, there was a significant difference between the IHC and NC groups in terms of the rate of family history of urolithiasis. Furthermore, the rate of parental consanguinity was found to be higher in the IHC group.…”

“…In a study performed by Lopez et al, 18 the frequency of hematuria was reported to be 12% in patients with recurrent UTI and IHC. In another study conducted by Biyikli et al, 17 hematuria was reported as 35% in children with IHC and recurrent UTI, whereas this ratio was 33% in those without IHC. In our study, the frequency of hematuria was reported to be 16.7% in patients with IHC, and there was no significant difference with NC group.…”

“…In a study performed on the children with recurrent UTI, although there was no significant difference, urinary system abnormalities were detected in 37.5% of patients with IHC and 19% of those without IHC. 17 The difference in these results may be due to the selection of study populations and age groups. Since our study included all age groups of childhood, predisposing urinary abnormalities were also frequent in NC group.…”

“…[5][6][7]10,[17][18][19] In a study from Serbia, Stojanovic et al 6 detected the rate of IHC as 21% in children with UTI. In a study from Turkey conducted by Biyikli et al 17 on 75 children with recurrent UTI over the age of 5 years, IHC was reported in 32 (43%) patients. Sadeghi-Bojd et al 19 found the frequency of IHC as 30% in Iranian children with UTI which was significantly higher than the control subjects.…”

Osteoporosis in paediatric patients with spina bifida

“…72 Hypercalciuria was also found in 43% of children with recurrent urinary tract infection. 73 Therapy for bone fragility in childhood has been limited to conservative measures, such as optimizing calcium and vitamin D intake, even though adequate calcium and vitamin D intake may not be enough to treat osteoporosis, 74 particularly in patients with a high fracture risk. To date, no outcome study on the use of vitamin D has proven convincingly that this vitamin is insufficient for patients with a high fracture risk.…”