Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children

F. Bruder Stapleton; Ronald J. Hogg; Joan S. Reisch; Kaye Green; Philip L. Berry; L. Leighton Hill; Sami A. Sanjad; Ronald J. Hogg; Kaye Green; Frank Boineau; John E. Lewy; Radhakrishna Baliga; Watson Arnold; Eileen Ellis; Gary M. Lum; Douglas M. Ford; James Wenzl; F. Bruder Stapleton; Shane Roy; Robert J. Wyatt; Billy S. Arant; Michel Baum; Joan Reisch; Susan B. Conley; Gilbert Rose; Michael Foulds; Sudesh Makker; Ben H. Brouhard; Alok Kalia; Luther B. Travis; Eileen Brewer; Richard Siegler

doi:10.1038/ki.1990.49

Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children

F. Bruder Stapleton, Ronald J. Hogg, Joan S. Reisch, Kaye Green, Philip L. Berry, L. Leighton Hill, Sami A. Sanjad, Ronald J. Hogg, Kaye Green, Frank Boineau, John E. Lewy, Radhakrishna Baliga, Watson Arnold, Eileen Ellis, Gary M. Lum, Douglas M. Ford, James Wenzl, F. Bruder Stapleton, Shane Roy, Robert J. WyattBilly S. Arant, Michel Baum, Joan Reisch, Susan B. Conley, Gilbert Rose, Michael Foulds, Sudesh Makker, Ben H. Brouhard, Alok Kalia, Luther B. Travis, Eileen Brewer, Richard Siegler

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Abstract

A prospective multicenter study was designed to determine the frequency and prognostic importance of hypercalciuria in children with hematuria. Urinary calcium excretion was examined in 215 patients with unexplained isolated hematuria (no proteinuria, urolithiasis, infection or systemic disorder). Hypercalciuria (urinary calcium excretion > 4 mg/kg/day) was identified in 76 patients (35%). Compared to patients with normal urinary calcium excretion, children with hematuria and hypercalciuria were characterized by male preponderance, white race, family history of urolithiasis, gross hematuria and calcium oxalate crystals. Renal biopsies were performed in 10 patients with urinary calcium excretion 0.4 to 2.5 mg/kg/day; three had IgA glomerulonephritis, three had glomerular basement membrane thinning, one had proliferative glomerulonephritis and three were normal. Renal biopsies in three patients with hypercalciuria showed focal segmental glomerulosclerosis, hereditary nephritis or no abnormalities. Oral calcium loading tests showed renal hypercalciuria in 26 patients, absorptive hypercalciuria in 15 patients and were not diagnostic in 35 patients. Serum parathyroid hormone, bicarbonate and phosphorus and urinary cyclic adenosine monophosphate concentrations were similar in the three groups of hypercalciuric patients. Urinary calcium excretion after one week of dietary calcium restriction was higher (5.8 mg/kg/day) in renal hypercalciuria than in other hypercalciuric patients (3.4 mg/kg/day), P < 0.01. One to four years follow-up was available for 184 patients. Eight of 60 hypercalciuric patients developed urolithiasis or renal colic compared to 2 of 124 patients with normal urinary calcium excretion (P < 0.001). Hypercalciuria is commonly associated with isolated hematuria and represents a risk factor for future urolithiasis in children with hematuria. Oral calcium loading tests offer little diagnostic benefit over 24-hour urinary calcium excretion following dietary calcium restriction.

Original language	English (US)
Pages (from-to)	807-811
Number of pages	5
Journal	Kidney international
Volume	37
Issue number	2
DOIs	https://doi.org/10.1038/ki.1990.49
State	Published - 1990

ASJC Scopus subject areas

Nephrology

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Stapleton, F. B., Hogg, R. J., Reisch, J. S., Green, K., Berry, P. L., Hill, L. L., Sanjad, S. A., Hogg, R. J., Green, K., Boineau, F., Lewy, J. E., Baliga, R., Arnold, W., Ellis, E., Lum, G. M., Ford, D. M., Wenzl, J., Stapleton, F. B., Roy, S., ... Siegler, R. (1990). Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children. Kidney international, 37(2), 807-811. https://doi.org/10.1038/ki.1990.49

Stapleton, FB, Hogg, RJ , Reisch, JS, Green, K, Berry, PL, Hill, LL, Sanjad, SA, Hogg, RJ, Green, K, Boineau, F, Lewy, JE, Baliga, R, Arnold, W, Ellis, E, Lum, GM, Ford, DM, Wenzl, J, Stapleton, FB, Roy, S, Wyatt, RJ, Arant, BS, Baum, M, Reisch, J, Conley, SB, Rose, G, Foulds, M, Makker, S, Brouhard, BH, Kalia, A, Travis, LB, Brewer, E & Siegler, R 1990, 'Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children', Kidney international, vol. 37, no. 2, pp. 807-811. https://doi.org/10.1038/ki.1990.49

@article{d332adca87824159a90bef86a2e0422d,

title = "Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children",

abstract = "A prospective multicenter study was designed to determine the frequency and prognostic importance of hypercalciuria in children with hematuria. Urinary calcium excretion was examined in 215 patients with unexplained isolated hematuria (no proteinuria, urolithiasis, infection or systemic disorder). Hypercalciuria (urinary calcium excretion > 4 mg/kg/day) was identified in 76 patients (35%). Compared to patients with normal urinary calcium excretion, children with hematuria and hypercalciuria were characterized by male preponderance, white race, family history of urolithiasis, gross hematuria and calcium oxalate crystals. Renal biopsies were performed in 10 patients with urinary calcium excretion 0.4 to 2.5 mg/kg/day; three had IgA glomerulonephritis, three had glomerular basement membrane thinning, one had proliferative glomerulonephritis and three were normal. Renal biopsies in three patients with hypercalciuria showed focal segmental glomerulosclerosis, hereditary nephritis or no abnormalities. Oral calcium loading tests showed renal hypercalciuria in 26 patients, absorptive hypercalciuria in 15 patients and were not diagnostic in 35 patients. Serum parathyroid hormone, bicarbonate and phosphorus and urinary cyclic adenosine monophosphate concentrations were similar in the three groups of hypercalciuric patients. Urinary calcium excretion after one week of dietary calcium restriction was higher (5.8 mg/kg/day) in renal hypercalciuria than in other hypercalciuric patients (3.4 mg/kg/day), P < 0.01. One to four years follow-up was available for 184 patients. Eight of 60 hypercalciuric patients developed urolithiasis or renal colic compared to 2 of 124 patients with normal urinary calcium excretion (P < 0.001). Hypercalciuria is commonly associated with isolated hematuria and represents a risk factor for future urolithiasis in children with hematuria. Oral calcium loading tests offer little diagnostic benefit over 24-hour urinary calcium excretion following dietary calcium restriction.",

author = "Stapleton, {F. Bruder} and Hogg, {Ronald J.} and Reisch, {Joan S.} and Kaye Green and Berry, {Philip L.} and Hill, {L. Leighton} and Sanjad, {Sami A.} and Hogg, {Ronald J.} and Kaye Green and Frank Boineau and Lewy, {John E.} and Radhakrishna Baliga and Watson Arnold and Eileen Ellis and Lum, {Gary M.} and Ford, {Douglas M.} and James Wenzl and Stapleton, {F. Bruder} and Shane Roy and Wyatt, {Robert J.} and Arant, {Billy S.} and Michel Baum and Joan Reisch and Conley, {Susan B.} and Gilbert Rose and Michael Foulds and Sudesh Makker and Brouhard, {Ben H.} and Alok Kalia and Travis, {Luther B.} and Eileen Brewer and Richard Siegler",

note = "Funding Information: This study was supported by a grant from the National Institutes of Health (1 ROl AM32910), a Clinical Associate Physician Award (RROO2I 1) from the general Clinical Research Centers, and a grant from the National Kidney Foundation of Texas.",

year = "1990",

doi = "10.1038/ki.1990.49",

language = "English (US)",

volume = "37",

pages = "807--811",

journal = "Kidney international",

issn = "0085-2538",

publisher = "Nature Publishing Group",

number = "2",

}

TY - JOUR

T1 - Idiopathic hypercalciuria

T2 - Association with isolated hematuria and risk for urolithiasis in children

AU - Stapleton, F. Bruder

AU - Hogg, Ronald J.

AU - Reisch, Joan S.

AU - Green, Kaye

AU - Berry, Philip L.

AU - Hill, L. Leighton

AU - Sanjad, Sami A.

AU - Hogg, Ronald J.

AU - Green, Kaye

AU - Boineau, Frank

AU - Lewy, John E.

AU - Baliga, Radhakrishna

AU - Arnold, Watson

AU - Ellis, Eileen

AU - Lum, Gary M.

AU - Ford, Douglas M.

AU - Wenzl, James

AU - Stapleton, F. Bruder

AU - Roy, Shane

AU - Wyatt, Robert J.

AU - Arant, Billy S.

AU - Baum, Michel

AU - Reisch, Joan

AU - Conley, Susan B.

AU - Rose, Gilbert

AU - Foulds, Michael

AU - Makker, Sudesh

AU - Brouhard, Ben H.

AU - Kalia, Alok

AU - Travis, Luther B.

AU - Brewer, Eileen

AU - Siegler, Richard

N1 - Funding Information: This study was supported by a grant from the National Institutes of Health (1 ROl AM32910), a Clinical Associate Physician Award (RROO2I 1) from the general Clinical Research Centers, and a grant from the National Kidney Foundation of Texas.

PY - 1990

Y1 - 1990

N2 - A prospective multicenter study was designed to determine the frequency and prognostic importance of hypercalciuria in children with hematuria. Urinary calcium excretion was examined in 215 patients with unexplained isolated hematuria (no proteinuria, urolithiasis, infection or systemic disorder). Hypercalciuria (urinary calcium excretion > 4 mg/kg/day) was identified in 76 patients (35%). Compared to patients with normal urinary calcium excretion, children with hematuria and hypercalciuria were characterized by male preponderance, white race, family history of urolithiasis, gross hematuria and calcium oxalate crystals. Renal biopsies were performed in 10 patients with urinary calcium excretion 0.4 to 2.5 mg/kg/day; three had IgA glomerulonephritis, three had glomerular basement membrane thinning, one had proliferative glomerulonephritis and three were normal. Renal biopsies in three patients with hypercalciuria showed focal segmental glomerulosclerosis, hereditary nephritis or no abnormalities. Oral calcium loading tests showed renal hypercalciuria in 26 patients, absorptive hypercalciuria in 15 patients and were not diagnostic in 35 patients. Serum parathyroid hormone, bicarbonate and phosphorus and urinary cyclic adenosine monophosphate concentrations were similar in the three groups of hypercalciuric patients. Urinary calcium excretion after one week of dietary calcium restriction was higher (5.8 mg/kg/day) in renal hypercalciuria than in other hypercalciuric patients (3.4 mg/kg/day), P < 0.01. One to four years follow-up was available for 184 patients. Eight of 60 hypercalciuric patients developed urolithiasis or renal colic compared to 2 of 124 patients with normal urinary calcium excretion (P < 0.001). Hypercalciuria is commonly associated with isolated hematuria and represents a risk factor for future urolithiasis in children with hematuria. Oral calcium loading tests offer little diagnostic benefit over 24-hour urinary calcium excretion following dietary calcium restriction.

AB - A prospective multicenter study was designed to determine the frequency and prognostic importance of hypercalciuria in children with hematuria. Urinary calcium excretion was examined in 215 patients with unexplained isolated hematuria (no proteinuria, urolithiasis, infection or systemic disorder). Hypercalciuria (urinary calcium excretion > 4 mg/kg/day) was identified in 76 patients (35%). Compared to patients with normal urinary calcium excretion, children with hematuria and hypercalciuria were characterized by male preponderance, white race, family history of urolithiasis, gross hematuria and calcium oxalate crystals. Renal biopsies were performed in 10 patients with urinary calcium excretion 0.4 to 2.5 mg/kg/day; three had IgA glomerulonephritis, three had glomerular basement membrane thinning, one had proliferative glomerulonephritis and three were normal. Renal biopsies in three patients with hypercalciuria showed focal segmental glomerulosclerosis, hereditary nephritis or no abnormalities. Oral calcium loading tests showed renal hypercalciuria in 26 patients, absorptive hypercalciuria in 15 patients and were not diagnostic in 35 patients. Serum parathyroid hormone, bicarbonate and phosphorus and urinary cyclic adenosine monophosphate concentrations were similar in the three groups of hypercalciuric patients. Urinary calcium excretion after one week of dietary calcium restriction was higher (5.8 mg/kg/day) in renal hypercalciuria than in other hypercalciuric patients (3.4 mg/kg/day), P < 0.01. One to four years follow-up was available for 184 patients. Eight of 60 hypercalciuric patients developed urolithiasis or renal colic compared to 2 of 124 patients with normal urinary calcium excretion (P < 0.001). Hypercalciuria is commonly associated with isolated hematuria and represents a risk factor for future urolithiasis in children with hematuria. Oral calcium loading tests offer little diagnostic benefit over 24-hour urinary calcium excretion following dietary calcium restriction.

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ER -

Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children

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