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 & 12 others 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

Research output: Contribution to journalArticle

116 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)807-811
Number of pages5
JournalKidney International
Volume37
Issue number2
StatePublished - Feb 1990

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Hypercalciuria
Urolithiasis
Hematuria
Calcium
Kidney
Dietary Calcium
Glomerulonephritis
Hereditary Nephritis
Renal Colic
Biopsy
Focal Segmental Glomerulosclerosis
Calcium Oxalate
Glomerular Basement Membrane
Bicarbonates
Parathyroid Hormone
Proteinuria
Cyclic AMP
Phosphorus
Immunoglobulin A
Multicenter Studies

ASJC Scopus subject areas

  • Nephrology

Cite this

Stapleton, F. B., Hogg, R. J., Reisch, J. S., Green, K., Berry, P. L., Hill, L. L., ... Siegler, R. (1990). Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children. Kidney International, 37(2), 807-811.

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

In: Kidney International, Vol. 37, No. 2, 02.1990, p. 807-811.

Research output: Contribution to journalArticle

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.
Stapleton FB, Hogg RJ, Reisch JS, Green K, Berry PL, Hill LL et al. Idiopathic hypercalciuria: Association with isolated hematuria and risk for urolithiasis in children. Kidney International. 1990 Feb;37(2):807-811.
Stapleton, F. Bruder ; Hogg, Ronald J. ; Reisch, Joan S. ; Green, Kaye ; Berry, Philip L. ; Hill, L. Leighton ; Sanjad, Sami A. ; Hogg, Ronald J. ; Green, Kaye ; Boineau, Frank ; Lewy, John E. ; Baliga, Radhakrishna ; Arnold, Watson ; Ellis, Eileen ; Lum, Gary M. ; Ford, Douglas M. ; Wenzl, James ; Stapleton, F. Bruder ; Roy, Shane ; Wyatt, Robert J. ; Arant, Billy S. ; Baum, Michel ; Reisch, Joan ; Conley, Susan B. ; Rose, Gilbert ; Foulds, Michael ; Makker, Sudesh ; Brouhard, Ben H. ; Kalia, Alok ; Travis, Luther B. ; Brewer, Eileen ; Siegler, Richard. / Idiopathic hypercalciuria : Association with isolated hematuria and risk for urolithiasis in children. In: Kidney International. 1990 ; Vol. 37, No. 2. pp. 807-811.
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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.",
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AU - Reisch, Joan

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AU - Rose, Gilbert

AU - Foulds, Michael

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