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Hypercalciuria in High Risk Neonate

Journal of the Korean Pediatric Society 1994;37(3):322-331.
Published online March 15, 1994.
Hypercalciuria in High Risk Neonate
Eun Sun Kim, Seung Joo Lee
Department of Pediatrics, College of Medicine, Ewha Woman`s University, Seoul, Korea
중환 신생아에서의 고칼슘뇨에 대한 연구
김은선, 이승주
이화대학교 의과대학 소아과
Abstract
The incidence and risk factors for hypercalciuria were studied in 23 sick preterm (Group I), 36 well preterm (Group II), 16 sick term (Group III) and 41 well term (Group IV) neonates who were admitted to NICU and nursery of Whwa Woman's University Hospital from May 1988 to February 1992. The results were as follows: 1) The incidences of hypercalciuria were 73.9% in sick preterm (Group I) and 56.3% in sick term (Group II) which were significantly higher than 13.9% of control preterm (Group II) and 7.3% of control term (Group IV). Maximal urinary Ca/Cr ratios were 0.63¡¾0.503 in group I and 0.50¡¾0.513 in group III, significantly higher than 0.19¡¾0.142 of control term and 0.17¡¾0.131 of control term. 2) In sick neonates with hypercalcuria, birth wight and gestational age were significantly lower and the frequencies of frosemide and intravenous calcium therapy were significantly higher than those of sick neonates without hypercalciuria. 3) In sick neonates, furosemide increased the incidence of hypercalciuria to 90.9%, significantly higher than 57.1% in neonates without furosemide. Maximal urine Ca/Cr ratio and 24 hour urine calcium were also significantly higher in neonates with furosemide than those of neonates without furosemide. 4) In sick neonates, intravenous calcium gluconate increased the incidence of hypercalciuria to 86.6%, significantly higher than 54.2% in neonates without intravenous calcium. Maximal urine Ca/Cr ratio and 24 hour urine calcium were also significantly higher in neonates treated with IV calcium than those of neonates without IV calcium. 5) Calcium intake and maximal random urine Ca/Cr ratio were positively correlated (r=0.46, p=0.037). In conclusion, the majority of sick newborns in our intensive care unit were hypercalciuric. Sick condition, premature, furosemide and intravenous calcium gluconate were the risk factors that could lead to hypercalciuria. Use of these agents in sick neonates especially preterm neonates requires careful monitoring of urine calcium excretion.
Key Words: Hypercalciuria, sick neonate, furosemide, IV calcium


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