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Hypercalciuria in Children with Hematuria.

Journal of the Korean Pediatric Society 1989;32(5):644-652.
Published online May 31, 1989.
Hypercalciuria in Children with Hematuria.
Tae Sung Ko, Chang Youn Lee, Young Seo Park, Hae Il Cheong, Yong Choi, Kwang Wook Ko
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
혈뇨를 동반한 소아에서의 과칼슘 뇨증
고태성, 이창연, 박영서, 정해일, 최용, 고광욱
서울대학교 의과대학 소아과학교실
Received: 2 November 1988   • Accepted: 2 November 1988
Abstract
Ten children with gross hematuria were diagnosed as hypercalciuria in the Department of Pediatrics, Seoul National University Children’s Hospital during the period from June 1983 to Aug. 1987. We reviewed their clinical data, retrospectively, and could obtain the following results. 1) The age at the onset of gross hematuria ranged from 4 months to 10 7/12 years, and the male to female ratio was 4:1 2) All patients had experienced recurrent gross hematuria before the diagnosis, and the hematuria was induced and exacerbated after physical exercise in 4 cases. Three children had a past medical history of urinary stone(s), and four had a dietary history of high calcium intake 3) The average amount of urine calcium excretion was 7.9 ± 3.2 mg/ kg/ day(4.2 -14.4 mg/ kg/day), and the average urinary calcium( mg/ dl) to creatinine( mg/ dl) ratio was 0.49 ± 0.24(0.24 - 1.02). 4) Calcium loading tests were executed in 6 cases, and 4 cases were ascertained as renal leak type and 2 cases as absorptive type. The latter 2 cases had a history of high calcium intake. 5) All patients showed improvement in urinary calcium excretion and hematuria with low salt(low calcium) diet with or without hydrochlorothiazide. In conclusion, hypercalciuria should be considered in the differential diagnosis of hematuria in children. It can be diagnosed easily by measuring urine calcium and creatinine without any invasive studies. After then, appropriate medical managements are recommended to manage hematuria effectively and even to prevent the formation of subsequent urinary tract calculi.
Key Words: Hematuria, Hypercalciuria


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