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Journal of the Korean Society of Pediatric Nephrology 2007;11(2): 168-177. doi: https://doi.org/10.3339/jkspn.2007.11.2.168
혈뇨 환아에서 고칼슘뇨군과 비고칼슘뇨군의 혈액 및 소변화학검사와 신기능 지표들의 비교
이진희, 이현승, 이근영, 장필상, 이경일, 김동언
1가톨릭대학교 의과대학 소아과학교실
2가톨릭대학교 의과대학 소아과학교실
3가톨릭대학교 의과대학 소아과학교실
4가톨릭대학교 의과대학 소아과학교실
5가톨릭대학교 의과대학 소아과학교실
6가톨릭대학교 의과대학 소아과학교실
Comparison of Blood and Urine Renal Indices Between Hypercalciuric and Non-hypercalciuric Hematuria Patients
Jin-Hee Lee, Hyun-Seung Lee, Keun-Young Lee, Pil-Sang Jang, Kyung-Yil Lee, Dong-Un Kim
1Department of Pediatrics, College of Mediine, The Catholic University of Korea
2Department of Pediatrics, College of Mediine, The Catholic University of Korea
3Department of Pediatrics, College of Mediine, The Catholic University of Korea
4Department of Pediatrics, College of Mediine, The Catholic University of Korea
5Department of Pediatrics, College of Mediine, The Catholic University of Korea
6Department of Pediatrics, College of Mediine, The Catholic University of Korea
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ABSTRACT
Purpose : The purpose of this study was to investigate whether hypercalciuria patients with hematuria show different renal indices compared to non-hypercalciuria patients with hematuria.
Methods : We retrospectively reviewed the medical records of patients with gross or microscopic hematuria whose blood chemistry and 24 hour urine chemistry were examined. After excluding the patients with more than $4 mg/m^2/day$ proteinuria or the patients with urinary calcium excretion between 3 and 4 mg/kg/day, we divided the patients into two groups: a hypercalciuria group whose calcium excretion was more than 4 mg/kg/day(n=30) and a non hypercalciuria group whose calcium excretion was less than 3 mg/kg/day(n=41). The urinary excretion, clearance, and fractional excretion(FE) of Na, K, Cl, Ca, P, urea, and creatinine were calculated and compared between the two groups.
Results : The hypercalciuria group had more calcium excretion($6.1{pm}2.9$ vs $1.5{pm}0.9 mg/kg/day$), more urea excretion($341{pm}102$ vs $233{pm}123 mg/kg/day$), greater glomerular filtration rate(GFR) ($93.7{pm}31.1$ vs $79.5{pm}32.0 mL/min$) but lower FENa($1.0{pm}0.4%$ vs $1.3{pm}0.6%$) than the nonhyper-calciuria group, although the urinary sodium excretion was similar between the two groups.
Conclusion : The greater urea excretion and GFR in hypercalciuric patients suggest that they might be on a higher protein diet than the non-hypercalciuria group. The increased glomerular filtration of sodium and calcium induced by the higher GFR in hypercalciuria would have increased their delivery to the distal tubule, where sodium is effectively reabsorbed but calcium is not, which is suggested by the lower FENa but higher FECa in hyercalciuria. It is recommended that the diet of hematuria patients be reviewed in detail at initial presentation and during treatment.
Key words: Hypercalciuria | Hematuria | Urine chemistry | High protein diet
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