Özet:

Idiopathic hypercalciuria is a disease characterized by increased urinary calcium excretion associated with normal serum calcium levels and exclusion of secondary causes of hypercalciuria. Increased excretion of calcium in the urine causes resoption of calcium from the bone and decreases in bone mineral density. Since an important part of the total bone mass is acquired during childhood, early diagnosis and treatment of osteoporosis are important. Thirty children with the diagnoses of idiopathic hypercalciuria who applied to Ankara Training and Research Hospital Pediatric Nephrology Depatment with no associated disease causing secondary hypercalciuria and osteoporosis and thirty healthy children were included in the study. All children were evaluated for the clinical symptoms, past and family history. Dietary analysis for the intake of calcium, phosphate, sodium, potassium, protein and fiber was performed for theree days. Hematological and biochemical parameters were studied. Serum ALP, bone specific alkaline phosphates, osteocalcin, calcitonine, PTH and 25 OH vitamin D, and urinary deoxypiridinoline, citrate,oxalate levels were measured. Bone mineral density measurements were performed by quantitative ultrasonographic method for all children. Patients in hypercalciuric group had significantly lower average Z scores compared to that of control group. In addition, the ratio of patients with osteoporosis was significantly higher in hypercalciuric patients. Serum ALP, calcium, phosphate, osteocalcin, bone specific ALP and urine deoxypiridinoline, urine calcium levels were not significantly correlated with Z scores. PTH levels were significantly lower in hypercalciuric patients. There was a significant positive correlation between the serum vit D levels and Z scores. Dietary analysis demonstrated no significant correlations between daily intakes of calcium, phosphate, sodium, potassium, protein and fiber. In conclusion, a significant decrease in bone mineral density in children with idiopathic hypercalciuira and suitability of the method of quantitative ultrasonography in these patient groups were demonstrated. The need for follow-up of patients with hypercalciuria for osteoporosis and suitable supportive treatment were emphasized.

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