Clin Osteol 2005; 10(4): 87-93

Idiopathic hypercalciuria in childhoodReview articles

S. Skálová, S. Kutilek

Hypercalciuria is defined as urinary excretion of calcium exceeding 0.1 mmol/kg/24 hours in the absence of dietary manipulation. Idiopathic hyper­ calciuria (IH) is defined as hypercalciuria that persists after correction of dietary imbalances and has no detectable causes. IH in childhood can be ma­ nifested by hematuria, dysuria, recurrent abdominal pain and enuresis. Patients with IH are at high risk of urolithiasis and osteoporosis. The patho­ genesis of IH has not yet been elucidated, and to date three mechanisms have been proposed: (1) increased intestinal absorption of calcium; (2)defective re-absorption of calcium by the renal tubule; and (3) increased bone resorption. Most recent theories deal with increased concentrations of arachido­ nic acid, overexpression of the vitamin D receptor, mutations affecting the calcium-sensing receptor, overproduction of calcitriol, overproduction of vi­ tamin D receptor, and an overproduction of cytokines. Therapy of IH rests in dietary restrictions of sodium and in increase of potassium intake. Dai­ ly allowances of calcium should not exceed the age-dependent recommended doses. Hydrochlorothiazide therapy is advocated in patients with urolithiasis or in those with osteopenia/osteoporosis and an inadequate response to dietary therapy.

Keywords: hypercalcuria, osteoporosis.

Published: December 11, 2005  Show citation