metabolic risk factors in children with asymptomatic hematuria
TRANSCRIPT
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METABOLIC RISK FACTORS IN CHILDREN WITH ASYMPTOMATIC HEMATURIAFrancisco Rodolfo Spivacow, Elisa Elena del Valle, Paula Gabriela Rey
Dr.Mohammad Reza RazaviDr.Mohammad Mahdi Shater
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INTRODUCTION• Hematuria is one of the most common genitourinary abnormalities in
children
• clinical presentations
• associate signs and/or symptoms , past medical history, family history
• Idiopathic or benign hematuria
• Some of these patients may subsequently suffer from kidney stones with hypercalciuria , hyperuricosuria , or hyperoxaluria , with most of these having a positive family history of urolithiasis
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INTRODUCTION• The aim of this study was to evaluate the clinical presentation, family
history, and metabolic risk factors of 60 children with asymptomatic hematuria without kidney stones
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PATIENTS & METHODS• retrospective and cross-sectional analysis
• patients under 16 years of age who were referred to our institution between 1996 and 2012 for evaluation of metabolic risk factors
• referred to our institution by pediatric nephrologists and came from the general population
• Negative for any explained cause of hematuria(PMH, DH ,…)
• Family history of kidney stones
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PATIENTS & METHODS• Sampling
• Blood sample
• Urine sample
Hypercalciuria (HC), i.e., excretion of >4 mg/kg/day urinary calcium
Hyperoxaluria (OX), i.e., overproduction of oxalate[>50 mg/1.73 m2 body surface area (BSA)/day] in the kidneys
Hypocitraturia (CiT), i.e., urinary excretion of <400 mgcitrate/g creatinine
Hypomagnesuria (MG), i.e. urinary excretion of<1.24 mg magnesium/kg body weight/day
Hyperuricosuria (HU), i.e., urinary excretion of excessamounts of uric acid (>815 mg/1.73 m2 BSA/day).
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RESULTS• Study
• Family history of renal stone
• At least one urinary metabolic abnormality was present in 49 patients, while 11 patients had no metabolic abnormality.
• Befor metabolic study
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RESULTS• Single urinary metabolic risk factors
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RESULTS• Multiple urinary metabolic risk factors
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RESULTS• The most common urinary risk factor was idiopathic hypercalciuria (single
or associated), which was found in 43.5 % of patients, followed by hypocitraturia (single or associated), present in 31.7 %. Unduly acidic urine pH as a single abnormality was found in 10 % of this pediatric patient population.
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RESULTS• Metabolic risk factors in children with hematuria and in pediatric kidney
stone-formers
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CONCLUSIONS• Asymptomatic idiopathic hematuria in pediatric patients may often be
associated to different urinary biochemical abnormalities, similar to what is observed in pediatric kidney stone-formers.
• Long-term monitoring of children with hematuria and metabolic disorders may clarify the true association with kidney stone disease.
• Finally, hematuria of unknown etiology demands a biochemical risk factor evaluation that allows definition of its cause and treatment
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