EL TRATAMIENTO OPTIMO DE LA HIPERCALCIURIA EN NIÑOS AUN DEBE DEFINIRSE

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La hipercalciuria idiopática es una entidad frecuente entre los niños y tiene una etiología multifactorial. Habitualmente se detecta durante la evaluación de un niño que presenta hematuria o nefrolitiasis. Son necesarios estudios adicionales para comprender en detalle su importancia patológica y para idear estrategias terapéuticas óptimas.
butani9.jpg Autor:
Lavjay Butani
Columnista Experto de SIIC
Artículos publicados por Lavjay Butani
Coautores
Maha Haddad* Keith Lau* 
MD, Sacramento, EE.UU.*
Recepción del artículo
8 de Septiembre, 2006
Aprobación
28 de Septiembre, 2006
Primera edición
23 de Abril, 2007
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La hipercalciuria idiopática (HI), definida como la excreción elevada de calcio urinario en el contexto de una normocalcemia, es bastante habitual en la población pediátrica general. En estudios transversales se sugirió una asociación causal entre la HI y la hematuria, la nefrolitiasis y, más recientemente, la osteopenia. Se presentaron varias hipótesis para explicar los mecanismos que causan la elevación de la excreción urinaria de calcio. El propósito del presente artículo es efectuar una revisión acerca de la epidemiología, características clínicas, complicaciones, métodos diagnósticos disponibles y tratamiento de la HI en los niños.

Palabras clave
hipercalciuria, pediatría, patogenia, osteogenia


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Abstract
Idiopathic hypercalciuria (IH), defined as an elevated urinary calcium excretion in the setting of normocalcemia, is quite common in the general pediatric population. Cross sectional studies have suggested a causal association between IH and hematuria, nephrolithiasis and more recently, osteopenia. Various hypotheses have been put forward to explain the mechanisms causing the elevation in urinary calcium excretion. The purpose of this paper is to review the epidemiology, clinical features, complications, available diagnostic methods and treatment of IH in children.

Key words
hypercalciuria, pediatric, pathogenesis, osteopenia


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Especialidades
Principal: Pediatría
Relacionadas: Endocrinología y Metabolismo, Farmacología, Medicina Farmacéutica, Medicina Interna



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Lavjay Butani, University of California Davis Medical Center, CA 95817, 2516 Stockton Boulevard, Sacramento, EE.UU.
Bibliografía del artículo
1. Alon U, Warady BA, Hellerstein S. Hypercalciuria in the frequency-dysuria syndrome of childhood. J Pediatr 116(1):103-5, 1990.
2. Parekh DJ, Pope JI, Adams MC, Brock JW III. The role of hypercalciuria in a subgroup of dysfunctional voiding syndromes of childhood. J Urol 164(3 Pt 2):1008-10, 2000.
3. Albright F, Henneman P, Benedict P, Forbes A. Idiopathic hypercalciuria. A preliminary report. Proc R Soc Med 46:1077-1081, 1953.
4. Roy S III, Stapleton FB, Noe HN, Jerkins G. Hematuria preceding renal calculus formation in children with hypercalciuria. J Pediatr 99(5):712-5, 1981.
5. Kalia A, Travis LB, Brouhard BH. The association of idiopathic hypercalciuria and asymptomatic gross hematuria in children. J Pediatr 99(5):716-9, 1981.
6. Feld LG, Meyers KE, Kaplan BS, Stapleton FB. Limited evaluation of microscopic hematuria in pediatrics. Pediatrics 102(4):E42, 1998.
7. Stapleton FB, Roy S III, Noe HN, Jerkins G. Hypercalciuria in children with hematuria. N Engl J Med 310(21):1345-8, 1984.
8. Peacock M, Nordin BE. Tubular reabsorption of calcium in normal and hypercalciuric subjects. J Clin Pathol 21(3):353-8, 1968.
9. García Nieto V, Ferrández C, Monge M, De Sequera M, Rodrigo MD. Bone mineral density in pediatric patients with idiopathic hypercalciuria. Pediatr Nephrol 11(5):578-83, 1997.
10. Yao JJ, Bai S, Karnauskas AJ, Bushinsky DA, Favus MJ. Regulation of renal calcium receptor gene expression by 1,25-dihydroxyvitamin D3 in genetic hypercalciuric stone-forming rats. J Am Soc Nephrol 16(5):1300-8, 2005.
11. Pak CY. Physiological basis for absorptive and renal hypercalciurias. Am J Physiol 237(6):F415-23, 1979.
12. Coe FL, Bushinsky DA. Pathophysiology of hypercalciuria. Am J Physiol 247(1 Pt 2):F1-13, 1984.
13. Coe FL, Favus MJ, Crockett T, et al. Effects of low-calcium diet on urine calcium excretion, parathyroid function and serum 1,25(OH)2D3 levels in patients with idiopathic hypercalciuria and in normal subjects. Am J Med 72(1):25-32, 1982.
14. Aladjem M, Barr J, Lahat E, Bistritzer T. Renal and absorptive hypercalciuria: a metabolic disturbance with varying and interchanging modes of expression. Pediatrics 97(2):216-9, 1996.
15. Mehes K, Szelid Z. Autosomal dominant inheritance of hypercalciuria. Eur J Pediatr 133(3):239-42, 1980.
16. Melian JS, García Nieto V, Sosa AM. Inheritance and prevalence of hypercalciuria in the children from the island of La Gomera. Nefrologia 20(6):510-6, 2000.
17. Rudan I, Padovan M, Rudan D, et al. Inbreeding and nephrolithiasis in Croatian island isolates. Coll Antropol 26(1):11-21, 2002.
18. Resnick M, Pridgen DB, Goodman HO. Genetic predisposition to formation of calcium oxalate renal calculi. N Engl J Med 278(24):1313-8, 1968.
19. Scheinman SJ. X-linked hypercalciuric nephrolithiasis: clinical syndromes and chloride channel mutations. Kidney Int 53(1):3-17, 1998.
20. Frick KK, Bushinsky DA. Molecular mechanisms of primary hypercalciuria. J Am Soc Nephrol 14(4):1082-95, 2003.
21. Levy FL, Adams-Huet B, Pak CY. Ambulatory evaluation of nephrolithiasis: an update of a 1980 protocol. Am J Med 98(1):50-9, 1995.
22. Stapleton FB. Idiopathic hypercalciuria: association with isolated hematuria and risk for urolithiasis in children. The Southwest Pediatric Nephrology Study Group. Kidney Int 37(2):807-11, 1990.
23. García CD, Miller LA, Stapleton FB. Natural history of hematuria associated with hypercalciuria in children. Am J Dis Child 145(10):1204-7, 1991.
24. Ronnefarth G, Misselwitz J. Nephrocalcinosis in children: a retrospective survey. Members of the Arbeitsgemeinschaft fur padiatrische Nephrologie. Pediatr Nephrol 14(10-11):1016-21, 2000.
25. Penido MG, Lima EM, Marino VS, Tupinamba AL, Franca A, Souto MF. Bone alterations in children with idiopathic hypercalciuria at the time of diagnosis. Pediatr Nephrol 18(2):133-9, 2003.
26. Bataille P, Achard JM, Fournier A, et al. Diet, vitamin D and vertebral mineral density in hypercalciuric calcium stone formers. Kidney Int 39(6):1193-205, 1991.
27. Weisinger JR, Alonzo E, Bellorin-Font E, et al. Possible role of cytokines on the bone mineral loss in idiopathic hypercalciuria. Kidney Int 49(1):244-50, 1996.
28. Filipponi P, Mannarelli C, Pacifici R, et al. Evidence for a prostaglandin-mediated bone resorptive mechanism in subjects with fasting hypercalciuria. Calcif Tissue Int 43(2):61-6, 1988.
29. Penido MG, Lima EM, Souto MF, Marino VS, Tupinamba AL, Franca A. Hypocitraturia: a risk factor for reduced bone mineral density in idiopathic hypercalciuria? Pediatr Nephrol 21(1):74-8, 2006.
30. Melton LJ III, Crowson CS, Khosla S, Wilson DM, O'Fallon WM. Fracture risk among patients with urolithiasis: a population-based cohort study. Kidney Int 53(2):459-64, 1998.
31. Ghazali S, Barratt TM. Urinary excretion of calcium and magnesium in children. Arch Dis Child 49(2):97-101, 1974.
32. Manz F, Kehrt R, Lausen B, Merkel A. Urinary calcium excretion in healthy children and adolescents. Pediatr Nephrol 13(9):894-9, 1999.
33. De Santo NG, Di Iorio B, Capasso G, et al. Population based data on urinary excretion of calcium, magnesium, oxalate, phosphate and uric acid in children from Cimitile (southern Italy). Pediatr Nephrol 6(2):149-57, 1992.
34. Alconcher LF, Castro C, Quintana D, et al. Urinary calcium excretion in healthy school children. Pediatr Nephrol 11(2):186-8, 1997.
35. Chen YH, Lee AJ, Chen CH, Chesney RW, Stapleton FB, Roy S, 3rd. Urinary mineral excretion among normal Taiwanese children. Pediatr Nephrol 8(1):36-9, 1994.
36. Sweid HA, Bagga A, Vaswani M, Vasudev V, Ahuja RK, Srivastava RN. Urinary excretion of minerals, oxalate, and uric acid in north Indian children. Pediatr Nephrol 11(2):189-92, 1997.
37. Bell NH, Yergey AL, Vieira NE, Oexmann MJ, Shary JR. Demonstration of a difference in urinary calcium, not calcium absorption, in black and white adolescents. J Bone Miner Res 8(9):1111-5, 1993.
38. Bleich HL, Moore MJ, Lemann J Jr, Adams ND, Gray RW. Urinary calcium excretion in human beings. N Engl J Med 301(10):535-41, 1979.
39. Goldfarb S. Dietary factors in the pathogenesis and prophylaxis of calcium nephrolithiasis. Kidney Int 34(4):544-55, 1988.
40. Reddy ST, Wang CY, Sakhaee K, Brinkley L, Pak CY. Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis 40(2):265-74, 2002.
41. Lemann J, Worcester EM. Nephrolithiasis. In: Massry S, Glassock R, editors. Textbook of nephrology. Maryland: Williams and Wilkins; 1995. pp. 1054-1078.
42. Lemann J Jr, Pleuss JA, Gray RW, Hoffmann RG. Potassium administration reduces and potassium deprivation increases urinary calcium excretion in healthy adults [corrected]. Kidney Int 39(5):973-83, 1991.
43. Lemann J Jr, Piering WF, Lennon EJ. Possible role of carbohydrate-induced calciuria in calcium oxalate kidney-stone formation. N Engl J Med 280(5):232-7, 1969.
44. Ulmann A, Aubert J, Bourdeau A, Cheynel C, Bader C. Effects of weight and glucose ingestion on urinary calcium and phosphate excretion: implications for calcium urolithiasis. J Clin Endocrinol Metab 54(5):1063-8, 1982.
45. Nordin BE. Assesment of calcium excretion from the urinary calcium/creatinine ratio. Lancet 2:368-371, 1959.
46. Sargent JD, Stukel TA, Kresel J, Klein RZ. Normal values for random urinary calcium to creatinine ratios in infancy. J Pediatr 123(3):393-7, 1993.
47. Matos V, Van Melle G, Boulat O, Markert M, Bachmann C, Guignard JP. Urinary phosphate/creatinine, calcium/creatinine, and magnesium/creatinine ratios in a healthy pediatric population. J Pediatr 131(2):252-7, 1997.
48. Seifert-McLean CM, Cromer BA, Mosher G, Mahan JD. Urinary calcium excretion in healthy adolescents. J Adolesc Health Care 10(4):300-4, 1989.
49. Moore ES, Coe FL, McMann BJ, Favus MJ. Idiopathic hypercalciuria in children: prevalence and metabolic characteristics. J Pediatr 92(6):906-10, 1978.
50. Safarinejad MR. Urinary mineral excretion in healthy Iranian children. Pediatr Nephrol 18(2):140-4, 2003.
51. So NP, Osorio AV, Simon SD, Alon US. Normal urinary calcium/creatinine ratios in African-American and Caucasian children. Pediatr Nephrol 16(2):133-9, 2001.
52. Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 63(5):1817-23, 2003.
53. Mir S, Serdaroglu E. Quantification of hypercalciuria with the urine calcium osmolality ratio in children. Pediatr Nephrol 20(11):1562-5, 2005.
54. Daudon M, Hennequin C, Boujelben G, Lacour B, Jungers P. Serial crystalluria determination and the risk of recurrence in calcium stone formers. Kidney Int 67(5):1934-43, 2005.
55. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155(3):839-43, 1996.
56. Ohkawa M, Tokunaga S, Nakashima T, Orito M, Hisazumi H. Thiazide treatment for calcium urolithiasis in patients with idiopathic hypercalciuria. Br J Urol 69(6):571-6, 1992.
57. Schoofs MW, Van der Klift M, Hofman A, et al. Thiazide diuretics and the risk for hip fracture. Ann Intern Med 139(6):476-82, 2003.
58. Adams JS, Song CF, Kantorovich V. Rapid recovery of bone mass in hypercalciuric, osteoporotic men treated with hydrochlorothiazide. Ann Intern Med 130(8):658-60, 1999.
59. Vescini F, Buffa A, La Manna G, et al. Long-term potassium citrate therapy and bone mineral density in idiopathic calcium stone formers. J Endocrinol Invest 28(3):218-22, 2005.
60. Pak CY, Peterson RD, Poindexter J. Prevention of spinal bone loss by potassium citrate in cases of calcium urolithiasis. J Urol 168(1):31-4, 2002.
61. Bushinsky DA, Neumann KJ, Asplin J, Krieger NS. Alendronate decreases urine calcium and supersaturation in genetic hypercalciuric rats. Kidney Int 55(1):234-43, 1999.
62. Weisinger JR, Alonzo E, Machado C, et al. Role of bones in the physiopathology of idiopathic hypercalciuria: effect of amino-bisphosphonate alendronate. Medicina (Bs Aires) 57 Suppl 1:45-8, 1997.
63. Heilberg IP, Martini LA, Teixeira SH, et al. Effect of etidronate treatment on bone mass of male nephrolithiasis patients with idiopathic hypercalciuria and osteopenia. Nephron 79(4):430-7, 1998.

 
 
 
 
 
 
 
 
 
 
 
 
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