Renal consequences of immobilisation in children with fractured femurs.
Parameters of renal function and calcium homeostasis were studied in 8 children, immobilised for 5-9 weeks with fractured femurs, weekly during immobilisation and fourth weekly following mobilisation until all parameters returned to normal. During immobilisation 1 patient became hypercalcaemic, but all showed an increase in serum calcium and all developed hypercalciuria. During immobilisation all showed diminished urine osomolality after a 12-hour fast (mean 591 +/- 133 mOsm/kg) which improved 4-39 weeks after mobilisation (mean 973 +/- 87 mOsm/kg). Serum creatinine, urinary beta-2-microglobulin and renal ultrasound appearances were all normal. An inverse relationship, R = -0.70, was demonstrated between serum calcium and fasting urine osmolality during immobilisation. Three patients showed diminished urinary concentrating ability beyond 4 weeks after mobilisation. For 1 patient this defect persisted for 8 months and glomerular filtration rate was diminished 9 months after mobilisation, raising the possibility of long term renal damage in immobilised patients.
Andrews
P I
PI
Department of Nephrology, Prince of Wales Children's Hospital, Sydney, Australia.
Rosenberg
A R
AR
D000293:Adolescent; D002118:Calcium / Q000652:urine; D002648:Child; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000628:therapy*; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology; D007103:Immobilization / Q000009:adverse effects*; D007674:Kidney Diseases / Q000150:complications / Q000209:etiology* / Q000652:urine; D008297:Male
D002118:Calcium