Hematuria due to hyperuricosuria in children: 36-month follow-up.
Hyperuricosuria (HU), defined as a urinary acid excretion higher than 95 percent of normal values, is an important lithogenic factor, accounting for about 5-20% of recurrent hematuria in childhood. We prospectively studied 30 children (15 male, 15 female; aged 3 to 13 years old) with previously undiagnosed isolated hematuria and HU for 6 to 36 months. The family history of nephrolithiasis was positive in 40%. Idiopathic hypercalciuria (IH), UCa > 4 mg/kg/day, was not found initially, but was diagnosed after 6 to 24 months in 20% of the patients. The following treatments were utilized: restricted purine diet (13%), allopurinol (4%) and potassium citrate (1%). No specific treatment was given to 82% of the patients. Therapy normalized uricosuria with resolution of hematuria over 6-12 months. Thirteen percent and 6% of untreated patients developed urolithiasis after 6 and 12 months respectively. The data suggest that HU, like IH, is associated with hematuria. Furthermore, recognition of this association may prevent unnecessary, and in some cases, invasive diagnostic manoeuvres.
Cattini Perrone
H
H
Nephrology Division, Escola Paulista de Medicina, São Paulo, Brazil.
Bruder Stapleton
F
F
Toporovski
J
J
Schor
N
N
D000293:Adolescent; D000493:Allopurinol / Q000627:therapeutic use; D002118:Calcium / Q000652:urine; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000178:diet therapy / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007669:Kidney Calculi / Q000235:genetics; D008297:Male; D019357:Potassium Citrate / Q000627:therapeutic use; D014527:Uric Acid / Q000652:urine*
D014527:Uric Acid; D000493:Allopurinol; D019357:Potassium Citrate; D002118:Calcium