title: The effect of inhaled corticosteroids on the urinary calcium to creatinine ratio in childhood asthma.
abstract: BACKGROUND
  The use of inhaled corticosteroids (ICS) via spacers in childhood asthma is increasing. However, concern has been raised about its long-term impact. Hypercalciuria is a known adverse effect of treatment with systemic corticosteroids. The urinary calcium to creatinine ratio (UCa:Cr) is a simple, reliable and non-invasive tool for evaluation of hypercalciuria.
  
  
  OBJECTIVE
  To determine whether ICS can induce hypercalciuria in children with asthma.
  
  
  METHODS
  Outpatient clinic in a referral hospital.
  
  
  METHODS
  The UCa:Cr was determined in 25 children aged 3-6 years with mild-to-moderate persistent asthma before and after a 2-month course of inhaled budesonide 400 micrograms/day via an aerochamber. Children who had received oral corticosteroids, diuretics, antibiotics or theophylline were excluded.
  
  
  METHODS
  Paired Student's t-test and Fisher's exact test.
  
  
  RESULTS
  The mean UCa:Cr was similar in the children with asthma before and after 2 months' administration of budesonide (0.10 +/- 0.10 and 0.11 +/- 0.08, respectively; p = 0.601). The numbers of hypercalciuric children were two and five, respectively (p = 0.417). In 68% of patients, the UCa:Cr increased and in 16% the increase indicated hypercalciuria (UCa:Cr > 0.2).
  
  
  CONCLUSIONS
  Although the treatment of childhood asthma with budesonide 400 micrograms/day via an aerochamber does not appear to be associated with hypercalciuria, the existence of a subgroup of patients in whom ICS may induce hypercalciuria is plausible. This needs to be further evaluated in a larger study.
authors.affiliation: Pediatric Pulmonology Unit, Israel Poison Information Center, Haifa, Israel. d_bentur@rambam.health.gov.il
authors.forename: Lea
authors.initials: L
authors.lastname: Bentur
authors.forename: Jarrous
authors.initials: J
authors.lastname: Taisir
authors.forename: Yedidia
authors.initials: Y
authors.lastname: Bentur
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000493:pharmacokinetics*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001249:Asthma / Q000150:complications / Q000652:urine*; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use; D002118:Calcium / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D019819:Budesonide; D003404:Creatinine; D002118:Calcium