Abstract
Introduction A large number of genes and environmental factors, like dietary habits, play a role
in the development of hypercalciuria in children. In this study, we aimed to determine
the effects of the presence and grade of vesicoureteral reflux (VUR) on hypercalciuria
status in children.
Materials and Methods Data for 165 patients who admitted to the Pediatric Urology Department were retrospectively
analyzed. The patients were composed of following four different groups: (1) urinary
stone patients, (2) VUR patients under follow-up, (3) corrected VUR patients, and
(4) control. The demographic features, clinical data, and laboratory tests for the
groups were compared.
Results The mean age of the patients was 100.6 ± 54.69 months and the female/male ratio was
79:86. The mean urinary calcium/creatinine (UCa/Cr) excretion and the frequency of
high UCa/Cr ratios in the corrected VUR group were similar to those in the control
group (p = 0.375 and 0.965, respectively). In contrast, the mean UCa/Cr excretion and frequency
of high UCa/Cr ratios in the urinary stone and follow-up VUR groups were significantly
higher than those in the corrected VUR group (p < 0.001, < 0.001, 0.003, and 0.029, respectively). The mean UCa/Cr excretion and
frequency of high UCa/Cr ratios in the follow-up VUR group were similar to those in
the urinary stone group (p = 0.323 and 0.425, respectively). In the follow-up VUR group, although reflux laterality
had no effect on the UCa/Cr ratios (p = 0.180 and 0.108, respectively), the mean and frequency of high UCa/Cr ratios were
higher in high-grade reflux cases (p < 0.001 and p = 0.042, respectively).
Conclusion Both the mean UCa/Cr ratio and the rate of hypercalciuria in the corrected reflux
group were significantly lower than the corresponding values in the follow-up VUR
and urinary stone groups. Further, the follow-up VUR patients had similar urinary
calcium excretion levels as the stone patients. VUR treatment is associated with a
decrease in urinary calcium excretion to the normal population level. A positive correlation
between reflux degree and calcium excretion was observed.
Keywords
hypercalciuria - pediatric stone disease - reflux in follow-up - urinary calcium creatine
ratio - vesicoureteral reflux