RESUMO
This report describes the serum osteocalcin values in children with mild to moderate, but relatively stable, renal dysfunction followed in the Growth Failure in Children With Renal Diseases Study. This report is derived from data obtained during the control period (6 months) before the initiation of vitamin D therapy. Up to three measurements per patient were obtained. Serum osteocalcin concentration was compared with creatinine clearance (glomerular filtration rate) calculated by the Schwartz formula; with serum concentrations of alkaline phosphatase, parathyroid hormone, and bicarbonate; and with the percentages of the recommended dietary allowances of calories and protein ingested. By standard correlation techniques, there appeared to be an inverse correlation between calculated creatinine clearance and serum osteocalcin concentration, and a direct correlation between serum osteocalcin and parathyroid hormone values. However, when we employed a statistical technique that takes into account repeated measures in the same patient, no correlation was found between calculated glomerular filtration rate and serum osteocalcin concentration, and no direct correlation was found between serum osteocalcin and parathyroid hormone values. The lack of a correlation between calculated glomerular filtration rate and serum osteocalcin values may be due to large fluctuations in the serum osteocalcin concentration, even though renal function is relatively stable.
Assuntos
Falência Renal Crônica/sangue , Osteocalcina/sangue , Fosfatase Alcalina/sangue , Bicarbonatos/sangue , Calcitriol/uso terapêutico , Criança , Pré-Escolar , Creatinina/sangue , Humanos , Lactente , Falência Renal Crônica/terapia , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Diálise RenalRESUMO
Pediatricians frequently have faced one or more of an array of lower urinary tract symptoms without obvious cause. Now, with increasing recognition, many of these diagnostic enigmas have been ascribed to idiopathic hypercalciuria. This article reviews this "new" clinical syndrome, attempts to clarify pathophysiology, and selects patients for therapeutic intervention.
Assuntos
Cálcio/urina , Doenças Urológicas/etiologia , Adolescente , Adulto , Fatores Etários , Cálcio/metabolismo , Criança , Pré-Escolar , Diagnóstico Diferencial , Enurese/etiologia , Feminino , Hematúria/etiologia , Humanos , Lactente , Rim/metabolismo , Masculino , Proteinúria/etiologia , Fatores Sexuais , Síndrome , Infecções Urinárias/etiologia , Transtornos Urinários/etiologia , Doenças Urológicas/diagnóstico , Doenças Urológicas/terapiaRESUMO
Urinary undiversion was performed in 31 patients. Preoperative investigation and criteria for undiversion are discussed. Renal preservation rate is stable in 28 of 31 patients and bladder function satisfactory in 30 of 31 patients. Although prolongation of life and prevention of renal deterioration are of primary concern, psychologic aspects of undiversion must also be considered. Some children who underwent urinary diversion have poor renal reserve and eventually outgrow their kidneys, thus requiring renal transplantation. Their urinary tracts must be prepared for that eventuality.