Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones.

AIM: There is conflicting evidence about the role of obesity in paediatric nephrolithiasis. This Polish study explored the influence of nutritional status and lipid disturbances on urinary lithogenic factors and the risk of kidney stone formation in children and adolescents from three to 18 years of age. METHODS: We carried out serum lipid profile evaluations and 24-h urine chemistry analyses on 493 overweight/obese paediatric participants (mean age 13 years) without nephrolithiasis and 492 healthy normal weight sex and age-matched controls. RESULTS: A third (33%) of the study group had blood lipid disturbances, with more acidic urine, lower urinary citrate excretion and a higher fraction of ionised calcium and higher Bonn Risk Index than the controls. The participants' body mass index standard deviation score (BMI Z-score) was positively correlated with urinary oxalate and uric acid and negatively correlated with citrate excretion. Total cholesterol, low-density lipoprotein cholesterol and triglycerides correlated negatively with citraturia, while high-density lipoprotein cholesterol correlated positively. CONCLUSION: The main factor that predisposed overweight and obese children to kidney stones was hypocitraturia. Urinary citrate excretion was related to both BMI Z-scores and all lipid fraction abnormalities. However, hypercholesterolaemia and particularly low-density lipoprotein hypercholesterolaemia seemed to play a major role.

Urinary calcium excretion in children with monosymptomatic enuresis.

BACKGROUND: Among many factors predisposing to monosymptomatic enuresis (MNE) disturbances in urinary electrolites excretion play an important role. Because of many controversies in this field there is a need to debate the role of hypercalciuria in MNE. The aim of our study was to determine the urinary calcium in children with MNE. METHODS: The investigation was conducted on 204 children (83 MNE children and 121 reference group). Urinary calcium excretion (in 24-h collection and per kg of body mass), Ca/creatinine ratio, Ca(2+) in urine sample and in 24-h collection of urine were estimated. RESULTS: Hypercalciuria in MNE group was diagnosed in 18/83 (21.69%) patients. We found statistically significant differences between children with MNE in Ca(2+) in urine sample and 24-h collection and Ca/creat. ratio. Median urinary calcium excretion (mg/kg/24-h and mmol/24-h) was significantly higher in hypercalciuric enuretic patients. The urinary total calcium (mmol/24-h), urinary bound calcium and urinary calcium concentration (mmol/L) demonstrated a significant positive correlation with height, weight and age in reference group but not in MNE group. CONCLUSION: Urinary calcium excretion was significantly disturbed and further studies are needed to assess the role of hypercalciuria in the pathogenesis of MNE.

Urine L-carnitine excretion in hypertensive adolescents.

AIM: This study was performed to test the hypothesis that urinary levels of L-carnitine and its derivatives are enhanced in children and adolescents with hypertension and also check if analyzed parameters may serve as early markers of subclinical renal damage. METHODS: The study included 112 children and adolescents (67 males and 45 females) aged median 10-18 years. Participants were divided into two groups: HT-64 subjects with confirmed primary hypertension and R-reference group-48 subjects with white-coat hypertension. Urinary Free and Total L-carnitine were determined by the enzymatic method of Cederblad. The L-carnitine levels were expressed as urinary ratio in micromole per gram creatinine (µmol/g). RESULTS: The urinary excretion of Total and Free L-carnitine was significantly higher in hypertensive adolescents in comparison to reference group-white coat hypertension. Other important findings were positive correlations between Free L-carnitine/cr., Total L-carnitine/cr. ratio and serum uric acid level, serum cholesterol level and systolic blood pressure. CONCLUSION: The results of this study do not explain the increased urine levels of L-carnitine. The most likely reason for excessive urinary loss was disturbed renal tubular reabsorption. It is possible to hypothesize that in hypertensive adolescents subclinical kidney dysfunction occurs. It is proposed that studies examining the concurrent plasma and urine concentration of L-carnitine and correlation with acknowledged proximal tubular markers are needed.

Urinary nerve growth factor in patients with detrusor overactivity.

BACKGROUND: Detrusor overactivity (DO) is one of the most frequent bladder dysfunctions in children up to the age of 18. Nowadays, the only way to confirm DO is by urodynamic investigation, which is an invasive procedure. Among the many mediators influencing bladder function, nerve growth factor (NGF) plays an important role. The present study was designed to measure urinary NGF (uNGF) levels in patients with DO diagnosed by urodynamic study in comparison with healthy controls. METHODS: The investigation was conducted on 44 children, divided into two groups (24 patients with DO, 20 healthy children). Uroflowmetry was performed in all enrolled to the study and cystometry only to patients. uNGF levels were estimated in both studied groups. RESULTS: The median uNGF level in patients with DO before treatment was higher compared with healthy controls. There were no differences between uNGF levels in patients after anticholinergic treatment and the controls. We found differences in uroflowmetry parameters between the reference group and the patients. We found correlations between uroflowmetry parameters and uNGF/cr. level. CONCLUSIONS: 1. The uNGF level could be used for detecting DO in children and adolescents. 2. Measuring uNGF level is a simple, noninvasive procedure and very useful for choosing therapy in patients with DO in various clinical conditions.

[Sacral bone dysgenesis in a child whose mother has diabetes]. / Niedorozwój kosci krzyzowej u dziecka matki chorej na cukrzyce.

We introduced 2.5-year old girl with gait and miction disturbances as a result of sacral bone dysgenesis (only S1 existed) and abnormal position of nerve roots of medulla. The 28-year old mother of the child has been treated for diabetes mellitus type I since she was 15.