The main ways of correcting idiopathic hypercalciuria in children

Introduction. Idiopathic hypercalciuria (IH) is one of the most common metabolic disorders in children and is one of the leading causes of calcium urolithiasis and osteoporosis. The strategic goal of treatment for IH is to reduce urinary calcium excretion.

Materials and methods. The study included 93 IH children aged from 3 to 14 years with identified IH. At the first stage, IH children have been prescribed low sodium and high potassium diet with increased fluid intake for three months without additional drug therapy. For children with persistent IH at the second stage, the diet was supplemented daily with 1000–1500 mg of fish oil for children for 3 months. At the third stage of treatment, persistent IH patients were prescribed hydrochlorothiazide at a dose of 1 mg/kg for 3 months. After each stage of treatment, we analyzed IH’s manifestations in dynamics and monitored urinary calcium excretion by calcium/creatinine ratio (CCR).

Results. Evaluation of clinical and laboratory manifestations of IH after the first stage of treatment showed the effectiveness of the diet in 59.1% of patients. Among 38 patients included in the second stage of therapy, the normalization of urinary calcium excretion was noted in 52.6% of cases. The third stage of therapy was performed in 18 patients (19% of the initial group of IH children patients). The normalization of CCR was achieved in 16 (88.9%) children.

Conclusion. For the correction of IH in children, a step-by-step approach should be recommended, starting with recommendations on the drinking regimen and nutrition, then prescribing fish oil preparations and resorting to thiazide diuretics in the lack of an effect from the first stages of treatment.

Contribution.
Mikheeva N.M., Zverev Ya.F., Strozenko L.A. — research concept and design of the study;
Mikheeva N.M., Zverev Ya.F. — collection and processing of material;
Strozenko L.A. — statistical processing; 
Mikheeva N.M., Zverev Ya.F. — text writing;
Zverev Ya.F., Strozenko L.A., Lobanov Yu.F. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

The study protocol was approved by the local ethics committee. The patients’ parents gave written voluntary informed consent to participate in the study.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: March 29, 2021
Accepted: April 22, 2021
Published: May 14, 2021

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