scholarly journals The main ways of correcting idiopathic hypercalciuria in children

2021 ◽  
Vol 24 (2) ◽  
pp. 130-135
Author(s):  
Natalia M. Mikheeva ◽  
Yakov F. Zverev ◽  
Lyudmila A. Strozenko ◽  
Yuri F. Lobanov
Keyword(s):  
Fish Oil ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Idiopathic Hypercalciuria ◽  
Calcium Excretion ◽  
High Potassium ◽  
Second Stage ◽  
The Third ◽  
Low Sodium ◽  
Third Stage

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.

scholarly journals Renal Tubular Impairment in Children with Idiopathic Hypercalciuria

2006 ◽  
Vol 49 (2) ◽  
pp. 109-111 ◽  
Author(s):  
Sylva Skálová ◽  
Štěpán Kutílek
Keyword(s):  
Reference Data ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Idiopathic Hypercalciuria ◽  
Tubular Damage ◽  
Calcium Excretion ◽  
Spot Urine ◽  
Z Scores ◽  
Proximal Tubular ◽  
Renal Tubular

Idiopathic hypercalciuria (IH) is defined as hypercalciuria that persists after correction of dietary inbalances and has no detectable cause. The excretion of urinary N-acetyl-beta-D-glucosaminidase (U-NAG), a marker of proximal tubular damage, has been previously reported as either increased or normal in children with IH. We evaluated U-NAG in 20 children (13 boys and 7 girls, mean age 10.3 years ± 5.7 SD) with IH (urinary calcium excretion above 0.1 mmol/kg/24 hours, with no detectable cause) and with otherwise normal renal function tests. Ultrasound examination revealed urolithiasis (n = 4) and nephrocalcinosis (n = 1). The U-NAG values were evaluated in the spot urine collected from the second morning void and calculated as the urinary NAG/creatinine ratio (U-NAG/Cr) and expressed in nkat/mmol. The 24-hour urinary calcium excretion (U-Ca/24h) was assessed in a urinary sample from 24-hour collected urine and calculated in mmol/kg. The obtained results of U-Ca/24h and U-NAG/Cr were expressed as Z-scores. When compared to the reference data, the U-Ca/24h and U-NAG/Cr were significantly higher (p=0.0004 and p=0.006, respectively). There was no correlation between the U-NAG/Cr and U-Ca/24h (r = 0.18, p = 0.20). The U-NAG/Cr values were significantly higher in the 5 patients with urolithiasis/nephrocalcinosis, whether compared to the rest of the group (p=0.02), or to the reference data (p=0.01). The U-NAG/Cr activity was higher in 15 children without urolithiasis/nephrocalcinosis when compared to reference data (p < 0.01). There was no difference in U-Ca/24h between the children with and without urolithiasis/nephrocalcinosis (p = 0.58). These findings suggest that tubular impairment, as reflected by U-NAG/Cr, might occur in children with IH, especially in patients with urolithiasis/nephrocalcinosis. There doesn’t seem to be a direct relationship between the U-NAG/Cr activity and the degree of calcium leakage.

scholarly journals Efficiency of diet therapy in the treatment of idiopathic hypercalcuria in children

2019 ◽  
Vol 19 (2) ◽  
pp. 81-85
Author(s):  
Nataliya M. Mikheeva ◽  
Ya. F. Zverev ◽  
G. I. Vykhodtseva ◽  
Yu. F. Lobanov
Keyword(s):  
Diet Therapy ◽  
Urine Specific Gravity ◽  
Idiopathic Hypercalciuria ◽  
Calcium Excretion ◽  
Creatinine Ratio ◽  
High Potassium ◽  
Adequate Diet ◽  
Low Sodium ◽  
The Face ◽  
The One

Idiopathic hypercalciuria (IHC) is referred to a common metabolic disorders and considered to be the one of the main reasons for the development of nephrolithiasis. The aim of the study is to develop and evaluate the effectiveness of such adequate diet for the use in IHC children. Materials and Methods. The study included 44 children aged from 1 year to 14 years (10 boys and 34 girls, mean age: 5,1 ± 0,4 years) with revealed IHC at the level when calcium/creatinine ratio exceeded 0.6 mmol/mmol at normal levels of calcium and PTH in the blood plasma. Children with diagnosed ICH were prescribed a low sodium and high potassium diet with increased fluid intake for 3 months without additional medication. Results. Against the background of diet therapy 55,6% of children (10 people) reported a decrease in the face pastosity. In 10 out of 13 children (76,9%) with the previous oliguria the daily amount of urine increased significantly, which was accompanied by a decrease in urine specific gravity. Dysuric disorders were eliminated in 4 patients. In 3 months hematuria was not detected in the analysis of urine in 5 (50%) of children. Among the children who had a combination of some clinical and laboratory signs of the IHC, the complete elimination occurred in 71% of cases. The value of calcium/ creatinine ratio was normalized in 26 (59%) patients. Conclusion. Thus, the use of a diet with low sodium and elevated potassium content in conjunction with the increase in volume of consumed liquid within 3 months promotes both the disappearance of symptoms of IHC and normalization of calcium excretion in over 50% of children without prescription ofpharmaceuticals.

The Coherence of Mary Barton: Romance, Realism, and Utopia

2015 ◽  
Vol 5 (3) ◽  
pp. 185-200
Author(s):  
Robert Z. Birdwell
Keyword(s):  
Thomas Carlyle ◽  
The Novel ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Three Stages ◽  
Mode Of Production

Critics have argued that Elizabeth Gaskell's first novel, Mary Barton (1848), is split by a conflict between the modes of realism and romance. But the conflict does not render the novel incoherent, because Gaskell surpasses both modes through a utopian narrative that breaks with the conflict of form and gives coherence to the whole novel. Gaskell not only depicts what Thomas Carlyle called the ‘Condition of England’ in her work but also develops, through three stages, the utopia that will redeem this condition. The first stage is romantic nostalgia, a backward glance at Eden from the countryside surrounding Manchester. The second stage occurs in Manchester, as Gaskell mixes romance with a realistic mode, tracing a utopian drive toward death. The third stage is the utopian break with romantic and realistic accounts of the Condition of England and with the inadequate preceding conceptions of utopia. This third stage transforms narrative modes and figures a new mode of production.

How well do voice-hearing assessment measures capture the positive experiences of individuals?

2019 ◽  
Author(s):  
Lucy Armstrong ◽  
Lorna Hogg ◽  
Pamela Charlotte Jacobsen
Keyword(s):  
Systematic Review ◽  
Lived Experience ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Hearing Assessment ◽  
Positive Experiences ◽  
Assessment Measures ◽  
Stage 1 ◽  
The Voice

The first stage of this project aims to identify assessment measures which include items on voice-hearing by way of a systematic review. The second stage is the development of a brief framework of categories of positive experiences of voice hearing, using a triangulated approach, drawing on views from both professionals and people with lived experience. The third stage will involve using the framework to identify any positve aspects of voice-hearing included in the voice hearing assessments identified in stage 1.

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