J Korean Pediatr Soc.  1994 Mar;37(3):322-331.

Hypercalciuria in High Risk Neonates

• Kim ES
• Lee SJ

Abstract

The incidence and risk factors for hypercalciuria were studied in 23 sick preterm (Group I), 36 well preterm (Group II), 16 sick term(Group III)and 41 well term(Group IV) neonates who were admitted to NICU and nursery of Ewha Woman's University Hospital from May 1988 to February 1992. The results were as follws: 1) The incidences of hypercalciuria were 73.9% in sick preterm (Group I) and 56.3% in sick term (Group III) which were significantly higher than 13.9% of control preterm (Group II) and 7.3% of control term (Group IV). Maximal urinary Ca/Cr ration were 0.63+/-0.503 in group I and 0.50+/-0.513 in group III, significantly higher than 0.19+/-0.142 of control term and 0.17+/-0.131 of control term. 2) In sick neonates with hypercalcuria, birth wight and gestational age were significantly lower and the frequencies of frosemide and intravenous calcium therpy were significantly higher than those of sick neonates without hypercalciuria. 3) In sick neonates, furosemide increased the incidence of hypercalciuria to 90.9%, significantly higher than 57.1% in neonates without furosemide. Maximal urine Ca/Cr ratio 24 hour urine calcium were also significantly higher in neonates with furosemide than those of neonates without furosemide. 4) In sick neonates, intravenous calcium gluconate increased the incidence of hypercalciuria to 86.6%, significantly higher than 54.2% in neonates without intravenous calcium. Maximal urine Ca/Cr ratio and 24 hour urine calcium were also significantly higher in neonates treated with IV calcium than those of neonates without IV calcium. 5) Calcium intake and maximal random urine Ca/Cr ratio were positively correlated (r=0.46, p=o.037). In conclusion, the majority of sick newborns in our intensive care unit were hypercalciuric. Sick condition, premature, furosemide and intravenous calcium gluconate were the risk factors that could lead to hypercalciuria. Use of these agents in sick neonates especially preterm neonates requires careful monitoring of urine calcium excretion.

MeSH Terms

Calcium
Calcium Gluconate
Furosemide
Gestational Age
Humans
Hypercalciuria*
Incidence
Infant, Newborn*
Intensive Care Units
Nurseries
Parturition
Risk Factors
Calcium
Calcium Gluconate
Furosemide