Hypercalciuria in Children
Hypercalciuria means there are high levels of calcium in the urine. This can be checked on a single urine sample, but is best checked with a 24-hour urine test. The high level of calcium in the urine is often caused by increased absorption or a defect of the kidneys. Increased levels of urine calcium can cause kidney stones.
Hypercalciuria is treated by bringing the urine calcium to normal levels. This lowers the risk of getting kidney stones.
1. As part of your child's work-up, we will do blood tests and we may suggest a 24-hour urine to test for risk factors leading to kidney stones. The results of this test will help us plan further treatment. We will also do 24-hour urine tests 2 to 4 times a year to watch the level of calcium in the urine.
2. A kidney (renal) ultrasound and abdominal x-ray (KUB) will be ordered to look for kidney stones. These tests will be done every 12 to 18 months.
3. Diet is a very big part of the treatment to lower calcium in the urine. Increased fluids, low salt, and a normal intake of calcium are key. You should read food labels so you have a better idea of what your child is eating and drinking. Our pediatric kidney nutritionist will be talking with you about your child's eating habits and how you can help adjust your child's diet.
Increasing fluids. Kidney stones are more likely to form in urine that is concentrated. By drinking more, your child's urine will become more dilute. This will lower the risk of stones forming.
The goal for your child is to drink ___________oz. of water/fluids each day. It is best to drink water, but all fluids count. Some children use water bottles to remind them to drink. You may need to tell your child's teacher that your child needs to drink a lot of water and may also need bathroom breaks more often.
Decreasing salt. The salt (sodium) in the urine is linked to calcium. If the amount of salt in the diet is lowered, the amount of calcium in the urine will also be lower.
The goal for your child is to have no more than _____________mg of sodium a day. You can start by not having a saltshaker on the table and not adding any salt to food you cook at home. You will also need to be aware of how much salt is in the foods you buy. Many foods come in low or no-salt options that can be used in cooking. Our kidney nutritionist can talk with you about how you can lower the salt in your child's diet. Here are some foods that are high in salt:
- processed meats (sandwich meat, hot dogs, Lunchables®)
- canned soups
- tomato sauce
Eating the right amount of calcium. Your child's high urine calcium levels are not caused by eating too much calcium. In fact, because your child is losing calcium in the urine, most of this comes from the bones. We want to be sure that your child takes in enough calcium in his daily diet, but not more than is needed. The goal for your child is to have _______mg of calcium a day.
4. Drugs are often used if your child has a kidney stone or if the level of calcium in the urine is high and does not come down with fluid and diet changes alone. Diuretics are the most common types of drugs used.
Diuretics. Moduretic or Hydrochlorothiazide are diuretics we often use. These drugs help to lower the amount of calcium in the urine. For 2-6 hours after taking the drug, your child will have to go to the bathroom more often. The kidneys will lose more potassium with the use of these drugs. Because of this effect, we suggest you increase the potassium in your child's diet. We will be checking the level of your child's potassium about 2 weeks after starting the diuretic.
Potassium. Our kidney nutritionist will talk with you about how you can increase potassium in your child's diet. Some foods to include:
- melons (watermelon, cantaloupe)
If your child's potassium level is low, we may prescribe a supplement such as Polycitra-K or Urocit-K. These contain citrate which also helps protect the kidneys from kidney stones. We will keep track of the level of potassium through blood tests.
We will keep track of your child's hypercalciuria and risk for kidney stones with 24-hour urine tests, x-rays, and clinic visits. If your child has pain with urination, new pain in the back or stomach, or you see blood in your child's urine, call your child's doctor or our clinic.
UW Pediatric Nephrology Clinic
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 06/19/2013
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