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Urinary calcium and uric acid excretion in children with UTI having vesicoureteral reflux
Sufia Khatun1, Md Habibur Rahman2, Ishrat Jahan3, Rezwana Ashraf4, SK M Nazmul Hasan5, Nayema Afroje6, Abdullah Al Mamun2, Mohammad Maajharul Islam7, Rezaul Karim8
1 Department of Biochemistry, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
2 Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3 Department of Pediatric Nephrology, Dhaka Medical College, Dhaka, Bangladesh
4 National Institute of Kidney Diseases & UrologyDhaka, Dhaka, Bangladesh
5 Department of Hepatology, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
6 Department of Gynaecology and Obstetrics, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
7 Department of Pediatric Nephrology, Potokhali Medical College Hospital, Patuakhali, Bangladesh
8 Department of General Pediatrics, Cumilla Diabetic Hospital, Comilla, Bangladesh
Correspondence Address:
Dr. Sufia Khatun
Department of Biochemistry, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Dhaka
Bangladesh
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/pnjb.pnjb_19_21
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Introduction: Patients with urinary tract infection (UTI) associated with vesicoureteric reflux (VUR) are prone to develop hypercalciuria and hyperuricosuria compared with UTI patients without VUR, which may lead to the formation of stones due to stasis, infection, and inflamed urinary mucosa. Objective: To assess calcium and uric acid excretion in children with VUR and without VUR having a history of treatment for UTI. Materials and Methods: This cross-sectional and analytical study was conducted in the Department of Paediatric Nephrology and Urology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Sixty-one children of both sex from 2 months to 12 years were treated for UTI 4 weeks prior to enrollment for the study and evaluated by micturating cystourethrogram taking all precautionary measures to detect VUR. Patients were grouped into Group A (30 patients with VUR) and Group B (31 patients without VUR). Fasting urine was analyzed for calcium/creatinine (Ca/Cr) and uric acid/creatinine (UA/Cr) ratios. Urinary calcium and urinary uric acid levels were determined by the colorimetric test, and urinary creatinine was measured by the clinical risk and error analysis method by using the Dimension RxL Max System (SIEMENS) of both groups of patients in the Department of Biochemistry, BSMMU. Results: Median (min–max) of Ca/Cr ratio was 0.207 (0.034–0.646) and 0.150 (0.090–0.500) in Group A and Group B, respectively, and the difference between these two groups was statistically significant (P < 0.050). Median (min–max) of UA/Cr ratio was 0.972 (0.307–1.951) and 0.616 (0.500–1.390) in Group A and Group B, respectively, and the difference between these two groups was also statistically significant (P < 0.050). Hypercalciuria was significantly higher in Group A (20.0%) than in Group B (3.2%; P < 0.050). Similarly, hyperuricosuria was significantly higher in Group A (33.3%) than in Group B (6.5%; P < 0.05). Conclusion: Children with VUR having UTI may have a higher level of hypercalciuria and hyperuricosuria than those without VUR. |
