Metabolic risk factors in children with asymptomatic hematuria Francisco Rodolfo Spivacow, Elisa Elena del Valle, Paula Gabriela Rey Dr.shater, Dr.razavi

2. METABOLIC RISK FACTORS IN CHILDREN WITH
ASYMPTOMATIC HEMATURIA
Francisco Rodolfo Spivacow, Elisa Elena del Valle, Paula Gabriela Rey
Dr.Mohammad Reza Razavi
Dr.Mohammad Mahdi Shater

3. INTRODUCTION
• Hematuria is one of the most common genitourinary abnormalities in children
• clinical presentations
• associate signs and/or symptoms , past medical history, family history
• Idiopathic or benign hematuria
• Some of these patients may subsequently suffer from kidney stones with
hypercalciuria , hyperuricosuria , or hyperoxaluria , with most of these having a
positive family history of urolithiasis

4. INTRODUCTION
• The aim of this study was to evaluate the clinical presentation, family history, and
metabolic risk factors of 60 children with asymptomatic hematuria without kidney
stones

5. PATIENTS & METHODS
• retrospective and cross-sectional analysis
• patients under 16 years of age who were referred to our institution between 1996
and 2012 for evaluation of metabolic risk factors
• referred to our institution by pediatric nephrologists and came from the general
population
• Negative for any explained cause of hematuria(PMH, DH ,…)
• Family history of kidney stones

6. PATIENTS & METHODS
• Sampling
• Blood sample
• Urine sample
Hypercalciuria (HC), i.e., excretion of >4 mg/kg/day urinary
calcium
Hyperoxaluria (OX), i.e., overproduction of oxalate
[>50 mg/1.73 m2 body surface area (BSA)/day] in the
kidneys
Hypocitraturia (CiT), i.e., urinary excretion of <400 mg
citrate/g creatinine
Hypomagnesuria (MG), i.e. urinary excretion of
<1.24 mg magnesium/kg body weight/day
Hyperuricosuria (HU), i.e., urinary excretion of excess
amounts of uric acid (>815 mg/1.73 m2 BSA/day).

7. RESULTS
• Study
• Family history of renal stone
• At least one urinary metabolic abnormality was present in 49 patients, while 11
patients had no metabolic abnormality.
• Befor metabolic study

8. RESULTS
• Single urinary metabolic risk factors

9. RESULTS
• Multiple urinary metabolic risk factors

10. RESULTS
• The most common urinary risk factor was idiopathic hypercalciuria (single or
associated), which was found in 43.5 % of patients, followed by hypocitraturia
(single or associated), present in 31.7 %. Unduly acidic urine pH as a single
abnormality was found in 10 % of this pediatric patient population.

11. RESULTS
• Metabolic risk factors in children with hematuria and in pediatric kidney stone-
formers

12. CONCLUSIONS
• Asymptomatic idiopathic hematuria in pediatric patients may often be associated to
different urinary biochemical abnormalities, similar to what is observed in pediatric
kidney stone-formers.
• Long-term monitoring of children with hematuria and metabolic disorders may
clarify the true association with kidney stone disease.
• Finally, hematuria of unknown etiology demands a biochemical risk factor
evaluation that allows definition of its cause and treatment