Dicle ŞENER, Şeyma EKMEKÇİ, Ahmet NAYIR, Sema CANTEZ

Renal Hiperkalsiürili Çocuklar ve Ebeveynlerinde Hipertansiyon Riski

Amaç: Hiperkalsiürili çocuklar ve ebeveynlerinde sessiz seyreden hipertansiyon riskini araştırmak.Gereç ve Yöntem: Hiperkalsiüri tanısıyla takipli, 3-10 yaş arası 20 çocuk ve ebeveynleri çalışmaya kabul edildi. Çocukların ve ebeyenlerinin 24 saatlik arteriyel kan basınçları holter cihazı ile ölçüldü. Vakaların böbrek fonksiyon testleri, serum elektrolitleri, serum alkalen fosfataz, kalsiyum, fosfor, parathormon, osteokalsin, kalsitriol düzeyleri, idrar kalsiyum/kreatinin, 24 saatlik idrar kalsiyum atılımları incelendi. Çocukların ve ebeyenlerinin kemik yoğunluk ölçümleri yapıldı.Bulgular: Çocuklar sistolik kan basınçlarına göre; %15 hipertansif, %60 prehipertansif; diyastolik kan basınçlarına göre %30 prehipertansif bulundu. Annelerin %15’i prehipertansif, babaların da %10’u hipertansif, %40’ı prehipertansifti. Çocuklarda hipertansiyon riskinin, hiperkalsiüri derecesinden bağımsız olarak arttığı görüldü. Hiperkalsiürili çocuklarda ve ebeveynlerinde, kemik yoğunlukları incelendiğinde babaların femur boynu kemik mineral yoğunlukları ile gündüz ortalama sistolik, sabah erken ortalama sistolik, sabah erken ortalama diyastolik kan basınçları arasında negatif yönde ilişki saptandı. Hipertansiyon ve kemik metabolizması arasındaki bu ilişki, çocuklarda osteokalsin düzeyleri ile desteklendi. Sonuç: Hiperkalsiüri sistemik bir hastalık olarak kabul edilmeli, hastalar hipertansiyon ve osteoporoz riski açısından da yakından izlenmelidir

Anahtar Kelimeler:

Hiperkalsiüri, hipertansiyon, osteoporoz, osteokalsin, kalsiyum, fosfor, sodyum, urolithiazis

Risk of Hypertension in Children and Parents with Renal Hypercalciuria

Aim: The aim of the study is to determine the risk of silent hypertension in children and parents with renal hypercalciuria Material and Method: 20 children diagnosed by Istanbul University Faculty of Medicine, Department of Pediatric Nephrology as renal hypercalciuria, and also their parents were included in the study. Their 24-hour blood pressures were measured with a Holter device. Renal function tests, serum electrolyte values, alkaline phosphatase, calcium, phosphorus, parathormone, osteocalcine, calcitriol levels, urinary calcium / creatinin Ca/Cr ratios and daily urinary calcium excretions were investigated. Bone density measurements of children and parents were done.Results: According to the total average systolic blood pressure, the children were categorized as hypertensive 15 % , and prehypertensive 60 % . According to the total average diastolic blood pressures, they were categorized as prehypertensive 30 % , while 15 % of mothers and 10 % of fathers were hypertensive, and 40 % of them were prehypertensive We determined increased risk of hypertension in children with renal hypercalciuria, regardless of the degree of hypercalciuria. When bone densities of children and parents with hypercalciuria were investigated, we found a negative correlation between father’s femoral neck bone mineral density and their daytime average systolic, early morning average systolic and early morning average diastolic blood pressures. The relationship between hypertension and bone metabolism was supported by osteocalcin levels in the pediatric group. Conclusion: Renal hypercalciuria must be seen as a systemic disorder and patients shoud be followed regarding hypertension and osteoporosis

Keywords:

Renal hypercalciuria, hypertension, osteoporosis, osteocalcin, calcium, phosphorus, sodium, renal calculi,

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