PO-0789 Impact Of Hypercalciuria In Paediatric Recurrent Urinary Tract Infection

Abstract

Discussion The progressive increase in patients supported with this therapy mirrors its remarkable growth internationally. CVVH is the most dominant form of artificial renal support in Australian and European critical care, and its role as adjuvant therapy in sepsis is attracting increased focus. 3Conclusion CVVH activity is increasing at our institution, facilitated by a competent and flexible team of CVVH specialists. Future adequately powered multivariate logistic regression analysis should address outcomes of patients supported on CVVH. Background Hypercalciuria has been considered as a predisposing factor for recurrent urinary tract infection (UTI) in recent studies. The mechanism may be related to uroepithelial injury by calcium microcrystals. The aim of this study was to evaluate the association of idiopathic Hypercalciuria with recurrent UTI in children. Methods In this analytic study urine calcium:creatinine ratio of 40 children at the age of 2-16 years with recurrent urinary tract infection (without urinary tract anomalies and voiding dysfunction) was compared with 40 age and sex matched healthy children. Calcium:creatinine ratio more than 0.2 in a spot urine test was considered as hypercalciuria. Cases with hypercalcemia were excluded from the study. Recurrent UTI was defined as at least 3 episodes of UTI during 1 year or 2 episodes in 6 months. Results Mean age of patients was 5 ± 2.22 years and mean age of control group was 5.13 ± 1.98 years. The mean calcium:creatinine ratio in case group (0.21 ± 0.17) was significantly higher than control group (0.08 ± 0.08) (p < 0.05). Hypercalcuria was detected in nineteen out of forty patients in case group (47.5%) and in 7.5% of control group (p < 0.001). History of familial urolithiasis was positive in 21% of hypercalciuric patients. There was not any significant difference in frequency of urinary symptoms between hypercalciuric and normocalciuric patients with recurrent UTI. Conclusion Children who suffer from recurrent UTI in spite of absence of urinary tract anomalies should be checked for hypercalciuria. Control of hypercalciuria with low salt regimen and high fluid intake and treatment with hydrochlorothiazide may decrease UTI episodes. PO-0789

The Efficacy and Safety Of Using Hydrochlorothiazide As Adjuvant Therapy In Pediatric Urinary Tract Infections

“…One group received general preventive instructions for UTI and the other group received hydrochlorothiazide in addition to preventive instructions. They found that the recurrence rate of UTI was ((66%)) in both groups (16).The beneficial effect of hypercalciuria treatment in reducing the episodes of UTI needs to be more accurately studied and attention should be paid to eliminating other contributing factors (17).In our study, ((15.2%)) of the patients had recurrent UTI, ((0.6%)) had renal scar and ((1.9%)) of the patients died during treatment (mainly neonates) because of progression of the disease to sepsis and 2 neonates died because of respiratory problems. Sheikh N. study found that approximately ((15%)) of children with UTI had renal scarring post infection and the likelihood of complications increases in children with upper UTI, recurrent UTI, vesicoureteral reflux or undiagnosed UTI.…”