Abstract
Renal disease is a common complication of IDDM. The pathogenesis is believed to be microvascular and to increase with duration of IDDM. Hypercalciuria causes renal dysfunction and has been reported in children with IDDM. A group of children (157) with IDDM had urine and blood collected after a 10 hour fast. Thirty-seven age similar non-diabetic (ND) subjects were controls. Urine calcium (Ca), phosphate (PO4) and creatinine (Cr) were measured. The Ca/Cr and PO4/Cr ratios were calculated as an indicator of urinary excretion. IH (definition: Ca/Cr 2 SD>mean for ND) was found in 45 (29%) of the IDDM subjects (6% prevalence in ND children). PO4/Cr in IDDM (1.2±0.06) was greater than ND (0.72±0.08) p<0.002. Ca/Cr correlated with PO4/Cr in subjects with IDDM while no relationship was found in ND. Ca/Cr correlated both with coincident serum glucose (r=0.34, p<0.001) and glycosylated hemoglobin (r=0.25 p<0.001) but was not related to duration of diabetes or the current insulin dose. Both Ca/Cr and PO4/Cr correlated inversely with serum PO4 in IDDM; serum PO4 correlated directly with PO4/Cr but was not related to Ca/Cr in ND. PTH levels in ND and IDDM children were normal.
Conclusion:1) a defect in tubular reabsorption of Ca and P exists in IDDM that is related to blood glucose concentration; 2) the ion product of Ca3(PO4)2 in the urine of (29%) IDDM children exceeds the solubility constant and is 3 times that of the ND children; 3) IH may be a cause, previously unrecognized, of some renal complications of IDDM.
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Malone, J., Lowitt, S., Duncan, J. et al. 1231 IDIOPATHIC HYPERCALCIURIA (IH): A POTENTIAL CAUSE OF RENAL DISEASE IN CHILDREN WITH INSULIN DEPENDENT DIABETES MELLITUS (IDDM). Pediatr Res 19, 316 (1985). https://doi.org/10.1203/00006450-198504000-01261
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DOI: https://doi.org/10.1203/00006450-198504000-01261