Body weight changes in children with idiopathic nephrotic syndrome.

BACKGROUND: Aim of the study was to evaluate factors affecting body mass change in children with idiopathic nephrotic syndrome (INS) during 6-months treatment of initial disease bout with glucocorticoids (GC). MATERIAL AND METHODS: We studied 31 children with INS (22♂, 9♀, 3.6±1.8 years) treated during 6 months with GC due to initial INS bout and 31 control healthy children (18♂, 13♀, 4.0±1.8 years). Following factors were evaluated: body mass, body mass index (BMI), BMI Z-score, gender, age, gestational age at birth, birth weight, GC dose, parental age and BMI, time spent for TV/computer, physical activity, place of residence. RESULTS: Mean initial BMI Z-score was 0.35±1.1 in children with INS and -0.11±1.5 in the control group, after 6 months 0.8±1.2 (P=0.049) and 0.07±1.5 (P=0.629), respectively. Δ0-6 BMI Z-score correlated with initial BMI Z-score (r=-0.45, P=0.001), maternal age (r=0.38, P=0.04), and paternal BMI (r=0.51, P=0.0037). CONCLUSIONS: 1. Initial 6-month GC therapy may result in body mass increase in children with INS. 2. Risk factors for body mass increase in children with INS during the first 6 months of therapy include low initial BMI, older maternal age and paternal obesity.

BONE MINERAL DENSITY IN CHILDREN WITH IDIOPATHIC HYPERCALCIURIA.

UNLABELLED: The aim of the study was to evaluate bone mineral density (BMD) in the lumbar spine in children with idiopathic hypercalciuria. PATIENTS AND METHODS: The study group included 31 children (14 boys, 17 girls) aged 5 to 17 years (mean age 9.8 ± 4.0 years) with idiopathic hypercalciuria. All children remained on normal calcium diet, without vitamin D and citrate supplementation. We evaluated lumbar spine (L1-L4) BMD (L1-L4 BMD) (expressed as Z-score) and blood serum levels of 25-hydroxyvitamin D3 (250HD3), calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and intact parathormone (iPTH). We also evaluated 24-hour urinary Ca, P, and sodium (Na) excretion. RESULTS: Reduced L1-L4 BMD Z-score <-1 was found in 25.8% of children, Z-score values from -1 to 1 in 64.5% of children, and Z-score > 1 in 9.7% of children. Reduced 250HD3 level (< 20 ng/mL) was found in 71% of children, levels in the range of 20-30 ng/mL in 22.6% of children, and levels > 30 ng/mL in 6.4% of children. Seven out of 8 children with L1-L4 BMD Z-score <-1 were found to have 250HD3 deficiency (level < 20 ng/mL). Among children with reduced lumbar spine BMD, most were girls at the mean age of 13.8 years. Ca and P levels were normal in all children. We did not find significant differences in 25OHD3, Ca, and P levels in relation to gender and age. We found a positive correlation between L1-L4 BMD Z-score and serum 250HD3 level. Concomitant nephrolithiasis was found in 50% of patients with reduced lumbar spine BMD. CONCLUSIONS: Reduced lumbar spine BMD in patients with idiopathic hypercalciuria seems to be related to vitamin D3 deficiency.

[False positive urine cultures in children under two years of age - own research].

INTRODUCTION: The basis of the diagnosis of urinary tract infection in children is positive culture of properly collected urine sample. The reliability of the urine cultures depends on the method how the urine sample was taken and sometimes this may increase the risk of misdiagnosis. AIM OF THE STUDY: To determine the frequency of false positive urine cultures taken from midstream to a container or to a plastic collection bag in children under 2 years of age. MATERIAL AND METHODS: The study included 50 children (25 girls, 25 boys) aged 12 days to 24 months (mean age 7.26±6.51months) referred to the hospital with suspicion of urinary tract infection. The most frequent indications for urine analysis were: history of infection and/or abnormalities of urinary tract in 28 (56%) children, failure to thrive in 8 (16%) and fever in 6 (12%). Urine was taken from midstream to a container in 32 (64%) children and collected to a plastic bag in 18 (36%) children. RESULTS: Hospital verifications of urine cultures were performed by suprapubic puncture culture in 24 (48% children) or by catheterization of the urinary bladder in 26 (52%) children. Urinary tract infection was confirmed in 11 (34%) among 32 children who had positive culture of urine form midstream. None of the children with positive urine culture from a plastic collection bag had urinary tract infection confirmed by suprapubic puncture or catheterization. CONCLUSIONS: Correct method of urine collection for bacteriological tests in children under two years of life can avoid the misdiagnosis of urinary tract infection and following unnecessary hospitalization, imaging procedures as well as potentially harmful treatment.