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Vol. 63. Issue 6.
Pages 475-479 (1 December 2005)
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Vol. 63. Issue 6.
Pages 475-479 (1 December 2005)
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Estudio de la morfología y la función renal en niños diagnosticados de enuresis nocturna. Su relación con la sensibilidad o la resistencia a la desmopresina
Study of renal morphology and function in children with nocturnal enuresis. Relationship with sensitivity or resistance to desmopressin
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C.L. Marrero Pérez, V. García Nieto
Corresponding author
vgarcia@comtf.es

Correspondencia: Dr. V. García Nieto. Unidad de Nefrología Pediátrica. Hospital Universitario Nuestra Señora de Candelaria. Ctra. del Rosario, s/n. 38010 Santa Cruz de Tenerife. España.
, M.I. Luis Yanes
Unidad de Nefrología Pediátrica. Hospital Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife. España
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Antecedentes

En los últimos años, se ha descrito que, con frecuencia, los niños con enuresis nocturna presentan hipercalciuria. Así mismo, se acaba de comunicar que los niños con enuresis nocturna resistente a desmopresina tienen una capacidad de concentración renal superior a la de aquellos pacientes con enuresis sensible a ese fármaco.

Objetivos

Estudiar la función renal y la eliminación urinaria de calcio y registrar los antecedentes familiares de enuresis y de litiasis en un grupo de niños enuréticos respondedores y resistentes a desmopresina controlados en nuestro hospital.

Material y métodos

Cohorte de 60 pacientes, 42 varones y 18 mujeres, que fueron remitidos al hospital por padecer enuresis nocturna.

Resultados

Se detectó hipercalciuria en 26 niños (43,3 %) e hipocitraturia en ocho (13,3 %). La frecuencia de hipercalciuria fue superior en los pacientes resistentes con respecto a los sensibles a desmopresina, sin diferencias estadísticamente significativas. En 11 niños se detectaron anomalies morfológicas ecográficas renales. No se comprobaron diferencias en el manejo renal del agua al distribuir a los pacientes según el grado de sensibilidad a la desmopresina.

Conclusiones

En nuestra serie se demuestra la elevada frecuencia de hipercalciuria en niños con enuresis nocturna. No observamos diferencias en la osmolalidad urinaria maxima entre los niños sensibles y los resistentes a la desmopresina.

Palabras clave:
Enuresis nocturna
Hipercalciuria
Urolitiasis
Herencia
Desmopresina
Background

In the last few years, there have been reports that children with nocturnal enuresis frequently have hypercalciuria.Likewise, children with desmopressin-resistant enuresis have recently been reported to have a higher renal concentration capacity than patients with desmopressinsensitive enuresis.

Objectives

To study renal function and urinary calcium excretion and to register familial history of enuresis and urolithiasis in a group of children with enuresis, whether responders or nonresponders to desmopressin, followed-up in our hospital.

Material and methods

A cohort of 60 patients (42 boys and 18 girls) who were referred to the hospital because of nocturnal enuresis.

Results

Hypercalciuria was detected in 26 children (43.3 %) and hypocitraturia in eight (13.3 %). The frequency of hyper-calciuria was higher in desmopressin-resistant patients than in desmopressin-sensitive patients, but this difference was not statistically significant. Sonographic renal morphological anomalies were detected in 11 children (18.3 %). No differences in renal handling of water were detected when the patients were distributed according to the grade of sensitivity to desmopressin.

Conclusions

In our cohort we found a high frequency of hypercalciuria in children with nocturnal enuresis. No differences were observed in maximal urinary osmolality among desmopressin-resistant and desmopressin-sensitive children.

Key words:
Nocturnal enuresis
Hypercalciuria
Urolithiasis
Inheritance
Desmopressin
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Bibliografía
[1.]
T. Nevéus, G. Läckgren, T. Tuvemo, J. Hetta, K. Hjälmas, A. Stenberg.
Enuresis. Background and treatment.
Scand J Urol Nephrol, (2000), pp. 1-44
[2.]
T. Nevéus, G. Lackgren, T. Tuvemo, U. Olsson, A. Stenberg.
Desmopressin resistant enuresis: Pathogenetic and therapeutic considerations.
J Urol, 162 (1999), pp. 2136-2140
[3.]
D.A. Eller, Y.L. Homsy, P.F. Austin, S. Tanguay, A. Cantor.
Spot urine osmolality, age and bladder capacity as predictors of response to desmopressin in nocturnal enuresis.
Scand J Urol Nephrol, 183 (1997), pp. 41-45
[4.]
T. Nevéus.
Oxybutynin, desmopressin and enuresis.
J Urol, 166 (2001), pp. 2459-2462
[5.]
J.S. Melián, V. García Nieto, A.M. Sosa.
Herencia y prevalencia de hipercalciuria en la población infantil de la isla de La Gomera.
Nefrología, 20 (2000), pp. 510-516
[6.]
F.B. Stapleton, R.L. Kroovand.
Stones in childhood.
Kidney stones Medical and surgical management, pp. 1065-1080
[7.]
F.B. Stapleton.
Childood stones.
Endocrinol Metab Clin North Am, 31 (2002), pp. 1001-1015
[8.]
V. García Nieto, F. Santos.
Pruebas funcionales renales.
Nefrología pediátrica, pp. 15-25
[9.]
V. García Nieto, M. Monge Zamorano, M.I. Luis Yanes.
Polidipsia y poliuria en la infancia.
Protocolos diagnósticos y terapéuticos en pediatría. Nefrología, pp. 201-207
[10.]
A. García, A. Morera, M. Muros, V. García.
Incidencia del defecto de la capacidad de concentración en la infancia.
An Esp Pediatr, 21 (1984), pp. 160-161
[11.]
S.D. Mark, J.D. Frank.
Nocturnal enuresis.
Br J Urol, 75 (1995), pp. 427-434
[12.]
H.K. Schaumburg, S. Ritig, J.C. Djurhuus.
No relationship hipercalciuria between family hipercalciuria history of enuresis and response to desmopressin.
J Urol, 166 (2001), pp. 2435-2437
[13.]
J.P. Norgaard, S. Rittig, J.C. Djurhuus.
Nocturnal enuresis: an approach to treatment based on pathogenesis.
J Pediatr, 114 (1989), pp. 705-710
[14.]
S. Wille, M. Aili, A. Harris, S. Aronson.
Plasma and urinary levels of vasopressin in enuretic and non-enuretic children.
Scand J Urol Nephrol, 28 (1994), pp. 119-122
[15.]
T. Nevéus, T. Tuvemo, G. Lackgren, A. Stenberg.
Bladder capacity and renal concentrating ability in enuresis: pathogenic implications.
J Urol, 165 (2001), pp. 2002-2005
[16.]
E.S. Moore, F.L. Coe, B.J. McMann, M.J. Favus.
Idiopathic hypercalciuria in children: Prevalence and metabolic characteristic.
J Pediatr, 92 (1978), pp. 906-910
[17.]
S. Roy, F.B. Stapleton, H.N. Noe, G. Jerkins.
Hematuria preceding calculus formation in children with hypercalciuria.
J Pediatr, 99 (1981), pp. 712-715
[18.]
A. Kalia, L.B. Travis.
The association of idiopathic hypercalciuria and asymptomatic gross hematuria in children.
J Pediatr, 99 (1981), pp. 716-719
[19.]
E.S. Moore.
Hypercalciuria un children.
Karger, (1981),
[20.]
U. Alon, B.A. Warady, S. Hellerstein.
Hypercalciuria in the frequency-dysuria syndrome of childhood.
J Pediatr, 116 (1990), pp. 103-105
[21.]
J.W. Brock 3rd.
The frecuency and frecuency dysuria syndromes of childhood: Hypercalciuria as a possible etiology.
Urology, 44 (1994), pp. 411-412
[22.]
V. García Nieto, M. Monge Zamorano, E. Sánchez Almeida, M. García García, D. Castro Díaz.
Polaquiuria e hipercalciuria idiopática de la infancia.
Arch Esp Urol, 48 (1995), pp. 1017-1021
[23.]
D.J. Parekh, I.V. Pope JC, M.C. Adams, J.W. Brock 3rd.
The role of hypercalciuria in a subgroup of dysfunctional voiding syndromes of childhood.
J Urol, 164 (2000), pp. 1008-1010
[24.]
P. Vachvanichsanong, M.C. Malagon, E.S. Moore.
Urinary incontinence due to idiopathic hypercalciuria in children.
J Urol, 152 (1994), pp. 1226-1228
[25.]
V. García Nieto, D. Castro Díaz, J.L. Gómez de la Rosa.
Urodynamics and hypercalciuria.
J Pediatr, 117 (1990), pp. 838
[26.]
B. Fivush.
Irritability and dysuria in infants with idiopathic hypercalciuria.
Pediatr Nephrol, 4 (1990), pp. 262-263
[27.]
A. Cervera, M.J. Corral, F.J. Gómez Campdera, A.M. De Lecea, A. Luque, J.M. López Gómez.
Idiopathic hypercalciuria in children. Classification, clinical manifestations and outcome.
Acta Paediatr Scand, 76 (1987), pp. 271-278
[28.]
V. García Nieto, M. Muros de Fuentes, M. Quintero Quintero, J.L. Gómez de la Rosa.
Estudio de la clínica de presentación de la hipercalciuria idiopática en la infancia.
Act Pediatr Esp, 49 (1991), pp. 413-416
[29.]
G. Pace, G. Aceto, L. Cormio, A. Traficante, A. Tempesta, M.L. Lospalluti, et al.
Nocturnal enuresis can be caused by absorptive hypercalciuria.
Scand J Urol Nephrol, 33 (1999), pp. 111-114
[30.]
S. Wille.
Functional bladder capacity and calcium-creatinine quota in enuretic patients, former enuretic and non enuretic controls.
Scand J Urol Nephrol, 28 (1994), pp. 353-357
[31.]
T. Nevéus, P. Hansell, A. Stenberg.
Vasopressin and hypercalciuria in enuresis: A reapprasisal.
BJU Int, 90 (2002), pp. 725-729
[32.]
G. Valenti, A. Laera, G. Pace, G. Aceto, M.L. Lospalluti, R. Penza, et al.
Urinary aquaporin 2 and calciuria correlate with the severity of enuresis in children.
J Am Soc Nephrol, 11 (2000), pp. 1873-1881
[33.]
G. Valenti, A. Laera, S. Gouraud, G. Pace, G. Aceto, R. Penza, et al.
Low-calcium diet in hypercalciuric enuretic children restores AQP2 excretion and improves clinical symptoms.
Am J Physiol Renal Physiol, 283 (2002), pp. F895-903
[34.]
G. Aceto, R. Penza, M.S. Coccioli, F. Palumbo, L. Cresta, M. Cimador, et al.
Enuresis subtypes based on nocturnal hypercalciuria: A multicenter study.
Copyright © 2005. Asociación Española de Pediatría
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