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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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Copyright © 2005. Asociación Española de Pediatría
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