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      Study of Renal Metabolic Disturbances Related to Renal Lithiasis at School Age in Very-Low-Birth-Weight Children

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          We studied 34 asymptomatic children who were born with a very-low-birth-weight (VLBW) and had no perinatal history of acute renal failure nor treatment with furosemide. The study was done at preschool or school age, looking for echographic changes and renal tubular disturbances which are known to predispose to renal lithiasis. The results were compared with those of a control group of 18 children who had been born at term with a body weight >2,500 g. One or more renal tubular disturbances were found in 64.70% of the VLBW children. Most frequently found were decreased ammonium excretion in response to furosemide (38.23%), enhanced N-acetylglucosaminidase excretion (35.29%), hypercalciuria (26.47%), and hypocitraturia (23.53%). Echography revealed renal cortical hyperechogenicity (17.65%) and renal lithiasis (8.82%) in some of the VLBW children. We found a significant positive correlation (r = 0.7) between the perinatal level of plasma phosphate and the total amount of H<sup>+</sup> excreted in response to furosemide at preschool or school age. Because these renal tubular anomalies may be precursors of future lithiasis, and the renal function and echography tests are not invasive, we suggest that renal tubular function be measured and followed up in every VLBW child, particularly when perinatal hypophosphatemia has occurred.

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          Author and article information

          S. Karger AG
          July 1998
          22 June 1998
          : 79
          : 3
          : 269-273
          a La Laguna University, San Cristóbal de la Laguna, b Pediatric Nephrology Unit, c Clinical Laboratory, and d Neonatology Unit, Nuestra Señora de la Candelaria Hospital, Santa Cruz de Tenerife, Spain; e Albert Einstein College of Medicine, New York, N.Y., USA
          45048 Nephron 1998;79:269–273
          © 1998 S. Karger AG, Basel

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