Should We Screen Preterm Infants for Nephrocalcinosis? An Evidence-based Decision

Shahirose S Premji; Majeeda Kamaluddeen

Disclosures

Pediatr Health. 2010;4(1):24-35. 

In This Article

Hypercalciuria

Hypercalciuria, defined as an increased urinary calcium:creatinine ratio, was noted in those developing nephrocalcinosis.[2,6,26,28] Premature infants with nephrocalcinosis compared with those without nephrocalcinosis had a significantly higher urinary calcium:creatinine ratio at 2 weeks,[4] 4 weeks,[6] from 2 to 6 weeks of life,[16] at term,[6] and at study age (4.7 ± 1.1 years).[26] Differences in urinary calcium:creatinine ratio reported between infants with and without nephrocalcinosis did not persist over time in some studies.[4,16] Higher urinary calcium:creatinine ratio noted in infants with nephrocalcinosis in some studies was not found in other studies reporting findings at various ages.[3,17,27,29] Since both premature infants with and without nephrocalcinosis have calcium:creatinine ratios indicative of hypercalciuria,[29] or abnormal calcium load test,[27] it has been inferred that prematurity is a risk factor for nephrocalcinosis;[16,26,29] however, those without nephrocalcinosis demonstrate improvement while those who develop nephrocalcinosis show an increase in renal calcium excretion.[16] One can surmise that preterm infants may have a natural tendency for hypercalciuria, or alternatively, hypercalciuria may be an adverse consequence of nephrocalcinosis.[30]

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