The Experts below are selected from a list of 219 Experts worldwide ranked by ideXlab platform
Joaquin Escribano - One of the best experts on this subject based on the ideXlab platform.
-
Reduced bone mass in 7-year-old children with asymptomatic Idiopathic Hypercalciuria.
Annals of nutrition & metabolism, 2014Co-Authors: Joaquin Escribano, Natalia Ferre, Carmen Rubio-torrents, Veronica Luque, Veit Grote, Marta Zaragoza-jordana, Mariona Gispert-llauradó, Ricardo Closa-monasteroloAbstract:Background: Idiopathic Hypercalciuria (IHC), i.e. an elevated urinary calcium excretion without concomitant hypercalcemia, is a common disorder in children and ca
-
dietary interventions for preventing complications in Idiopathic Hypercalciuria
Cochrane Database of Systematic Reviews, 2014Co-Authors: Joaquin Escribano, Albert Balaguer, Albert Feliu, Marta Roque I Figuls, Natalia FerreAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality that is characterised by excessive amounts of calcium excreted in the urine by people whose calcium serum levels are normal. Morbidity associated with Idiopathic Hypercalciuria is chiefly related to kidney stone disease and bone demineralisation leading to osteopenia and osteoporosis. Idiopathic Hypercalciuria contributes to kidney stone disease at all life stages; people with the condition are prone to developing oxalate and calcium phosphate kidney stones. In some cases, crystallised calcium can be deposited in the renal interstitium, causing increased calcium levels in the kidneys. In children, Idiopathic Hypercalciuria can cause a range of comorbidities including recurrent macroscopic or microscopic haematuria, frequency dysuria syndrome, urinary tract infections and abdominal and lumbar pain. Various dietary interventions have been described that aim to decrease urinary calcium levels or urinary crystallisation. Objectives Our objectives were to assess the efficacy, effectiveness and safety of dietary interventions for preventing complications in Idiopathic Hypercalciuria (urolithiasis and osteopenia) in adults and children, and to assess the benefits of dietary interventions in decreasing urological symptomatology in children with Idiopathic Hypercalciuria. Search methods We searched the Cochrane Renal Group's Specialised Register (23 April 2013) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE. Selection criteria We included all randomised controlled trials (RCTs) and quasi-RCTs that investigated dietary interventions aimed at preventing complications of Idiopathic Hypercalciuria, compared with placebo, no intervention, or other dietary interventions regardless of route of administration, dose or amount. Data collection and analysis Studies were assessed for inclusion and data extracted using a standardised data extraction form. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). Main results We included five studies (379 adult participants) that investigated a range of interventions. Lack of similarity among interventions investigated meant that data could not be pooled. Overall, study methodology was not adequately reported in any of the included studies. There was a high risk of bias associated with blinding (although it seems unlikely that outcomes measures were unduly influenced by lack of intervention blinding), random sequence generation and allocation methodologies were unclear in most studies, but selective reporting bias was assessed as low. One study (120 participants) compared a low calcium diet with a normal calcium, low protein, low salt diet for five years. There was a significant decrease in numbers of new stone recurrences in those treated with the normal calcium, low protein, low salt diet (RR 0.77, 95% CI 0.61 to 0.98). This diet also led to a significant decrease in oxaluria (MD 78.00 µmol/d, 95% CI 26.48 to 129.52) and the calcium oxalate relative supersaturation index (MD 1.20 95% CI 0.21 to 2.19). One study (210 participants) compared a low salt, normal calcium diet with a broad diet for three months. The low salt, normal calcium diet decreased urinary calcium (MD -45.00 mg/d, 95% CI -74.83 to -15.17) and oxalate excretion (MD -4.00 mg/d, 95% CI -6.44 to -1.56). A small study (17 participants) compared the effect of dietary fibre as part of a low calcium, low oxalate diet over three weeks, and found that although calciuria levels decreased, oxaluria increased. Phyllanthus niruri plant substrate intake was investigated in a small subgroup with Hypercalciuria (20 participants); there was no significant effect on calciuria levels occurred after three months of treatment. A small cross-over study (12 participants) evaluating the changes in urinary supersaturation indices among patients who consumed calcium-fortified orange juice or milk for one month found no benefits for participants. None of the studies reported any significant adverse effects associated with the interventions. Authors' conclusions Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with Idiopathic Hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects. No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
The Cochrane Library - Dietary interventions for preventing complications in Idiopathic Hypercalciuria
The Cochrane database of systematic reviews, 2014Co-Authors: Joaquin Escribano, Albert Balaguer, Albert Feliu, Marta Roque I Figuls, Natalia FerreAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality that is characterised by excessive amounts of calcium excreted in the urine by people whose calcium serum levels are normal. Morbidity associated with Idiopathic Hypercalciuria is chiefly related to kidney stone disease and bone demineralisation leading to osteopenia and osteoporosis. Idiopathic Hypercalciuria contributes to kidney stone disease at all life stages; people with the condition are prone to developing oxalate and calcium phosphate kidney stones. In some cases, crystallised calcium can be deposited in the renal interstitium, causing increased calcium levels in the kidneys. In children, Idiopathic Hypercalciuria can cause a range of comorbidities including recurrent macroscopic or microscopic haematuria, frequency dysuria syndrome, urinary tract infections and abdominal and lumbar pain. Various dietary interventions have been described that aim to decrease urinary calcium levels or urinary crystallisation. Objectives Our objectives were to assess the efficacy, effectiveness and safety of dietary interventions for preventing complications in Idiopathic Hypercalciuria (urolithiasis and osteopenia) in adults and children, and to assess the benefits of dietary interventions in decreasing urological symptomatology in children with Idiopathic Hypercalciuria. Search methods We searched the Cochrane Renal Group's Specialised Register (23 April 2013) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE. Selection criteria We included all randomised controlled trials (RCTs) and quasi-RCTs that investigated dietary interventions aimed at preventing complications of Idiopathic Hypercalciuria, compared with placebo, no intervention, or other dietary interventions regardless of route of administration, dose or amount. Data collection and analysis Studies were assessed for inclusion and data extracted using a standardised data extraction form. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). Main results We included five studies (379 adult participants) that investigated a range of interventions. Lack of similarity among interventions investigated meant that data could not be pooled. Overall, study methodology was not adequately reported in any of the included studies. There was a high risk of bias associated with blinding (although it seems unlikely that outcomes measures were unduly influenced by lack of intervention blinding), random sequence generation and allocation methodologies were unclear in most studies, but selective reporting bias was assessed as low. One study (120 participants) compared a low calcium diet with a normal calcium, low protein, low salt diet for five years. There was a significant decrease in numbers of new stone recurrences in those treated with the normal calcium, low protein, low salt diet (RR 0.77, 95% CI 0.61 to 0.98). This diet also led to a significant decrease in oxaluria (MD 78.00 µmol/d, 95% CI 26.48 to 129.52) and the calcium oxalate relative supersaturation index (MD 1.20 95% CI 0.21 to 2.19). One study (210 participants) compared a low salt, normal calcium diet with a broad diet for three months. The low salt, normal calcium diet decreased urinary calcium (MD -45.00 mg/d, 95% CI -74.83 to -15.17) and oxalate excretion (MD -4.00 mg/d, 95% CI -6.44 to -1.56). A small study (17 participants) compared the effect of dietary fibre as part of a low calcium, low oxalate diet over three weeks, and found that although calciuria levels decreased, oxaluria increased. Phyllanthus niruri plant substrate intake was investigated in a small subgroup with Hypercalciuria (20 participants); there was no significant effect on calciuria levels occurred after three months of treatment. A small cross-over study (12 participants) evaluating the changes in urinary supersaturation indices among patients who consumed calcium-fortified orange juice or milk for one month found no benefits for participants. None of the studies reported any significant adverse effects associated with the interventions. Authors' conclusions Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with Idiopathic Hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects. No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
pharmacological interventions for preventing complications in Idiopathic Hypercalciuria
Cochrane Database of Systematic Reviews, 2009Co-Authors: Joaquin Escribano, Albert Balaguer, Filomena Pagone, Albert Feliu, Marta Roque I FigulsAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality characterised by excessive amounts of calcium excreted into the urine in patients with normal serum levels of calcium. The morbidity of Hypercalciuria is related to kidney stone disease and bone demineralization. In children, Hypercalciuria can cause recurrent haematuria, frequency-dysuria syndrome, urinary tract infection and abdominal and lumbar pain. Several pharmacological treatments have been described that can decrease the levels of urinary calcium or its index of urinary crystallization. Objectives To assess the benefits and harms of pharmacological interventions for preventing complications and decreasing urological symptoms in patients with Idiopathic Hypercalciuria. Search strategy We searched MEDLINE, EMBASE, the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), handsearched relevant conference proceedings and reference lists of articles. Selection criteria All randomised controlled trials (RCTs) and quasi-RCTS that compared any pharmacological intervention for preventing complications in Idiopathic Hypercalciuria, with placebo, other pharmacological intervention or a different administration mode or dose of the same treatment given for a minimum duration of four months and had a follow-up period of at least six months. Data collection and analysis Four authors assessed the studies for inclusion and extracted the data. Disagreements were resolved through discussion. Results were expressed as risk ratios (RR) with 95% confidence intervals (CI) or mean difference (MD). Main results Five studies (316 adult patients) were included. Four compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and one analysed the effect of thiazide plus a neutral potassium salt. There was a significant decrease in the number of new stone recurrences in those treated with thiazides (RR 1.61, 95% CI 1.33 to 1.96), although the follow-up periods varied. The stone formation rate also showed a statistically significant decrease in the patients treated with diuretics (MD -0.18, 95% CI -0.30 to -0.06). Thiazides plus potassium salts significantly decreased calciuria and vitamin D levels. Authors' conclusions There is some evidence that in patients with Idiopathic Hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with Idiopathic Hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
The Cochrane Library - Pharmacological interventions for preventing complications in Idiopathic Hypercalciuria
The Cochrane database of systematic reviews, 2009Co-Authors: Joaquin Escribano, Albert Balaguer, Filomena Pagone, Albert Feliu, Marta Roque I FigulsAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality characterised by excessive amounts of calcium excreted into the urine in patients with normal serum levels of calcium. The morbidity of Hypercalciuria is related to kidney stone disease and bone demineralization. In children, Hypercalciuria can cause recurrent haematuria, frequency-dysuria syndrome, urinary tract infection and abdominal and lumbar pain. Several pharmacological treatments have been described that can decrease the levels of urinary calcium or its index of urinary crystallization. Objectives To assess the benefits and harms of pharmacological interventions for preventing complications and decreasing urological symptoms in patients with Idiopathic Hypercalciuria. Search strategy We searched MEDLINE, EMBASE, the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), handsearched relevant conference proceedings and reference lists of articles. Selection criteria All randomised controlled trials (RCTs) and quasi-RCTS that compared any pharmacological intervention for preventing complications in Idiopathic Hypercalciuria, with placebo, other pharmacological intervention or a different administration mode or dose of the same treatment given for a minimum duration of four months and had a follow-up period of at least six months. Data collection and analysis Four authors assessed the studies for inclusion and extracted the data. Disagreements were resolved through discussion. Results were expressed as risk ratios (RR) with 95% confidence intervals (CI) or mean difference (MD). Main results Five studies (316 adult patients) were included. Four compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and one analysed the effect of thiazide plus a neutral potassium salt. There was a significant decrease in the number of new stone recurrences in those treated with thiazides (RR 1.61, 95% CI 1.33 to 1.96), although the follow-up periods varied. The stone formation rate also showed a statistically significant decrease in the patients treated with diuretics (MD -0.18, 95% CI -0.30 to -0.06). Thiazides plus potassium salts significantly decreased calciuria and vitamin D levels. Authors' conclusions There is some evidence that in patients with Idiopathic Hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with Idiopathic Hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
Marta Roque I Figuls - One of the best experts on this subject based on the ideXlab platform.
-
dietary interventions for preventing complications in Idiopathic Hypercalciuria
Cochrane Database of Systematic Reviews, 2014Co-Authors: Joaquin Escribano, Albert Balaguer, Albert Feliu, Marta Roque I Figuls, Natalia FerreAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality that is characterised by excessive amounts of calcium excreted in the urine by people whose calcium serum levels are normal. Morbidity associated with Idiopathic Hypercalciuria is chiefly related to kidney stone disease and bone demineralisation leading to osteopenia and osteoporosis. Idiopathic Hypercalciuria contributes to kidney stone disease at all life stages; people with the condition are prone to developing oxalate and calcium phosphate kidney stones. In some cases, crystallised calcium can be deposited in the renal interstitium, causing increased calcium levels in the kidneys. In children, Idiopathic Hypercalciuria can cause a range of comorbidities including recurrent macroscopic or microscopic haematuria, frequency dysuria syndrome, urinary tract infections and abdominal and lumbar pain. Various dietary interventions have been described that aim to decrease urinary calcium levels or urinary crystallisation. Objectives Our objectives were to assess the efficacy, effectiveness and safety of dietary interventions for preventing complications in Idiopathic Hypercalciuria (urolithiasis and osteopenia) in adults and children, and to assess the benefits of dietary interventions in decreasing urological symptomatology in children with Idiopathic Hypercalciuria. Search methods We searched the Cochrane Renal Group's Specialised Register (23 April 2013) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE. Selection criteria We included all randomised controlled trials (RCTs) and quasi-RCTs that investigated dietary interventions aimed at preventing complications of Idiopathic Hypercalciuria, compared with placebo, no intervention, or other dietary interventions regardless of route of administration, dose or amount. Data collection and analysis Studies were assessed for inclusion and data extracted using a standardised data extraction form. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). Main results We included five studies (379 adult participants) that investigated a range of interventions. Lack of similarity among interventions investigated meant that data could not be pooled. Overall, study methodology was not adequately reported in any of the included studies. There was a high risk of bias associated with blinding (although it seems unlikely that outcomes measures were unduly influenced by lack of intervention blinding), random sequence generation and allocation methodologies were unclear in most studies, but selective reporting bias was assessed as low. One study (120 participants) compared a low calcium diet with a normal calcium, low protein, low salt diet for five years. There was a significant decrease in numbers of new stone recurrences in those treated with the normal calcium, low protein, low salt diet (RR 0.77, 95% CI 0.61 to 0.98). This diet also led to a significant decrease in oxaluria (MD 78.00 µmol/d, 95% CI 26.48 to 129.52) and the calcium oxalate relative supersaturation index (MD 1.20 95% CI 0.21 to 2.19). One study (210 participants) compared a low salt, normal calcium diet with a broad diet for three months. The low salt, normal calcium diet decreased urinary calcium (MD -45.00 mg/d, 95% CI -74.83 to -15.17) and oxalate excretion (MD -4.00 mg/d, 95% CI -6.44 to -1.56). A small study (17 participants) compared the effect of dietary fibre as part of a low calcium, low oxalate diet over three weeks, and found that although calciuria levels decreased, oxaluria increased. Phyllanthus niruri plant substrate intake was investigated in a small subgroup with Hypercalciuria (20 participants); there was no significant effect on calciuria levels occurred after three months of treatment. A small cross-over study (12 participants) evaluating the changes in urinary supersaturation indices among patients who consumed calcium-fortified orange juice or milk for one month found no benefits for participants. None of the studies reported any significant adverse effects associated with the interventions. Authors' conclusions Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with Idiopathic Hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects. No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
The Cochrane Library - Dietary interventions for preventing complications in Idiopathic Hypercalciuria
The Cochrane database of systematic reviews, 2014Co-Authors: Joaquin Escribano, Albert Balaguer, Albert Feliu, Marta Roque I Figuls, Natalia FerreAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality that is characterised by excessive amounts of calcium excreted in the urine by people whose calcium serum levels are normal. Morbidity associated with Idiopathic Hypercalciuria is chiefly related to kidney stone disease and bone demineralisation leading to osteopenia and osteoporosis. Idiopathic Hypercalciuria contributes to kidney stone disease at all life stages; people with the condition are prone to developing oxalate and calcium phosphate kidney stones. In some cases, crystallised calcium can be deposited in the renal interstitium, causing increased calcium levels in the kidneys. In children, Idiopathic Hypercalciuria can cause a range of comorbidities including recurrent macroscopic or microscopic haematuria, frequency dysuria syndrome, urinary tract infections and abdominal and lumbar pain. Various dietary interventions have been described that aim to decrease urinary calcium levels or urinary crystallisation. Objectives Our objectives were to assess the efficacy, effectiveness and safety of dietary interventions for preventing complications in Idiopathic Hypercalciuria (urolithiasis and osteopenia) in adults and children, and to assess the benefits of dietary interventions in decreasing urological symptomatology in children with Idiopathic Hypercalciuria. Search methods We searched the Cochrane Renal Group's Specialised Register (23 April 2013) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE. Selection criteria We included all randomised controlled trials (RCTs) and quasi-RCTs that investigated dietary interventions aimed at preventing complications of Idiopathic Hypercalciuria, compared with placebo, no intervention, or other dietary interventions regardless of route of administration, dose or amount. Data collection and analysis Studies were assessed for inclusion and data extracted using a standardised data extraction form. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). Main results We included five studies (379 adult participants) that investigated a range of interventions. Lack of similarity among interventions investigated meant that data could not be pooled. Overall, study methodology was not adequately reported in any of the included studies. There was a high risk of bias associated with blinding (although it seems unlikely that outcomes measures were unduly influenced by lack of intervention blinding), random sequence generation and allocation methodologies were unclear in most studies, but selective reporting bias was assessed as low. One study (120 participants) compared a low calcium diet with a normal calcium, low protein, low salt diet for five years. There was a significant decrease in numbers of new stone recurrences in those treated with the normal calcium, low protein, low salt diet (RR 0.77, 95% CI 0.61 to 0.98). This diet also led to a significant decrease in oxaluria (MD 78.00 µmol/d, 95% CI 26.48 to 129.52) and the calcium oxalate relative supersaturation index (MD 1.20 95% CI 0.21 to 2.19). One study (210 participants) compared a low salt, normal calcium diet with a broad diet for three months. The low salt, normal calcium diet decreased urinary calcium (MD -45.00 mg/d, 95% CI -74.83 to -15.17) and oxalate excretion (MD -4.00 mg/d, 95% CI -6.44 to -1.56). A small study (17 participants) compared the effect of dietary fibre as part of a low calcium, low oxalate diet over three weeks, and found that although calciuria levels decreased, oxaluria increased. Phyllanthus niruri plant substrate intake was investigated in a small subgroup with Hypercalciuria (20 participants); there was no significant effect on calciuria levels occurred after three months of treatment. A small cross-over study (12 participants) evaluating the changes in urinary supersaturation indices among patients who consumed calcium-fortified orange juice or milk for one month found no benefits for participants. None of the studies reported any significant adverse effects associated with the interventions. Authors' conclusions Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with Idiopathic Hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects. No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
pharmacological interventions for preventing complications in Idiopathic Hypercalciuria
Cochrane Database of Systematic Reviews, 2009Co-Authors: Joaquin Escribano, Albert Balaguer, Filomena Pagone, Albert Feliu, Marta Roque I FigulsAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality characterised by excessive amounts of calcium excreted into the urine in patients with normal serum levels of calcium. The morbidity of Hypercalciuria is related to kidney stone disease and bone demineralization. In children, Hypercalciuria can cause recurrent haematuria, frequency-dysuria syndrome, urinary tract infection and abdominal and lumbar pain. Several pharmacological treatments have been described that can decrease the levels of urinary calcium or its index of urinary crystallization. Objectives To assess the benefits and harms of pharmacological interventions for preventing complications and decreasing urological symptoms in patients with Idiopathic Hypercalciuria. Search strategy We searched MEDLINE, EMBASE, the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), handsearched relevant conference proceedings and reference lists of articles. Selection criteria All randomised controlled trials (RCTs) and quasi-RCTS that compared any pharmacological intervention for preventing complications in Idiopathic Hypercalciuria, with placebo, other pharmacological intervention or a different administration mode or dose of the same treatment given for a minimum duration of four months and had a follow-up period of at least six months. Data collection and analysis Four authors assessed the studies for inclusion and extracted the data. Disagreements were resolved through discussion. Results were expressed as risk ratios (RR) with 95% confidence intervals (CI) or mean difference (MD). Main results Five studies (316 adult patients) were included. Four compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and one analysed the effect of thiazide plus a neutral potassium salt. There was a significant decrease in the number of new stone recurrences in those treated with thiazides (RR 1.61, 95% CI 1.33 to 1.96), although the follow-up periods varied. The stone formation rate also showed a statistically significant decrease in the patients treated with diuretics (MD -0.18, 95% CI -0.30 to -0.06). Thiazides plus potassium salts significantly decreased calciuria and vitamin D levels. Authors' conclusions There is some evidence that in patients with Idiopathic Hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with Idiopathic Hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
The Cochrane Library - Pharmacological interventions for preventing complications in Idiopathic Hypercalciuria
The Cochrane database of systematic reviews, 2009Co-Authors: Joaquin Escribano, Albert Balaguer, Filomena Pagone, Albert Feliu, Marta Roque I FigulsAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality characterised by excessive amounts of calcium excreted into the urine in patients with normal serum levels of calcium. The morbidity of Hypercalciuria is related to kidney stone disease and bone demineralization. In children, Hypercalciuria can cause recurrent haematuria, frequency-dysuria syndrome, urinary tract infection and abdominal and lumbar pain. Several pharmacological treatments have been described that can decrease the levels of urinary calcium or its index of urinary crystallization. Objectives To assess the benefits and harms of pharmacological interventions for preventing complications and decreasing urological symptoms in patients with Idiopathic Hypercalciuria. Search strategy We searched MEDLINE, EMBASE, the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), handsearched relevant conference proceedings and reference lists of articles. Selection criteria All randomised controlled trials (RCTs) and quasi-RCTS that compared any pharmacological intervention for preventing complications in Idiopathic Hypercalciuria, with placebo, other pharmacological intervention or a different administration mode or dose of the same treatment given for a minimum duration of four months and had a follow-up period of at least six months. Data collection and analysis Four authors assessed the studies for inclusion and extracted the data. Disagreements were resolved through discussion. Results were expressed as risk ratios (RR) with 95% confidence intervals (CI) or mean difference (MD). Main results Five studies (316 adult patients) were included. Four compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and one analysed the effect of thiazide plus a neutral potassium salt. There was a significant decrease in the number of new stone recurrences in those treated with thiazides (RR 1.61, 95% CI 1.33 to 1.96), although the follow-up periods varied. The stone formation rate also showed a statistically significant decrease in the patients treated with diuretics (MD -0.18, 95% CI -0.30 to -0.06). Thiazides plus potassium salts significantly decreased calciuria and vitamin D levels. Authors' conclusions There is some evidence that in patients with Idiopathic Hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with Idiopathic Hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
Keith K. Lau - One of the best experts on this subject based on the ideXlab platform.
-
Treatment strategies for pediatric Idiopathic Hypercalciuria.
Frontiers in bioscience (Elite edition), 2009Co-Authors: Keith K. Lau, Lavjay ButaniAbstract:Idiopathic Hypercalciuria (IH) is a common metabolic disorder in children and is associated with the development of renal calculi, nephrocalcinosis, hematuria and osteopenia. The effect of various dietary modifications and available pharmacologic therapies on reducing urinary calcium excretion and/or urinary supersaturation is discussed in this article. The importance of a multidisciplinary approach involving the patient, their families, and health-care professionals is also addressed.
-
Clinical manifestations of pediatric Idiopathic Hypercalciuria.
Frontiers in bioscience (Elite edition), 2009Co-Authors: Keith K. LauAbstract:Idiopathic Hypercalciuria (IH) is a common metabolic disorder in children with protean manifestations, many of which can mimic other common pediatric diseases. Reports in the medical literature describe children with IH presenting with a wide array of calculi and non-calculi related clinical symptoms such as hematuria, urinary tract infections (UTIs), urgency, urinary incontinence and recurrent abdominal pain. Many of these symptom complexes have been only loosely associated with IH with no definite established causal relationship. Due to the common nature of IH and the varied clinical features attributed to it, it is of utmost importance for health-care professionals to be aware of these; this will facilitate early and appropriate investigations and prompt institution of therapy to avoid long-term morbidity.
Lavjay Butani - One of the best experts on this subject based on the ideXlab platform.
-
Treatment strategies for pediatric Idiopathic Hypercalciuria.
Frontiers in bioscience (Elite edition), 2009Co-Authors: Keith K. Lau, Lavjay ButaniAbstract:Idiopathic Hypercalciuria (IH) is a common metabolic disorder in children and is associated with the development of renal calculi, nephrocalcinosis, hematuria and osteopenia. The effect of various dietary modifications and available pharmacologic therapies on reducing urinary calcium excretion and/or urinary supersaturation is discussed in this article. The importance of a multidisciplinary approach involving the patient, their families, and health-care professionals is also addressed.
-
Idiopathic Hypercalciuria in children—how valid are the existing diagnostic criteria?
Pediatric Nephrology, 2004Co-Authors: Lavjay Butani, Alok KaliaAbstract:Idiopathic Hypercalciuria is a common metabolic abnormality in children of all ages. There is evidence of an association of Idiopathic Hypercalciuria with nephrolithiasis, hematuria, and osteoporosis. However, much of this evidence is anecdotal and the precise role of Hypercalciuria in the pathogenesis of these conditions is far from clear. Furthermore, the precise definition of Idiopathic Hypercalciuria has not yet been established. The methodologies for quantitating urinary calcium excretion have also not been standardized, adding another potential confounding factor to the accurate interpretation of urinary calcium excretion. Long-term studies on the natural history of unselected children with Idiopathic Hypercalciuria are needed to establish the true clinical significance of this condition. The focus of this review is to critically evaluate the methods currently being used to measure urinary calcium excretion in children and to assess the validity of existing criteria for diagnosing Idiopathic Hypercalciuria.
-
Idiopathic Hypercalciuria in children how valid are the existing diagnostic criteria
Pediatric Nephrology, 2004Co-Authors: Lavjay Butani, Alok KaliaAbstract:Idiopathic Hypercalciuria is a common metabolic abnormality in children of all ages. There is evidence of an association of Idiopathic Hypercalciuria with nephrolithiasis, hematuria, and osteoporosis. However, much of this evidence is anecdotal and the precise role of Hypercalciuria in the pathogenesis of these conditions is far from clear. Furthermore, the precise definition of Idiopathic Hypercalciuria has not yet been established. The methodologies for quantitating urinary calcium excretion have also not been standardized, adding another potential confounding factor to the accurate interpretation of urinary calcium excretion. Long-term studies on the natural history of unselected children with Idiopathic Hypercalciuria are needed to establish the true clinical significance of this condition. The focus of this review is to critically evaluate the methods currently being used to measure urinary calcium excretion in children and to assess the validity of existing criteria for diagnosing Idiopathic Hypercalciuria.
Albert Balaguer - One of the best experts on this subject based on the ideXlab platform.
-
dietary interventions for preventing complications in Idiopathic Hypercalciuria
Cochrane Database of Systematic Reviews, 2014Co-Authors: Joaquin Escribano, Albert Balaguer, Albert Feliu, Marta Roque I Figuls, Natalia FerreAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality that is characterised by excessive amounts of calcium excreted in the urine by people whose calcium serum levels are normal. Morbidity associated with Idiopathic Hypercalciuria is chiefly related to kidney stone disease and bone demineralisation leading to osteopenia and osteoporosis. Idiopathic Hypercalciuria contributes to kidney stone disease at all life stages; people with the condition are prone to developing oxalate and calcium phosphate kidney stones. In some cases, crystallised calcium can be deposited in the renal interstitium, causing increased calcium levels in the kidneys. In children, Idiopathic Hypercalciuria can cause a range of comorbidities including recurrent macroscopic or microscopic haematuria, frequency dysuria syndrome, urinary tract infections and abdominal and lumbar pain. Various dietary interventions have been described that aim to decrease urinary calcium levels or urinary crystallisation. Objectives Our objectives were to assess the efficacy, effectiveness and safety of dietary interventions for preventing complications in Idiopathic Hypercalciuria (urolithiasis and osteopenia) in adults and children, and to assess the benefits of dietary interventions in decreasing urological symptomatology in children with Idiopathic Hypercalciuria. Search methods We searched the Cochrane Renal Group's Specialised Register (23 April 2013) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE. Selection criteria We included all randomised controlled trials (RCTs) and quasi-RCTs that investigated dietary interventions aimed at preventing complications of Idiopathic Hypercalciuria, compared with placebo, no intervention, or other dietary interventions regardless of route of administration, dose or amount. Data collection and analysis Studies were assessed for inclusion and data extracted using a standardised data extraction form. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). Main results We included five studies (379 adult participants) that investigated a range of interventions. Lack of similarity among interventions investigated meant that data could not be pooled. Overall, study methodology was not adequately reported in any of the included studies. There was a high risk of bias associated with blinding (although it seems unlikely that outcomes measures were unduly influenced by lack of intervention blinding), random sequence generation and allocation methodologies were unclear in most studies, but selective reporting bias was assessed as low. One study (120 participants) compared a low calcium diet with a normal calcium, low protein, low salt diet for five years. There was a significant decrease in numbers of new stone recurrences in those treated with the normal calcium, low protein, low salt diet (RR 0.77, 95% CI 0.61 to 0.98). This diet also led to a significant decrease in oxaluria (MD 78.00 µmol/d, 95% CI 26.48 to 129.52) and the calcium oxalate relative supersaturation index (MD 1.20 95% CI 0.21 to 2.19). One study (210 participants) compared a low salt, normal calcium diet with a broad diet for three months. The low salt, normal calcium diet decreased urinary calcium (MD -45.00 mg/d, 95% CI -74.83 to -15.17) and oxalate excretion (MD -4.00 mg/d, 95% CI -6.44 to -1.56). A small study (17 participants) compared the effect of dietary fibre as part of a low calcium, low oxalate diet over three weeks, and found that although calciuria levels decreased, oxaluria increased. Phyllanthus niruri plant substrate intake was investigated in a small subgroup with Hypercalciuria (20 participants); there was no significant effect on calciuria levels occurred after three months of treatment. A small cross-over study (12 participants) evaluating the changes in urinary supersaturation indices among patients who consumed calcium-fortified orange juice or milk for one month found no benefits for participants. None of the studies reported any significant adverse effects associated with the interventions. Authors' conclusions Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with Idiopathic Hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects. No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
The Cochrane Library - Dietary interventions for preventing complications in Idiopathic Hypercalciuria
The Cochrane database of systematic reviews, 2014Co-Authors: Joaquin Escribano, Albert Balaguer, Albert Feliu, Marta Roque I Figuls, Natalia FerreAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality that is characterised by excessive amounts of calcium excreted in the urine by people whose calcium serum levels are normal. Morbidity associated with Idiopathic Hypercalciuria is chiefly related to kidney stone disease and bone demineralisation leading to osteopenia and osteoporosis. Idiopathic Hypercalciuria contributes to kidney stone disease at all life stages; people with the condition are prone to developing oxalate and calcium phosphate kidney stones. In some cases, crystallised calcium can be deposited in the renal interstitium, causing increased calcium levels in the kidneys. In children, Idiopathic Hypercalciuria can cause a range of comorbidities including recurrent macroscopic or microscopic haematuria, frequency dysuria syndrome, urinary tract infections and abdominal and lumbar pain. Various dietary interventions have been described that aim to decrease urinary calcium levels or urinary crystallisation. Objectives Our objectives were to assess the efficacy, effectiveness and safety of dietary interventions for preventing complications in Idiopathic Hypercalciuria (urolithiasis and osteopenia) in adults and children, and to assess the benefits of dietary interventions in decreasing urological symptomatology in children with Idiopathic Hypercalciuria. Search methods We searched the Cochrane Renal Group's Specialised Register (23 April 2013) through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE. Selection criteria We included all randomised controlled trials (RCTs) and quasi-RCTs that investigated dietary interventions aimed at preventing complications of Idiopathic Hypercalciuria, compared with placebo, no intervention, or other dietary interventions regardless of route of administration, dose or amount. Data collection and analysis Studies were assessed for inclusion and data extracted using a standardised data extraction form. We calculated risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). Main results We included five studies (379 adult participants) that investigated a range of interventions. Lack of similarity among interventions investigated meant that data could not be pooled. Overall, study methodology was not adequately reported in any of the included studies. There was a high risk of bias associated with blinding (although it seems unlikely that outcomes measures were unduly influenced by lack of intervention blinding), random sequence generation and allocation methodologies were unclear in most studies, but selective reporting bias was assessed as low. One study (120 participants) compared a low calcium diet with a normal calcium, low protein, low salt diet for five years. There was a significant decrease in numbers of new stone recurrences in those treated with the normal calcium, low protein, low salt diet (RR 0.77, 95% CI 0.61 to 0.98). This diet also led to a significant decrease in oxaluria (MD 78.00 µmol/d, 95% CI 26.48 to 129.52) and the calcium oxalate relative supersaturation index (MD 1.20 95% CI 0.21 to 2.19). One study (210 participants) compared a low salt, normal calcium diet with a broad diet for three months. The low salt, normal calcium diet decreased urinary calcium (MD -45.00 mg/d, 95% CI -74.83 to -15.17) and oxalate excretion (MD -4.00 mg/d, 95% CI -6.44 to -1.56). A small study (17 participants) compared the effect of dietary fibre as part of a low calcium, low oxalate diet over three weeks, and found that although calciuria levels decreased, oxaluria increased. Phyllanthus niruri plant substrate intake was investigated in a small subgroup with Hypercalciuria (20 participants); there was no significant effect on calciuria levels occurred after three months of treatment. A small cross-over study (12 participants) evaluating the changes in urinary supersaturation indices among patients who consumed calcium-fortified orange juice or milk for one month found no benefits for participants. None of the studies reported any significant adverse effects associated with the interventions. Authors' conclusions Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with Idiopathic Hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects. No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
pharmacological interventions for preventing complications in Idiopathic Hypercalciuria
Cochrane Database of Systematic Reviews, 2009Co-Authors: Joaquin Escribano, Albert Balaguer, Filomena Pagone, Albert Feliu, Marta Roque I FigulsAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality characterised by excessive amounts of calcium excreted into the urine in patients with normal serum levels of calcium. The morbidity of Hypercalciuria is related to kidney stone disease and bone demineralization. In children, Hypercalciuria can cause recurrent haematuria, frequency-dysuria syndrome, urinary tract infection and abdominal and lumbar pain. Several pharmacological treatments have been described that can decrease the levels of urinary calcium or its index of urinary crystallization. Objectives To assess the benefits and harms of pharmacological interventions for preventing complications and decreasing urological symptoms in patients with Idiopathic Hypercalciuria. Search strategy We searched MEDLINE, EMBASE, the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), handsearched relevant conference proceedings and reference lists of articles. Selection criteria All randomised controlled trials (RCTs) and quasi-RCTS that compared any pharmacological intervention for preventing complications in Idiopathic Hypercalciuria, with placebo, other pharmacological intervention or a different administration mode or dose of the same treatment given for a minimum duration of four months and had a follow-up period of at least six months. Data collection and analysis Four authors assessed the studies for inclusion and extracted the data. Disagreements were resolved through discussion. Results were expressed as risk ratios (RR) with 95% confidence intervals (CI) or mean difference (MD). Main results Five studies (316 adult patients) were included. Four compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and one analysed the effect of thiazide plus a neutral potassium salt. There was a significant decrease in the number of new stone recurrences in those treated with thiazides (RR 1.61, 95% CI 1.33 to 1.96), although the follow-up periods varied. The stone formation rate also showed a statistically significant decrease in the patients treated with diuretics (MD -0.18, 95% CI -0.30 to -0.06). Thiazides plus potassium salts significantly decreased calciuria and vitamin D levels. Authors' conclusions There is some evidence that in patients with Idiopathic Hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with Idiopathic Hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
-
The Cochrane Library - Pharmacological interventions for preventing complications in Idiopathic Hypercalciuria
The Cochrane database of systematic reviews, 2009Co-Authors: Joaquin Escribano, Albert Balaguer, Filomena Pagone, Albert Feliu, Marta Roque I FigulsAbstract:Background Idiopathic Hypercalciuria is an inherited metabolic abnormality characterised by excessive amounts of calcium excreted into the urine in patients with normal serum levels of calcium. The morbidity of Hypercalciuria is related to kidney stone disease and bone demineralization. In children, Hypercalciuria can cause recurrent haematuria, frequency-dysuria syndrome, urinary tract infection and abdominal and lumbar pain. Several pharmacological treatments have been described that can decrease the levels of urinary calcium or its index of urinary crystallization. Objectives To assess the benefits and harms of pharmacological interventions for preventing complications and decreasing urological symptoms in patients with Idiopathic Hypercalciuria. Search strategy We searched MEDLINE, EMBASE, the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), handsearched relevant conference proceedings and reference lists of articles. Selection criteria All randomised controlled trials (RCTs) and quasi-RCTS that compared any pharmacological intervention for preventing complications in Idiopathic Hypercalciuria, with placebo, other pharmacological intervention or a different administration mode or dose of the same treatment given for a minimum duration of four months and had a follow-up period of at least six months. Data collection and analysis Four authors assessed the studies for inclusion and extracted the data. Disagreements were resolved through discussion. Results were expressed as risk ratios (RR) with 95% confidence intervals (CI) or mean difference (MD). Main results Five studies (316 adult patients) were included. Four compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and one analysed the effect of thiazide plus a neutral potassium salt. There was a significant decrease in the number of new stone recurrences in those treated with thiazides (RR 1.61, 95% CI 1.33 to 1.96), although the follow-up periods varied. The stone formation rate also showed a statistically significant decrease in the patients treated with diuretics (MD -0.18, 95% CI -0.30 to -0.06). Thiazides plus potassium salts significantly decreased calciuria and vitamin D levels. Authors' conclusions There is some evidence that in patients with Idiopathic Hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with Idiopathic Hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic Idiopathic Hypercalciuria.
