Question Title: Another question regarding stones and calcium in urine

Thank you for answering my previous question regarding crystals in my daughters urine. The calcium level in her urine is very high. The reference range is 0.0-0.2 and her level was 0.7 with, I believe, a normal creatinine value. She had a renal ultrasound that showed everything to be normal, with no stones. Is this test sufficient when looking for scarring or obstruction, or other problems in the kidney that could be allowing calcium to be filtered out of the body? Should I request that her serum calcium levels be checked? What else could be going on to cause this to be happening? I am keeping her well hydrated, and my pediatrician says that is the only "treatment" option. I don't understand how he can say that without knowing for sure if her body is depleted of calcium. I do know that this could be idiopathic, but want to make sure. Again, any insight would be appreciated.

Thanks in Advance,
Cyndi

Dear Cyndi,
Different studies have inherent error. Just because one urine analysis shows elevated calcium(calciuria), I would not be overly concerned unless she is forming stones. It is dificult to evaluate concentrations of electrolytes in childrens urine because it is nearly impossible to obtain a 24 hr. urine collection correctly.I think you are doing the right thing by keeping your daughter well hydrated, but if she hasn’t had a stone, and there is no family history of stones, I would not be overly concerned. I’m not saying forget about it, be rather re-evaluate it in the future.
The ultrasound, is a good study to show significant scarring, but the gold standard is a DMSA scan, glucoheptinate scan or MAG 3 renal scan. The ultrasound is a better test for follow-up rather than the initial diagnosis.
I don’t know if further work-up is nescesary at this time, if your child is asymptomatic. If you have further concerns, I would follow with a pediatric urologist.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

Sincerely,
HFHS M.D.-AK
*keyword: Pediatric UTI

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