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Hypercalciuria in children with monosymptomatic nocturnal enuresis

By M. Civilibal, N. Selcuk Duru, M. Elevli, and N. Civilibal

Journal of Pediatric Urology, Volume 10, Issue 6, December 2014, Pages 1145–1148

Editor's comments:
Several studies have already suggested that hypercalciuria may play a role in nocturnal polyuria in nocturnal enuresis. The study by Civilibal et al. included a quite large study group of 120 bedwetting children and a control group of 80 children. The authors found that 23% of the bedwetting children had hypercalciuria, but only 4% of the non-bedwetting children. Unfortunately, the authors were not able to gather information on the children’s diet, especially their calcium intake. This needs to be investigated further.



The aim of this study was to measure the 24 h urinary calcium content in children with monosymptomatic nocturnal enuresis (MNE) and compare with those in healthy children to investigate whether there is any relation with enuresis and hypercalciuria

Material and methods

This study included 120 children and adolescents with MNE aged between 7 and 14 years. Eighty age- and sex-matched healthy children served as a control group. To determine urinary calcium excretion, 24 h urine samples were collected. The children with enuresis were divided into two sub-groups as hypercalciuric and normocalciuric groups according to the amount of urinary calcium excretion. 


Hypercalciuria was found in 27 (23%) of the MNE patients compared with two (4%) of continent children (p < 0.001). In addition, the mean 24 h urine calcium/body weight ratio was higher in the enuresis group than in the control group, 2.94 ± 2.42 versus 1.59 ± 1.72, respectively (p = 0.002). When the children with enuresis were divided into two groups as normokalsiuric and hypercalciuric, the hypercalciuric children were younger and the majority of this group were boys. 


Our study showed that hypercalciuria is common in children with MNE, so we suggested measuring urine calcium levels in NE patients. However, further studies are needed to clarify the relationship between hypercalciuria and NE in larger series.


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