Background and Aim: Severe loss of calcium in the urine is called hypercalciuria. This review aimed to evaluate the etiology of hypercalciuria in children, mainly new hypercalciuria research, to provide an update on the management, and complications that can improve the prognosis of hematuria.
Methods: For this narrative review, articles from several sources, including Scopus, Google Scholar, Embase, Web of Science, PubMed, and the Directory of Open Access Journals were used.
Results: The main identifiable cause of nephrolithiasis in children is metabolic causes, and hypercalciuria is considered the most common cause. Hypercalciuria increases the risk of urinary stones and other problems.
Conclusion: Hypercalciuria is a very important cause of kidney stones, the challenge for pediatric nephrologists is early diagnosis in affected children and prevention of their renal complications. This article reviews the causes of hypercalciuria and provides a framework for the initial evaluation and monitoring of such patients. There is no internationally accepted, uniform, evidence-based algorithm for its diagnostic evaluation anywhere. It is recommended that extensive public attention be paid to the cause and management of hypercalciuria
Keywords: Calcium, Nephrolithiasis, hypercalciuria

Background and Aim: Nocturnal enuresis and migraine are common disorders among
children, each having a major impact on the health and life status of the children and
their families. In several children, these two disorders have also been observed together.
Accordingly, this study evaluates the relationship between migraine and nocturnal enuresis
by examining the frequency of migraine in children with nocturnal enuresis.
Methods: In this analytical cross-sectional study, the experimental group includes children
with nocturnal enuresis, who were diagnosed by a pediatric nephrologist. The control
group is comprised of children without nocturnal enuresis. In both groups, the frequency
of migraine headaches diagnosed by pediatric neurologists was checked and finally, the
frequency obtained in the two groups was compared. The sample size was 47 people for
each group. Information analysis was done through analytical statistics, including tables and
statistical charts and their analysis. Independent t-test, the chi-square test, the Fisher test, and
if necessary, equations were used to analyze the non-parametric data.
Results: The distribution of frequency between gender and nocturnal enuresis was the same
in two groups (57.4% male and 42.6% female). Also, the mean age in the patient category
was 7.6±2.3 years and in the healthy category was 8.3±2.6 years. The frequency distribution
between having migraine, migraine with aura, the number of times experiencing headache,
and family history at the time of admission were the same in the two groups.
Conclusion: In conclusion the frequency of migraine, migraine with aura, the number of
times experiencing headache, and family history of migraine were the same in the two groups

Background and Aim: The pathogenesis of idiopathic nephrotic syndrome (INS) remains
unclear. Previously, the INS was assumed a T cell-mediated disease. Cytokines secreted from
T helper 2 cells, reduced T regulatories, which led to activation of T effector cells, resulting
in the increased permeability of glomerulus and nephrotic syndrome. The remedial influence
of B cell depletion by anti-cluster of differentiation marker 20 factors suggests a role of B
cells in the pathogenesis of the disease. However, the exact mechanisms of action of these
medications are unknown. One of these mechanisms is the effect on CD3-20+ T cells.
Methods: A total of 10 patients in relapse of INS and 10 patients in remission were included
in this study. The number of CD3-20+ T cells was calculated by flow cytometry in these two
groups.
Results: In the relapse group, on average, 1.10% of T cells were CD3-20+ cells; in the
remission group, the same data was 0.41%.
Conclusion: The mean number of CD3-20+ T cells in the remission group was lower than
in the relapse group; however, there was no statistical difference between the two groups

Background and Aim: Changes in electrocardiographic parameters are reported after
hemodialysis (HD). This study determines the alternations in electrocardiographic parameters,
hemodynamics, and body weight post-HD.
Methods: Electrocardiography was evaluated pre- and post-dialysis in 20 patients (55%
males) aged 16.25±6.25 years. Changes in electrocardiographic parameters were compared
considering changes in weight (post-dialysis and between dialysis sessions), blood pressure
(BP) indices, and the occurrence of intra-dialysis hypotension (IDH).
Results: A significant decrease was observed in weight, systolic, diastolic, and mean arterial
BPs post-dialysis (P<0.05, for all). No substantial changes in durations of PR interval, QT
interval corrected for heart rate, and QRS complex, as well as QT dispersion, were found
post-dialysis (P>0.05 for all). Hemodynamic and electrocardiographic alternations were not
significantly different between cases with adequate versus inadequate weight gain (P>0.05
for all). Meanwhile, dialysis-induced ventricular strain patterns (ST-T segment changes) were
found in 20% of patients, including three cases with inadequate weight gain inter-dialysis. In
one case, electrocardiographic findings of hyperkalemia resolved post-dialysis. Whereas, the
left ventricular strain pattern appeared in one other case.
Conclusion: HD is associated with significant acute changes in systolic and diastolic BP and
mean arterial pressure (MAP). These changes, if repeated frequently, can result in myocardial
ischemia and infarction. HD protects the heart against hyperkalemia, and thereby arrhythmia;
however, it causes ventricular strain patterns, which a predictive of adverse cardiovascular
outcomes. Evaluating the long-term complications of hemodynamic and electrocardiogram
changes in pediatric HD cases is suggested.

Background and Aim: Nephrotic syndrome (NS) is associated with variable ranges of
vitamin D deficiency in the pediatric population. This study examines the vitamin D status in
children with NS during active disease in a tertiary care center in eastern India.
Methods: This observational study was conducted for 18 months in a tertiary care hospital
taking 60 cases of NS of 2-12 years of age and 30 age- and sex-matched controls. Serum
25(OH) vitamin D and alkaline phosphatase (ALP) levels were assayed and analyzed.
Results: In this study, the mean vitamin D level (12.54±6.85 ng/mL) in cases was significantly
lower (P=0.002) compared to the control group (22.1±5.8 ng/mL). Mean vitamin D level
was low in all groups of NS cases and the lowest in steroid-resistant NS (SRNS) followed
by steroid-dependent NS (SDNS)/frequent relapse NS group. Vitamin D insufficiency (12-
20 ng/mL) was more prevalent in the first episode whereas deficiency (<12 ng/mL) was
more common in subjects with relapse. Serum ALP levels were raised in 35% of vitamin
D deficient cases but normal in the rest of the deficient, all insufficient, and sufficient cases.
Conclusion: Hypovitaminosis D was more common in children with NS as compared to
the general pediatric population irrespective of sex. Vitamin D status varied according to the
course of the disease of NS. A strong negative correlation of vitamin D status and serum ALP
was observed in children with NS but serum ALP level for screening of vitamin D status
could not be used.

Background and Aim: The range of congenital anomalies affecting the kidneys and urinary
tract (CAKUT) is wide, extending from asymptomatic ectopic kidneys to severe bilateral
kidney agenesis. This study unveils the spectrum of morphological anomalies in the kidneys
and urinary tract among pediatric patients.
Methods: Over 2 years, 116 patients underwent comprehensive evaluation, including lab
tests, imaging, and radionuclide scans.
Results: Among the 650 patients, 116 cases were identified as CAKUT, yielding a prevalence
rate of 17.8%. Among these, 67 of 116(57.7%) were male, with the majority (85%) aged 0
to 5 years. Abnormal ultrasonographic findings drove hospital visits in 46 of 116(39.7%)
cases, followed by recurrent fevers (19.8%), and urinary dribbling (12%). Anemia and renal
dysfunction were the main lab abnormalities in 90 of 116(77.5%) and 40 of 116(34.5%)
subjects, respectively. Meanwhile, CAKUT cases were categorized as non-obstructive in 78
of 116(68.1%) and obstructive in 37 of 116(31.9%), Primary vesicoureteral reflux (VUR) in
25/116 (21.6%) and ureteropelvic junction obstruction (UPJO) in 18/116 (15.6%) were most
common non-obstructive and obstructive anomalies respectively. Among VUR cases, grade
II and grade III VUR accounted for 9 of 25(36%) and 7 of 25(28%) subjects, respectively;
also, aspects associated with hypertension were in 18 of 25(72%) and renal scarring in 4 of
25 (16%). UPJO was present in 18 of 116(15.5%) and typically mild in 14 of 18(61%) on
ultrasonography (USG). Posterior urethral valves (PUV) accounted for 16 in 116(13.7%) of
cases, presenting with renal dysfunction in 13 of 16(81%) and hydronephrosis in 12 of 16
(75%).
Conclusion: This study provides valuable insights into the prevalence, clinical patterns,
and morphological diversity of CAKUT. These findings underscore the importance of early
diagnosis and multidisciplinary management for optimizing outcomes.

Background and Aim: Ureteropelvic junction obstruction (UPJO) is a common cause of
hydronephrosis and is typically diagnosed antenatally. About 70% of these cases will selfresolve;
however, symptomatic children may present with abdominal pain (i.e. Dietl crisis),
vomiting, rash, or fever.
Case Presentation: A 14-year-old male patient presented with cyclical vomiting every two
months for the past two years. The patient’s mother also described an eight-year history
of headaches and intermittent abdominal pain. A renal magnetic resonance urography
scan revealed decreased right kidney function and delayed cortex to ureter transit time. A
pyeloplasty and stent placement were performed to correct the obstructing vessel.
Conclusion: Clinical guidelines for abdominal pain and cyclical vomiting earlier in the
patients’ healthcare may have led to an appropriate workup and treatment years before. We
recommend physicians consider UPJO as a differential diagnosis in adolescent patients with
cyclical vomiting and abdominal pain and consult the North American Society for Pediatric
Gastroenterology, Hepatology, and Nutrition (NASPGHN) guidelines to better guide the
diagnosis.