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Am J Physiol Renal Physiol (June 18, 2002). doi:10.1152/ajprenal.00354.2001
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Articles in PresS, published online ahead of print June 18, 2002
Am J Physiol Renal Physiol, 10.1152/ajprenal.00354.2001
Submitted on November 27, 2001
Accepted on June 8, 2002

Low calcium diet in hypercalciuric enuretic children restores urinary Aquaporin 2 excretion and improves clinical symptoms

Giovanna Valenti1*, Antonia Laera1, Sabine Gouraud1, Giuseppe Pace2, Gabriella Aceto3, Rosa Penza3, Francesco P Selvaggi2, and Maria Svelto1

1 Department of General and Environmental Physiology, University of Bari, Bari, Italy
2 Emergency and Transplantation (DETO), University of Bari, Bari, Italy
3 Developmental Age Biomedicine, University of Bari, Bari, Italy

* To whom correspondence should be addressed. E-mail: g.valenti{at}biologia.uniba.it.

In this study we analyzed the effect of a therapeutic intervention in 46 enuretic children. Among them, 26 (57%) were hypercalciuric. All patients (n=46) were treated with DDAVP for three to six months. Hypercalciuric patients (n=26) received in addition a low calcium diet (approximately 500mg/die) for the same period. After the therapy, the bedwetting episodes stopped in 80% of the 46 patients tested. In those patients having low vasopressin levels before the therapy, circulating vasopressin concentration returned to normal (above 4 pg/ml) and the hypercalciuria was resolved in hypercalciuric patients (Ca/creatinine ratio below 0.2). Urinary AQP2 levels were semiquantified by densitometric scanning and reported as a ratio between the intensity of the signal in the day vs the night urine samples (D/N AQP2 ratio). In hypercalciuric patients the D/N AQP2 ratio returned to values close to those found in healthy children (from 1.19±0.20 before, to 0.69±0.10 after the treatment, n=26, P=0.03). In contrast, in normocalciuric children we saw no significant modulation of AQP2 excretion (from 1.07±0.14 before, to 0.99±0.14 after the treatment, n=20). This study clearly demonstrates that urinary calcium levels modulates AQP2 excrection and is likely to be useful to the treatment of children with enuresis.




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