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Nephrocalcinosis complicating medical treatment of posthemorrhagic hydrocephalus.

Abstract
Furosemide and acetazolamide are often used concurrently to treat posthemorrhagic hydrocephalus in premature infants with intraventricular hemorrhage. Eleven premature infants with posthemorrhagic hydrocephalus were monitored for the development of hypercalciuria during treatment using urine calcium/creatinine (Ca/Cr) ratios (normal: less than or equal to 0.21). Seven of 11 infants (64%) developed hypercalciuria; 5 of those 7 infants had nephrocalcinosis on renal ultrasonography. Infants who developed nephrocalcinosis had urine Ca/Cr ratios of 0.5-4.0. In all 5 infants with nephrocalcinosis, renal calculi decreased and urine Ca/Cr improved after drug therapy was discontinued. The combined use of acetazolamide and furosemide as therapy for posthemorrhagic hydrocephalus places premature infants at high risk for nephrocalcinosis. It is suggested that urine Ca/Cr be monitored closely in infants receiving these drugs and that other treatment modalities be considered when the urine Ca/Cr ratio exceeds 0.21.
AuthorsC E Stafstrom, H E Gilmore, P S Kurtin
JournalPediatric neurology (Pediatr Neurol) 1992 May-Jun Vol. 8 Issue 3 Pg. 179-82 ISSN: 0887-8994 [Print] United States
PMID1622512 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Furosemide
  • Creatinine
  • Acetazolamide
  • Calcium
Topics
  • Acetazolamide (administration & dosage, adverse effects)
  • Calcium (urine)
  • Cerebral Hemorrhage (drug therapy)
  • Creatinine (urine)
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Furosemide (administration & dosage, adverse effects)
  • Humans
  • Hydrocephalus (drug therapy)
  • Infant, Newborn
  • Infant, Premature, Diseases (drug therapy)
  • Kidney Function Tests
  • Male
  • Nephrocalcinosis (chemically induced)

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