Gluconate calcium therapy and neonatal hypercalciuria
M. A. Goldsmith, S. S. Bhatia, W. P. Kanto Jr, M. H. Kutner and D. Rudman
Nephrolithiasis was present in a 2-month-old premature infant with
bronchopulmonary dysplasia who had been receiving furosemide and
intravenous (IV) gluconate calcium therapy. This infant was found to be
hypercalciuric. Furosemide therapy is known to increase calcium excretion.
In the present study, we examined sick infants who were receiving gluconate
calcium without furosemide to evaluate the effect of gluconate calcium
therapy on urinary calcium excretion. The sick infants receiving gluconate
calcium had higher values of urinary calcium than did the well infants
taking regular formula feedings. Moreover, the calciuria appeared to
increase progressively with continued gluconate calcium therapy. It appears
that prolonged use of either furosemide or IV gluconate calcium leads to
hypercalciuria, which, in turn, may predispose the premature infant to
nephrolithiasis.
