Inhaled corticosteroids in young asthmatic children: Association with hypercalciuria

Introduction: The use of inhaled corticosteroids (ICS) via infant aerochamber in young, asthmatic children is increasing. However, concern has been raised about its long-term impact. Hypercalciuria is a known adverse effect of systemic corticosteroids. Objective: To determine whether ICS- induced hypercalciuria occurs in young, asthmatic children. Setting: Two outpatient clinics. Methods: Urinary calcium/creatinine ratio (UCa/Cr) was determined in 32 asthmatic children (age 6-36 mo) who were receiving inhaled budesonide or beclomethasone 200-600 μg/d for two to three months. A control group of asthmatic children within the same age range (n = 23) who did not receive ICS was included. None of the children were receiving oral corticosteroids, diuretics, antibiotics, or theophylline. Statistics: Student's t-test and χ² analysis. Results: The treated and control groups were similar with regard to age and male/female ratio. Mean ± SD UCa/Cr was significantly higher in the asthmatic children receiving ICS (0.23 ± 0.19 vs. 0.09 ± 0.07, respectively; p = 0.002). Fourteen (43.75%) of the treated patients had hypercalciuria (UCa/Cr >0.2) compared with only one (4.35%) in the control group (p = 0.002). Renal ultrasonography failed to demonstrate nephrocalcinosis in eight of the treated hypercalciuric patients. Conclusions: Treatment of young, asthmatic children with ICS may be associated with hypercalciuria. More studies are needed to evaluate the clinical significance of this finding.