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Renal GlucosuriaLast Updated:November 2, 2003

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Synonyms and related keywords:glucose in urine, renal glycosuria,

Fanconi syndrome, cystinosis, Wilson disease, hereditary tyrosinemia,oculocerebrorenal syndrome, Loe syndrome

AUTHOR INFORATION Section ! o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

Author* Leonard G Feld$ %$ &'%, Chairman, #e%artmento" +ediatrics, Atlantic ealth -ystem, +ro"essor,#e%artment o" +ediatrics, .niversity o" 'edicine and#entistry o" Ne /ersey

Leonard Feld, '#, +h#, is a member o" the "olloing

medical societies*American Academy o" +ediatrics,American College o" +hysician E1ecutives,American#iabetes Association,American eart Association,

American -ociety o" Ne%hrology,American -ociety o"+ediatric Ne%hrology,American -ociety o" &rans%lant-urgeons,Eastern -ociety "or +ediatric Research,!nternational -ociety o" Ne%hrology, /uvenile #iabetesFoundation !nternational,National idney Foundation,-ociety "or E1%erimental )iology and 'edicine, and-ociety o" +ediatric Research

Editors4* Laurence Fin(er)$ %, Clinical +ro"essor,

#e%artment o" +ediatrics, .niversity o" Cali"ornia at -anFrancisco and -tan"ord .niversity5 Ro(ert *onop$&'arm%, Clinical Assistant +ro"essor, #e%artment o"+harmacy, -ection o" Clinical +harmacology, .niversity o"'innesota5 Lut'er Tra+is$ %, William W lauser+ro"essor o" +ediatrics and +ediatric Ne%hrology,#e%artment o" +ediatrics, #ivisions o" Ne%hrology and#iabetes, .niversity o" &e1as 'edical )ranch andChildren6s os%ital5 Howard Trac'tman$ %, +rogram#irector, +ediatrics Research, -chneider Children6sos%ital, +ro"essor, #e%artment o" +ediatrics, #ivision o"

Ne%hrology, Albert Einstein College o" 'edicine5 and ,rai)- Lan)man$ %, ead, #ivision o" +ediatric Ne%hrology,Children6s 'emorial os%ital o" Chicago5 +ro"essor,#e%artment o" +ediatrics, Northestern .niversity -choolo" 'edicine

#isclosure

.uick Find

Author !n"ormation!ntroductionClinical#i""erentials

Wor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

Clic$ "or relatedimages7

Related Articles

Cystinosis

#iabetes 'ellitus

Fanconi -yndrome

8culocerebrorenal#ystro%hy Loe-yndrome4

Wilson #isease

,ontinuin)/ducation

C'E available "orthis to%ic7 Clic$hereto ta$e thisC'E7

&atient /ducation

Clic$here "or%atient education7

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ne.com/PED/topic581.htmhttp://www.emedicine.com/PED/topic756.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic2441.htmhttp://cme.emedicine.com/wc.dll?cmeAddToCart~addtest~&type=ARTICLE&dir=ped&topic=Renal+Glucosuriahttp://cme.emedicine.com/wc.dll?cmeAddToCart~addtest~&type=ARTICLE&dir=ped&topic=Renal+Glucosuriahttp://www.emedicinehealth.com/http://www.emedicine.com/ped/topic1991.htm#section~introduction%23section~introductionmailto:enter%20email%20address%20here?Subject=eMedicine%20Article%20-%20Renal%20Glucosuria&Body=I%20thought%20you%20might%20be%20interested%20in%20this%20article%20from%20eMedicine.%20%20You%20may%20either%20click%20on%20the%20following%20link%20or%20copy%20and%20paste%20it%20into%20your%20browser.%0Dhttp://www.emedicine.com/ped/topic1991.htm%0D%0A%0D%0AeMedicine%20is%20the%20leading%20provider%20of%20clinical%20medical%20information%20for%20medical%20professionals%20and%20consumers.%20%20To%20explore%20eMedicine%20today%20visit%20http://www.emedicine.commailto:enter%20email%20address%20here?Subject=eMedicine%20Article%20-%20Renal%20Glucosuria&Body=I%20thought%20you%20might%20be%20interested%20in%20this%20article%20from%20eMedicine.%20%20You%20may%20either%20click%20on%20the%20following%20link%20or%20copy%20and%20paste%20it%20into%20your%20browser.%0Dhttp://www.emedicine.com/ped/topic1991.htm%0D%0A%0D%0AeMedicine%20is%20the%20leading%20provider%20of%20clinical%20medical%20information%20for%20medical%20professionals%20and%20consumers.%20%20To%20explore%20eMedicine%20today%20visit%20http://www.emedicine.comhttp://www.emedicine.com/ped/topic1991.htm#section~author_information%23section~author_informationhttp://www.emedicine.com/ped/topic1991.htm#section~introduction%23section~introductionhttp://www.emedicine.com/ped/topic1991.htm#section~clinical%23section~clinicalhttp://www.emedicine.com/ped/topic1991.htm#section~differentials%23section~differentialshttp://www.emedicine.com/ped/topic1991.htm#section~workup%23section~workuphttp://www.emedicine.com/ped/topic1991.htm#section~treatment%23section~treatmenthttp://www.emedicine.com/ped/topic1991.htm#section~medication%23section~medicationhttp://www.emedicine.com/ped/topic1991.htm#section~follow-up%23section~follow-uphttp://www.emedicine.com/ped/topic1991.htm#section~follow-up%23section~follow-uphttp://www.emedicine.com/ped/topic1991.htm#section~miscellaneous%23section~miscellaneoushttp://www.emedicine.com/ped/topic1991.htm#section~bibliography%23section~bibliographyhttp://www.atlantichealth.org/home.asphttp://www.umdnj.edu/http://www.umdnj.edu/http://www.aap.org/http://www.acpe.org/http://www.diabetes.org/http://www.diabetes.org/http://www.americanheart.org/http://www.asn-online.org/http://www.aspneph.com/http://www.aspneph.com/http://www.asts.org/http://www.asts.org/http://www.aps-spr.org/Regional_Societies/ESPR2.htmhttp://www.isn-online.org/http://www.jdf.org/http://www.jdf.org/http://www.kidney.org/http://www.sebm.org/http://www.aps-spr.org/http://www.emedicine.com/cgi-bin/foxweb.exe/disclosure@/em/ga?book=ped&disclosure=1991http://www.emedicine.com/ped/topic1991.htm#section~author_information%23section~author_informationhttp://www.emedicine.com/ped/topic1991.htm#section~introduction%23section~introductionhttp://www.emedicine.com/ped/topic1991.htm#section~clinical%23section~clinicalhttp://www.emedicine.com/ped/topic1991.htm#section~differentials%23section~differentialshttp://www.emedicine.com/ped/topic1991.htm#section~workup%23section~workuphttp://www.emedicine.com/ped/topic1991.htm#section~treatment%23section~treatmenthttp://www.emedicine.com/ped/topic1991.htm#section~medication%23section~medicationhttp://www.emedicine.com/ped/topic1991.htm#section~follow-up%23section~follow-uphttp://www.emedicine.com/ped/topic1991.htm#section~miscellaneous%23section~miscellaneoushttp://www.emedicine.com/ped/topic1991.htm#section~bibliography%23section~bibliographyhttp://emedicine.com/asp/image_search.asp?query=Renal%20Glucosuria%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20http://emedicine.com/asp/image_search.asp?query=Renal%20Glucosuria%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20%20http://www.emedicine.com/PED/topic538.htmhttp://www.emedicine.com/PED/topic581.htmhttp://www.emedicine.com/PED/topic756.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic2441.htmhttp://cme.emedicine.com/wc.dll?cmeAddToCart~addtest~&type=ARTICLE&dir=ped&topic=Renal+Glucosuriahttp://www.emedicinehealth.com/http://www.topmedconsultants.com/emedicine/evaluations/mainsurvey.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INTRO%U,TION Section 0 o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

-ack)round: Renalglycosuria isthe e1cretion o" glucoseinthe urine in detectable amounts at normal blood glucoseconcentrations or in the absence o" hy%erglycemia7 !ngeneral, it is a benign condition and does not re9uire anys%eci"ic thera%y7 lycosuria may be associated ith tubulardisorders such as Fanconi syndrome, cystinosis, Wilsondisease, hereditary tyrosinemia, or oculocerebrorenalsyndrome Loe syndrome47

&at'op'ysiolo)y: lucose is "reely "iltered by theglomerulus ith a "ractional e1cretion o" less than 07:;7

Adults e1crete about

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is a great deal o" variability in the glucose(handling ca%acityo" individual ne%hrons7 &his variability arises "rom variation inthe length o" the %ro1imal tubule and di""erences inglomerular si?e and location7

&ubular ma1imum "or glucose &m glucose, mg>min>:7@3 m24corrected "or the glomerular "iltration rate FR4 does notvary as a "unction o" age7 &m glucose>FR mg>mL4 %resentsas "ollos*

!n"ants ( 07(27B

Children ( :72(27B

Adults ( 273:(27@0

&he &m glucose "or children e1%ressed in mg>min>:7@3 m2is

as "ollos*

+remature in"ants ( 2=(:0

&erm in"ants ( 3

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eg, Fanconi syndrome, diabetes mellitus47

!n cases associated ith tubular disorders, signs orsym%toms may include hy%o%hos%hatemic ric$ets,

dehydration, short stature, muscle hy%otonia, or ocularchanges o" cataracts or glaucoma Loe syndrome4 orayser(Fleischer ring Wilson disease47

,auses: &he renal abnormality is s%eci"ic to glucose and notother monosaccharides7 &he inheritance %attern is autosomalrecessive, although autosomal dominance has beenre%orted7 lycosuria can be divided into 3 clinical scenarios,as "ollos*

)enign glycosuria* &his condition has 3 variations and

generally is discovered on routine urinalysis7

o &y%e A is so(called classic glycosuria, ithreduction in both glucose threshold andma1imal glucose reabsor%tion rate7

o !n ty%e ), there is a reduction in the glucose

threshold, normal reabsor%tive rate, and anincreased s%lay7

o &y%e 8 is de"ined by the com%lete absence o"

glucose reabsor%tion7 +lasma glucoseconcentration, glucose tolerance testing, seruminsulin concentrations, and glycosylatedhemoglobin concentrations are normal7 8therrenal tubular abnormalities are absent7oever, there have been "amilies ithglycosuria and uricosuria in absence o" otheras%ects o" renal tubular dys"unction7

lycosuria ith diabetes mellitus and %regnancy(

induced diabetes mellitus* 8bviously, %atients have

elevated %lasma glucose concentration, abnormalglucose tolerance testing, and increased glycosylatedhemoglobin concentrations7

&ubular dys"unction Fanconi syndrome4* &his

includes a large number o" disorders characteri?ed by%resence o" %hos%haturia, bicarbonaturia,aminoaciduria, %olyuria, renal tubular acidosis, groth

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"ailure, and ric$ets7 !dio%athic, inherited, or ac9uired"orms e1ist7 &hera%y is directed to the tubularabnormality and disease state7

%IFF/R/NTIALS Section 4 o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(

u%'iscellaneous)ibliogra%hy

Cystinosis#iabetes 'ellitusFanconi -yndrome8culocerebrorenal #ystro%hy Loe -yndrome4Wilson #isease

Ot'er &ro(lems to (e ,onsidered:

!ntestinal glucose(galactose malabsor%tion!nterstitial ne%hritisereditary tyrosinemiaeavy metal into1ication

5OR*U& Section 6 o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

La( Studies:

.rinalysis ith microsco%ic analysis

Fasting blood glucose concentration

-erum electrolytes, bicarbonate, %hos%horus, and uric acid

lycosylated hemoglobin

Consider 2B(hour urine collection "or amino acids hen other tubular

abnormalities e1ist7

Fractional e1cretion o" %hos%horus D:=;4, uric acid D:=; or uric acid %erdL FR D07==4, sodium normal limit NL :(3;4, %otassium D2=;4,bicarbonate NL D:=;4

TR/AT/NT Section 7 o" !#

http://www.emedicine.com/ped/topic1991.htm#section~author_information%23section~author_informationhttp://www.emedicine.com/ped/topic1991.htm#section~introduction%23section~introductionhttp://www.emedicine.com/PED/topic538.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/ped/topic1991.htm#section~treatment%23section~treatmenthttp://www.emedicine.com/ped/topic1991.htm#top%23tophttp://www.emedicine.com/ped/topic1991.htm#section~differentials%23section~differentialshttp://www.emedicine.com/ped/topic1991.htm#section~workup%23section~workuphttp://www.emedicine.com/ped/topic1991.htm#top%23tophttp://www.emedicine.com/ped/topic1991.htm#section~clinical%23section~clinicalhttp://www.emedicine.com/ped/topic1991.htm#section~author_information%23section~author_informationhttp://www.emedicine.com/ped/topic1991.htm#section~introduction%23section~introductionhttp://www.emedicine.com/ped/topic1991.htm#section~clinical%23section~clinicalhttp://www.emedicine.com/ped/topic1991.htm#section~differentials%23section~differentialshttp://www.emedicine.com/ped/topic1991.htm#section~workup%23section~workuphttp://www.emedicine.com/ped/topic1991.htm#section~treatment%23section~treatmenthttp://www.emedicine.com/ped/topic1991.htm#section~medication%23section~medicationhttp://www.emedicine.com/ped/topic1991.htm#section~follow-up%23section~follow-uphttp://www.emedicine.com/ped/topic1991.htm#section~follow-up%23section~follow-uphttp://www.emedicine.com/ped/topic1991.htm#section~miscellaneous%23section~miscellaneoushttp://www.emedicine.com/ped/topic1991.htm#section~bibliography%23section~bibliographyhttp://www.emedicine.com/PED/topic538.htmhttp://www.emedicine.com/PED/topic581.htmhttp://www.emedicine.com/PED/topic756.htmhttp://www.emedicine.com/PED/topic1329.htmhttp://www.emedicine.com/PED/topic2441.htmhttp://www.emedicine.com/ped/topic1991.htm#section~author_information%23section~author_informationhttp://www.emedicine.com/ped/topic1991.htm#section~introduction%23section~introductionhttp://www.emedicine.com/ped/topic1991.htm#section~clinical%23section~clinicalhttp://www.emedicine.com/ped/topic1991.htm#section~differentials%23section~differentialshttp://www.emedicine.com/ped/topic1991.htm#section~workup%23section~workuphttp://www.emedicine.com/ped/topic1991.htm#section~treatment%23section~treatmenthttp://www.emedicine.com/ped/topic1991.htm#section~medication%23section~medicationhttp://www.emedicine.com/ped/topic1991.htm#section~follow-up%23section~follow-uphttp://www.emedicine.com/ped/topic1991.htm#section~miscellaneous%23section~miscellaneoushttp://www.emedicine.com/ped/topic1991.htm#section~bibliography%23section~bibliography

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Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

edical ,are: )enign renal glycosuria is a sel"(limiting %rocess and re9uires nos%ecial medical care7 !" other associated "indings suggest tubular disorders, thenother interventions are re9uired7

,onsultations: Consultation ith a %ediatric ne%hrologist may be a%%ro%riate7

%iet: No s%ecial dietary instructions are re9uired7 !n a very rare case o" e1tremelylarge amounts o" urinary glucose, glucose or another carbohydrate may be re9uiredduring e%isodes o" great %hysical activity to %revent hy%oglycemia7

/%I,ATION Section 8 o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

No treatment is re9uired "or benign renal glycosuria7

FOLLO59U& Section o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

Furt'er Outpatient ,are:

Routine medical "ollo(u% care ith the %rimary care %rovider is re9uired7

&ro)nosis:

+rognosis "or benign renal glycosuria is e1cellent7

&atient /ducation:

)enign renal glycosuria has no relationshi% to diabetes mellitus7 Ensure that

the %atient and "amily understand this and the e1cellent %rognosis7

IS,/LLAN/OUS Section ; o" !#

Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

edical2Le)al &it"alls:

No medical>legal concerns e1ist "or benign renal glycosuria, but be sure to

rule out other causes o" high urinary glucose concentrations, as indicated in

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the di""erential diagnosis7

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Author !n"ormation!ntroductionClinical#i""erentialsWor$u%&reatment'edicationFollo(u%'iscellaneous)ibliogra%hy

)rodehl /, Fran$en A, ellissen * 'a1imal tubular reabsor%tion o" glucosein in"ants and children7 Acta +aediatr -cand :@2 /ul5

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NOT/:

'edicine is a constantly changing science and not all thera%ies are clearly established7 Ne research changes drug andtreatment thera%ies daily7 &he authors, editors, and %ublisher o" this Hournal have used their best e""orts to %rovide in"ormat ionthat is u%(to(date and accurate and is generally acce%ted ithin medical standards at the time o" %ublication7 oever, asmedical science is constantly changing and 'uman error is always possi(le, the authors, editors, and %ublisher or any other%arty involved ith the %ublication o" this article do not arrant the in"ormation in this article is accurate or com%lete, nor are theyres%onsible "or omissions or errors in the article or "or the results o" using this in"ormation7 &he reader should con"irm thein"ormation in this article "rom other sources %rior to use7 !n %articular, all drug doses, indications, and contraindications should becon"irmed in the %ac$age insert7F.LL #!-CLA!'ER

Renal lucosuria e1cer%t

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