The effect of phototherapy on urinary calcium excretion in term neonates

Abstract

Phototherapy is the most common, most effective, and least dangerous treatment method for neonatal hyperbilirubinemia and is the treatment of the first choice for neonatal icterus. Hypocalcemia is one of the lesser-known complications of phototherapy. Some studies have shown a relationship between increased urinary calcium excretion and phototherapy-induced hypocalcemia. We aimed to assess the effect of phototherapy on urinary calcium excretion in term neonates. This before-after study was performed on 80 term neonates having hyper- bilirubinemia referred to the 17(th) Shahrivar Hospital, Rasht, Guilan Province, Northern Iran, over a one-year period from May 2013 to May 2014. Electrocardiography was performed to measure QTc in all neonates at admission and 48 h after phototherapy. Blood and urine samples were taken from all neonates before and 48 h after phototherapy. Phototherapy was performed using four lamps with similar wavelengths from a distance of 20 cm. The serum and urinary calcium and sodium levels and urinary creatinine level before and after phototherapy were measured and compared. Data were analyzed using SPSS software, version 16. The mean age of the study subjects was 7.01 ± 4.13 days. We did not find any significant difference between urinary calcium levels (P = 0.0001), urinary creatinine levels (P = 0.954), or the calcium/creatinine ratio (P = 0.086) before and after phototherapy. The neonates' mean ± standard deviation plasma as well as urinary sodium levels differed before and after phototherapy; the difference was not statistically significant (P = 0.658). Phototherapy might increase urinary calcium excretion although it does not cause hypocalcemia.