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What Causes Elevated Alkaline Phosphatase Levels And Frequent Urination?

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Posted on Fri, 18 Jul 2014
Question: Hello, my son has just been urgently referred to a paediatrician, he is 13 months old after his blood test showed his alkaline phospatase levels were 1773. He is excessively drinking and has been for some time, also leakjng nappies and excessive urination. We are due for a urine test & more bloods next week. He hasn't got diabeties as his blood sugar is normal at 5.2.
I am so worried. What could it be?
Should I be worried?
doctor
Answered by Dr. Sumanth Amperayani (3 hours later)
Brief Answer:
Renal tubular acidosis/ Hypovitaminosis D

Detailed Answer:
Hi...Thank you for consulting in Health Care magic. I understand your concern. I also appreciate the history given by you about his excessive drinking (polydipsia) and excessive urination (polyuria). Rather than age what will be of more help in diagnosis will be how is his weight gain and developmental milestone attainment. I have a few questions and will suggest few possibilities.

Questions:
1. What was the birth weight and what is the current weight?
2. How is the attaining of developmental milestones?
3. How many times does he pass urine and can you approximately tell how much volume he passes per day?
4. How much volume water does he consume per day on an average?
5. Is there any history of recurrent serious infections?
6. How many minutes is he exposed per day to direct sunlight between 10AM to 3PM?
7. Has anybody in the family been diagnosed to have a chronic kidney disease?
8. Has the mother received calcium and vitamin D supplement during pregnancy?

Possibilities:
1. Renal Tubular Acidosis
2. Hypovitaminosis D (Vitamin D deficiency)
3. Chronic kidney disease.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sumanth Amperayani (4 hours later)
Thank you for your reply.
He was 6.12lb at birth, born at 40+2 weeks, he was induced and during my pregnancy he was under consultant as on multiple occasions and scans he didnt move. I also had steriods injected at 32 weeks as the hosp thought i was in labour. I also had a v difficult labour and he wasnt happy at various points.
I think he weighs about 24lb. However not 100%.

His milestones are behind a little bit. He didn't roll until 6 months, sit up until 10 months, didn't crawl until 11.5 months. Still doesn't say any words, but otherwise healthy.

With regards to urine his nappy is sodden within the hour, he leaks ecery single night i have to change it theough the night and he still leaks.

He is drinking around 12 bottles of water a day.

He was hospitalised for croup, bronchilitis & queiried pnumonia in late april this year whilst on holiday in the dominican republic. In regards to possible infection.

Sunlight, well he plays regularly at nursery, weather permitting we are out. But just normal.

No one has chronic kidney disease.

Yes i had vit d injection.

I worry that it could also be bone cancer or anything like that sinister?
I know its almost impossible to answer but with the results at high as 1773 when im aware normal is around 120, what percentage is it likely to be more than an anomoly. Do you think it's more than certain regardless of what it is something is up?

I'm the sort that would prefer to be prepared.
Thank you.
doctor
Answered by Dr. Sumanth Amperayani (3 hours later)
Brief Answer:
Definitely not bone cancer

Detailed Answer:
Hi...Thanks for your trust in me.

I went through the history you provided in detail.
This is not suggestive of bone cancer...not anything so serious to cause a life threatening disease.

History of excess urine and excess water drinking is suggestive of the above possibilities and the only red herring is that the kid is not failing to thrive...that means...his weight gain is appropriate.

Possibilities:
1. Renal Tubular Acidosis
2. Hypovitaminosis D (Vitamin D deficiency)
3. Chronic kidney disease.

But I suggest that you discuss with your pediatrician about the possibilities I suggested and get your kid evaluated in those terms.

Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8339 Questions

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What Causes Elevated Alkaline Phosphatase Levels And Frequent Urination?

Brief Answer: Renal tubular acidosis/ Hypovitaminosis D Detailed Answer: Hi...Thank you for consulting in Health Care magic. I understand your concern. I also appreciate the history given by you about his excessive drinking (polydipsia) and excessive urination (polyuria). Rather than age what will be of more help in diagnosis will be how is his weight gain and developmental milestone attainment. I have a few questions and will suggest few possibilities. Questions: 1. What was the birth weight and what is the current weight? 2. How is the attaining of developmental milestones? 3. How many times does he pass urine and can you approximately tell how much volume he passes per day? 4. How much volume water does he consume per day on an average? 5. Is there any history of recurrent serious infections? 6. How many minutes is he exposed per day to direct sunlight between 10AM to 3PM? 7. Has anybody in the family been diagnosed to have a chronic kidney disease? 8. Has the mother received calcium and vitamin D supplement during pregnancy? Possibilities: 1. Renal Tubular Acidosis 2. Hypovitaminosis D (Vitamin D deficiency) 3. Chronic kidney disease. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. Dr. Sumanth MBBS., DCH., DNB (Paed).,