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- Title
Correspondence between Ca and calciuria, citrate level and pH of urine in pediatric urolithiasis.
- Authors
Porowski, Tadeusz; Kirejczyk, Jan; Konstantynowicz, Jerzy; Kazberuk, Anna; Plonski, Grzegorz; Wasilewska, Anna; Laube, Norbert
- Abstract
Background: Hypercalciuria and hypocitraturia are considered the most important risk factors for urolithiasis. Citrate binds to urinary calcium to form a soluble complex which decreases the availability of ionized calcium (Ca) necessary for calcium oxalate formation and phosphate crystallization. The aims of this study were to assess the Ca fraction in relation to total calciuria, citraturia and urinary pH and to determine whether urinary Ca concentration is a helpful biomarker in metabolic evaluation of children with urolithiasis. Methods: We collected 24-h urine samples from 123 stone-forming children and adolescents with hypocitraturia and from 424 healthy controls. Total calciuria (total calcium, Ca), Ca, pH, citrate, oxalate and Bonn Risk Index (BRI) were assessed and compared between the two groups. Results: Total calciuria and Ca content were higher in stone-formers than in the healthy children. In both stone-formers and controls, Ca content was inversely related to citraturia and urinary pH, whereas the Ca/Ca ratio differed slightly between the groups. A large variability in Ca level was found across individuals in both groups. The BRI increased with increasing calciuria and urine acidity. Conclusions: Compared to controls, stone-formers with hypocitraturia demonstrated a higher urinary Ca concentration, but this was proportional to calciuria. The large individual variability in urinary Ca content limits its practical use in metabolic evaluation of children with urolithiasis. However, the Ca/Citrate ratio may be a useful clinical tool in evaluating children with urolithiasis.
- Subjects
POLAND; URINARY calculi; ACADEMIC medical centers; BIOMARKERS; CALCIUM; CITRATES; HYDROGEN-ion concentration; HYPERCALCIUREA; KIDNEYS; SCIENTIFIC observation; RESEARCH funding; STATISTICS; U-statistics; DATA analysis; CROSS-sectional method; DATA analysis software; DESCRIPTIVE statistics; DISEASE complications; DISEASE risk factors
- Publication
Pediatric Nephrology, 2013, Vol 28, Issue 7, p1079
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-013-2420-0