URINARY CALCIUM AND OXALATE EXCRETION IN CHILDREN

被引：77

作者：

REUSZ, GS

DOBOS, M

BYRD, D

SALLAY, P

MILTENYI, M

TULASSAY, T

机构：

[1] First Department of Paediatrics, Semmelweis University Medical School, Budapest, H-1083

[2] Laboratory of Paediatric Nephrology and Metabolic Diseases, Medical School, Hannover

来源：

PEDIATRIC NEPHROLOGY | 1995年 / 9卷 / 01期

关键词：

CALCIUM; OXALATE; NORMAL VALUES; NEPHROLITHIASIS;

D O I：

10.1007/BF00858966

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

We have established normal values for calcium/ creatinine (Ca/Cr) and oxalate/creatinine (Ox/Cr) ratios in 25 infants (aged 1-7 days) and 391 children (aged 1 month to 14.5 years) and compared these with values obtained in 137 children with post-glomerular haematuria and 27 with nephrolithiasis. Oxalate was measured by ion chromatography. Nomograms of Marshall and Robertson were used to calculate urine saturation to calcium oxalate. The Ca/Cr ratio was normally distributed whereas the Ox/Cr ratio had a log-normal distribution. The molar ratio of Ca/Cr was the lowest in the first days of life and the highest between 7 month and 1.5 years (mean +/- SD = 0.39 +/- 0.28 mmol/mmol). Following a slight decrease it stabilised by the age of 6 years (0.34 +/- 0.19 mmol/mmol). The highest Ox/Cr values were measured during the Ist month of life [geometric mean 133 (range 61 - 280) mu mol/mmol], followed by a gradual decrease until 11 years of age [mean 24 (range 6-82) mu mol/mmol]. Thirty-six haematuric children had hypercalciuria (26%), 23 had absorptive hypercalciuria, 13 renal type. Children with absorptive hypercalciuria on a calcium-restricted diet had significantly higher oxalate excretion than those with renal hypercalciuria and the control group [38 (range 28-49) vs. 22 (range 16-29) and 23 (range 22-27) mu mol/mol respectively, P <0.01]. Calcium oxalate urine saturation of stone patients was higher than that of patients with haematuria and the normal population (1.18 +/- 0.05 vs. 1.06 +/- 0.03, P <0.03 and 0.84 +/- 0.03, P <0.001 respectively). The measurement of Ca/Cr and Ox/Cr in first-morning urine samples is suitable for screening for hypercalciuria and hyperoxaluria. Interpretation of the values requires age-specific reference values. Both calcium and oxalate determinations should be part of the evaluation of patients with haematuria, hypercalciuria or nephrolithiasis.

引用

页码：39 / 44

页数：6

共 40 条

[1]

Malek R.S., Kelalis P.P., Pediatric urolithiasis, J Urol, 113, pp. 545-550, (1976)

[2]

Walther P.C., Lamm D., Kaplan G.W., Pediatric urolithiasis. A ten year review, Pediatrics, 65, pp. 1068-1072, (1980)

[3]

Laufer J., Biochis H., Urolithiasis in children: current medical management, Pediatr Nephrol, 3, pp. 317-331, (1989)

[4]

Perrone H.C., dos Santos D.R., Santos M.V., Pinheiro M.E., Toporovski J., Ramos O.L., Schor N., Urolithiasis in childhood: metabolic evaluation, Pediatr Nephrol, 6, pp. 54-56, (1992)

[5]

Roy S., Stapleton F.B., Noe N.H., Jerkins G., Hematuria preceding renal stone formation in children with hypercalciuria, J Pediatr, 99, pp. 712-715, (1981)

[6]

Noe N.H., Stapleton F.B., Jerkins G., Roy S., Clinical experience with childhood urolithiasis, J Urol, 129, pp. 1166-1168, (1983)

[7]

Stapleton F.B., Jerkins G., Noe H.N., Hypercalciuria in children with urolithiasis, Am J Dis Child, 136, pp. 675-678, (1982)

[8]

Kruse K., Kracht U., Kruse U., Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents, Eur J Pediatr, 143, pp. 25-31, (1984)

[9]

Ghazali S., Barrat T.M., Urinary excretion of calcium and magnesium in children, Arch Dis Child, 49, pp. 97-101, (1974)

[10]

Paunier L., Borgeaud M., Wyss M., Urinary excretion of magnesium and calcium in normal children, Helv Paediatr Acta, 25, pp. 577-584, (1970)

← 1 2 3 4 →