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Urinary calcium and oxalate excretion in children

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Abstract

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 1st month of life [geometric mean 133 (range 61–280) μmol/mmol], followed by a gradual decrease until 11 years of age [mean 24 (range 6–82) μmol/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) μmol/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.

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Authors and Affiliations

  1. First Department of Paediatrics, Semmelweis University Medical School, Bókay J. 53, H-1083, Budapest, Hungary

    György S. Reusz, Mariann Dobos, Péter Sallay, Miklós Miltényi & Tivadar Tulassay

  2. Laboratory of Paediatric Nephrology and Metabolic Diseases, Medical School, Hannover, Germany

    Dennis Byrd

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  1. György S. Reusz
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  2. Mariann Dobos
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  3. Dennis Byrd
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  4. Péter Sallay
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  5. Miklós Miltényi
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  6. Tivadar Tulassay
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Reusz, G.S., Dobos, M., Byrd, D. et al. Urinary calcium and oxalate excretion in children. Pediatr Nephrol 9, 39–44 (1995). https://doi.org/10.1007/BF00858966

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  • DOI: https://doi.org/10.1007/BF00858966

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