Hypocitrauria as a Major Metabolic Abnormality in Pediatric Urolithiasis and Nephrocalcinosis
Keywords:
urolithiasis, nephrocalcinosis, metabolic abnormality, hypocitrauria, hypercalciuria, hyperoxaluriaAbstract
Objective: To determine calcium, oxalate, uric acid, potassium, magnesium and citrate in urines of childhood urolithaisis (UL) patients and childhood nephrocalcinosis (NC) compared to non-stone forming (NSF) children.
Method: Seven pediatric UL and 7 pediatric NC patients were recruited for the study. Urine (24-hour urine or spot urine) and stone specimens were collected. Twenty-seven NSF children served as controls were participated, and their spot urine samples were collected. Urinary levels of calcium, oxalate, uric acid, potassium, magnesium and citrate were determined.
Results: Urinary levels of citrate, potassium and magnesium in UL and NC patients were significantly lower than that in NSF controls. Urinary calcium in NC patients was significantly greater than the controls. Both UL and NC patients had urinary uric acid higher, while urinary oxalate lower, than the controls. Hypocitrauria (100%) were remarkably observed in childhood UL patients. Four children with NC (57.14%) had hypocitrauria whereas only 4% (1/27) was found in NSF children. The prevalence of hypercalciuria and hyperoxaluria in childhood UL patients and NSF children was not statistically different. Prevalence of hypercalciuria and hyperoxaluria in pediatric NC patients did not differ from the controls.
Conclusion: Hypocitrauria was considered as the main metabolic risk factors of UL and NC in Thai children. Modification in dietary habit as well as citrate supplementation is recommended to prevent recurrent urinary stone in UL patient and to decrease the likelihood of stone formation in NC patients.
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