Hypocitrauria as a Major Metabolic Abnormality in Pediatric Urolithiasis and Nephrocalcinosis


  • Sasipa Muensri Department of Bilochemistry, Faculty of Medicine, Chulalongkorn University
  • Piyaratana Tosukhowong Department of Bilochemistry, Faculty of Medicine, Chulalongkorn University
  • Ankanee Chanakul Department of Prediatrics, Faculty of Medicine, Chulalongkorn University
  • Wattanachai Ungjaroenwathana Section of Urology, Department of Surgery, Suppasit Prasong Hospital
  • Vorasak Shotelersuk Department of Prediatrics, Faculty of Medicine, Chulalongkorn University
  • Chanchai Boonla Department of Bilochemistry, Faculty of Medicine, Chulalongkorn University


urolithiasis, nephrocalcinosis, metabolic abnormality, hypocitrauria, hypercalciuria, hyperoxaluria


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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How to Cite

Muensri, S., Tosukhowong, P., Chanakul, A., Ungjaroenwathana, W., Shotelersuk, V., & Boonla, C. (2010). Hypocitrauria as a Major Metabolic Abnormality in Pediatric Urolithiasis and Nephrocalcinosis. Insight Urology, 31(2), 147–155. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/252408



Original article