Population based data on urinary excretion of calcium, magnesium, oxatate, phosphate and uric acid in children from Cimitile (southern Italy)

Santo, Natale G. De; Iorio, Biagio Di; Capasso, Giovambattista; Paduano, C; Stamler, Rose; Langman, Craig B.; Stamler, Jeremiah

doi:10.1007/bf00866297

Cited by 77 publications

(58 citation statements)

References 24 publications

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“…Unfortunately, to the best of our knowledge, there is currently no information to explain the low incidence of urolithiasis in Japanese children, and no attention has been paid to urinary calcium excretion or to the prevalence of hypercalciuria in Japan, whereas there are a considerable number of reports from other countries [7, 8, 9, 10, 11, 12, 13, 14]. …”

Section: Introductionmentioning

confidence: 99%

Low Prevalence of Hypercalciuria in Japanese Children

Kaneko

Tsuchiya²,

Kawamura³

et al. 2002

Nephron

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Background/Aim: There are several factors, such as race, age, sex, and geographical variations, associated with renal stone formation. Although it is known that the prevalence of urolithiasis in Japanese children is low, the reason remains obscure. We hypothesize that the low prevalence of urolithiasis is associated with the urinary calcium excretion. The aim of our study was to investigate the prevalence of hypercalciuria in Japanese children. Methods: This investigation is a population-based school survey. A group of 529 healthy Japanese children was screened for hypercalciuria by measurement of the urinary Ca/Cr ratio using the morning fasting urine. In addition, the urinary Na/Cr ratio was also calculated for each subject. Results: Hypercalciuria regarded as an urinary Ca/Cr value of more than 0.17 was noted only in 3 out of 529 children (0.6 %), while most cases (494/529, 93.4%) demonstrated hypocalciuria (urinary Ca/Cr <0.05). The mean urinary Ca/Cr value was 0.024 in all subjects combined. Linear regression analysis revealed a positive direct correlation between urinary Ca/Cr and Na/Cr values (rs = 0.14, p < 0.01). The urinary Ca/Cr ratio was not related to age in either sex. Conclusions: The present study demonstrates that the prevalence of hypercalciuria in Japanese children is low as compared with other countries, even though absorptive hypercalciuria and dietary hypercalciuria might be missed in this setting. This low prevalence of hypercalciuria may be associated with the lower prevalence of urolithiasis in Japanese children. As it is suggested that a low dietary intake of calcium and sodium may play some role in the low urinary calcium excretion, a randomized, controlled study comparing the efficacy of different modes of therapy, such as a low-calcium diet and/or a low-salt diet, might provide valuable information for the prevention of urolithiasis.

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Section: Introductionmentioning

confidence: 99%

Low Prevalence of Hypercalciuria in Japanese Children

Kaneko

Tsuchiya²,

Kawamura³

et al. 2002

Nephron

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“…Therefore, U-Ca/Cr could be a sensitive indicator of secondary hyperparathyroidism. While a high U-Ca/Cr ratio is often used as an indicator of hypercalciuria leading to nephrocalcinosis and nephrolithiasis [8][9][10], the present study is the first to establish a lower limit for this ratio.…”

Section: Discussionmentioning

confidence: 96%

Urinary calcium to creatinine ratio: a potential marker of secondary hyperparathyroidism in patients with vitamin D-dependent rickets type 1A

et al. 2015

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VITAMIN D plays an important role not only in the maintenance of mineral homeostasis but also in the modulation of osteoblast differentiation [1]. Native vitamin D is produced from food intake or synthesized in the skin in response to ultraviolet light. Vitamin D is then sequentially activated by two hydroxylases: 25-hydroxylase converts native vitamin D into 25-hydroxyvitamin D (25-OHD) in the liver and 1-alpha-hydroxylase (1α-OHase) converts 25-OHD into 1,25(OH) 2 D in the kidney. Inactivation of vitamin D also occurs in the liver by 24-hydroxylase which Urinary calcium to creatinine ratio: a potential marker of secondary hyperparathyroidism in patients with vitamin D-dependent rickets type 1A Kentaro Miyai 1), 2) , Toshikazu Onishi 2), 3) , Kenichi Kashimada 2), 4) and Yukihiro Hasegawa 1) 1) Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Japan 2) Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Japan 3) Department of Pediatrics, Kinki Central Hospital, Japan 4) Department of Pediatrics, Tsuchiura General Hospital, Japan Abstract. Patients with vitamin D-dependent rickets type 1A (VDDR1A) are usually treated with alfacalcidol, an analog of vitamin D. Around puberty, an increased dose of alfacalcidol is recommended for these patients to avoid hypocalcemia and secondary hyperparathyroidism. However, no indicators of secondary hyperparathyroidism except for PTH are presently known. The aim of this study is to evaluate whether urinary calcium to creatinine ratio (U-Ca/Cr) is useful as a biomarker of secondary hyperparathyroidism in VDDR1A patients in order to determine the proper dose of alfacalcidol. Two brothers with VDDR1A were recruited who had null mutations of CYP27B1 which encodes 1-alpha-hydroxylase of vitamin D. We investigated the relationship between U-Ca/Cr and intact-PTH around puberty when the brothers showed hypocalcemia with secondary hyperparathyroidism. The results were compared to those of five patients with vitamin D deficiency (VDD). As a result, high intact-PTH levels were observed when U-Ca/Cr decreased to less than 0.1 (mg/mg) in both VDDR1A brothers. This relationship was also observed in the VDD patients. However, it is necessary to take into account body calcium status, either in depletion or in excess, to accurately evaluate the relationship between U-Ca/Cr and secondary hyperparathyroidism. First, low U-Ca/Cr was detected in situations with calcium depletion without hyperparathyroidism in the VDDR1A patients. Second, high U-Ca/Cr with hyperparathyroidism could be detected theoretically in a condition of excess calcium supply. In conclusion, a U-Ca/Cr ratio of less than 0.1 (mg/mg) in VDDR1A patients is useful to accurately evaluate calcium depletion and secondary hyperparathyroidism. . Serum Ca level is maintained by PTH and 1,25(OH) 2 D primarily to avoid hypocalcemia. PTH secretion is under the control of Ca-sensing receptors on the surface of the parathyroid gland. The dose-response curve o...

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“…O resultado obtido para a excreção de cálcio em urina, em 24 horas, em mg/kg, comprovou o que já é consenso na comunidade científica mundial [6][7][8]24,25 . A coleta de urina em amostra única, com jejum noturno, foi utilizada por diversos autores 6,[24][25][26] .…”

Section: Discussionunclassified

“…A coleta desse tipo de amostra apresenta grandes dificuldades práticas, especialmente em pacientes pediátri-cos, podendo incorrer em erros e representar incômodo para a criança e ônus para a família. Os inconvenientes desse tipo de coleta levaram os pesquisadores a utilizarem os quocientes cálcio/creatinina [6][7][8] , ácido úrico/creatinina 6,7,9 e citrato/creatinina 10 em amostras urinárias simplificadas ou avaliar a excreção desses elementos nessas mesmas amostras, corrigida pelo clearance de creatinina ou em mg/dl do ritmo de filtração glomerular -RFG 6,11,12 .…”

Section: Introductionunclassified

Excreção urinária de cálcio, ácido úrico e citrato em crianças e adolescentes sadios

Penido¹,

Diniz²,

Guimarães³

et al. 2002

J. Pediatr. (Rio J.)

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Artigo submetido em 16.08.01, aceito em 12.12.01. ResumoObjetivo: determinar valores de referência regionais para a excreção urinária de cálcio, ácido úrico e citrato e estabelecer correlação entre essas excreções em urina em 24h e amostras únicas, para uso na prática clínica.Material e métodos: 125 crianças e adolescentes saudáveis, selecionados aleatoriamente, foram submetidos ao protocolo: exame clínico, bioquímica de sangue, hemograma, paratormônio, urina em 24h, urina em amostra única colhida com jejum, e exame parasitológico de fezes.Resultados: o valor máximo para a excreção de cálcio em urina em 24h foi 3,75mg/kg, em mg/dl do ritmo de filtração glomerular -RFG foi 0,10, e, para a relação cálcio/creatinina(mg/dl) na urina, em amostra única em jejum, foi de 0,25. Observou-se correlação positiva entre a excreção de cálcio em urina em 24h, e urina em amostra única em jejum (mg/dl e mg/dl do RFG). Os valores máximos para a excreção de ácido úrico em urina em 24h foram 600, 450 e 320mg e 13, 15 e 18 mg/kg para adolescentes, escolares e pré-escolares, respectivamente; em mg/dl do RFG em amostra única de urina foi 0,47. Observou-se correlação positiva para a excreção de ácido úrico em urina em 24h e urina em amostra única em jejum. Os valores médios para a excreção de citrato em urina em 24h foram 1,6, 1,1 e 0,5mmol para adolescentes, escolares e pré-escolares, respectivamente; para a relação citrato/creatinina em urina, em amostra única, com jejum, foi 0,3.Conclusões: as excreções de cálcio e ácido úrico em urina em 24h se correlacionaram com aquelas das amostras urinárias simplificadas, permitindo o uso destas para diagnósticos metabólicos, estudos populacionais e controle de pacientes hipercalciúricos e hiperuricosúricos sem controle de esfíncter vesical; o quociente citrato/creatinina em urina, em amostra única, pode ser utilizado para controle de pacientes com hipocitratúria.J Pediatr (Rio J) 2002; 78 (2): 153-60: cálcio, ácido úrico, citrato e excreção urinária. AbstractObjective: to obtain regional reference values for calcium, uric acid and citrate urinary excretion and establish a correlation between those excretions in 24-hour urine sample and single urine sample for their use in clinical practice.Methods: a hundred and twenty-five healthy children and adolescents were randomly chosen and submitted to the following protocol: clinical examination, biochemical analysis of blood, blood cell count, parathormone, 24-hour urine, fasting urine sample and stool test.Results: the maximum value of calcium excretion in 24-hour urine was 3.75mg/kg; in mg/dl of the glomerular filtration rate, it was 0.10; and for the calcium/creatinine (mg/dl) ratio in the fasting urine sample was 0.25. Positive correlation was observed between calcium excretion in the 24-hour urine and the fasting sample (mg/dl and mg/dl of glomerular filtration rate). The maximum values of uric acid excretion in 24-hour urine were 600, 450, and 320mg and 13, 15 and 18mg/kg for adolescents, school and preschool children, respectively; in mg/dl of ...

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Population based data on urinary excretion of calcium, magnesium, oxatate, phosphate and uric acid in children from Cimitile (southern Italy)

Cited by 77 publications

References 24 publications

Low Prevalence of Hypercalciuria in Japanese Children

Low Prevalence of Hypercalciuria in Japanese Children

Urinary calcium to creatinine ratio: a potential marker of secondary hyperparathyroidism in patients with vitamin D-dependent rickets type 1A

Excreção urinária de cálcio, ácido úrico e citrato em crianças e adolescentes sadios

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