Urinary Calcium Oxalate Saturation in Healthy Infants and Children

Höppe, Bernd; Jahnen, Andrea; Bach, D.; Hesse, Albrecht

doi:10.1016/s0022-5347(01)64550-6

Cited by 58 publications

(36 citation statements)

References 16 publications

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“…Figure 1 shows supersaturation values versus urine output for these nine children with no detectable abnormality by traditional evaluation, but elevated supersaturation. Calcium oxalate data are expressed as z-scores to allow comparison of values across different ages, as published normal values vary by age range and gender through childhood [10]. Seven (22%) of the 32 children had no predisposition to stone formation as detected by either traditional evaluation, low urine volume, or supersaturation.…”

Section: Resultsmentioning

confidence: 99%

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Role of urinary supersaturation in the evaluation of children with urolithiasis

et al. 2005

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Timed urine collections are a standard part of the evaluation for predisposition to stone formation in children with urolithiasis. Supersaturation is defined as the ratio of the concentration of dissolved salt to its solubility in urine. The purpose of the present study was to determine if adding supersaturation to the standard timed urine collection increased the ability to detect a metabolic predisposition to stone formation. Thirty-two children with urolithiasis had 24-hour urine measurements of calcium, oxalate, citrate, uric acid, and cystine (the "traditional" evaluation), as well as supersaturation for calcium oxalate, calcium phosphate, and uric acid, on the same urine sample. Nine (28%) of the 32 were hypercalciuric, 2 (6%) hyperoxaluric, and 4 (12%) hypocitraturic. In total, 14 (44%) had a metabolic predisposition that was detected by the traditional evaluation. Supersaturation was elevated in 18 (56%), including nine who did not have metabolic predisposition detected by traditional evaluation. Urine volume was low in 17 (53%) of 32 children, including eight of nine children with abnormal supersaturation but normal traditional evaluation. Only one child with normal traditional evaluation and normal urine volume had elevated supersaturation. These results show that the benefit of adding supersaturation to the traditional evaluation was largely negated by consideration of urine volume.

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Section: Resultsmentioning

confidence: 99%

“…Low urine volume was considered <1 cc/kg/h [6]. Z-scores were calculated for calcium oxalate supersaturations using published pediatric normative data [10]. A zscore of !2.0 was considered elevated.…”

Section: Methodsmentioning

confidence: 99%

Role of urinary supersaturation in the evaluation of children with urolithiasis

et al. 2005

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“…Oxalate absorption was calculated from the amount of [ 13 C 2 ]oxalate in the 24-h urine and expressed as a percen< tage of the dose of [ 13 C 2 ]oxalate ingested via the capsule. All urinary analysis of oxalate, calcium, citrate and uric acid, as well as the calculation of the urinary saturation index for CaOx, brushite, and uric acid were performed as recently described [24]. Statistical analysis was performed by SPSS Statistics 17.0 for Windows (SPSS, Chicago, IL, USA) using Student's t test and Pearson's correlation coefficient.…”

Section: Methodsmentioning

confidence: 99%

Enteric hyperoxaluria, recurrent urolithiasis, and systemic oxalosis in patients with Crohn’s disease

et al. 2012

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“…The maximum urinary oxalate excretion of 1.16 mmol/1.73m 2 per 24 h was seen on day 1 (normal for age < 0.37 mmol/1.73m 2 per 24 h, [7]), which decreased rapidly to normal levels on day 4 ( Table 1). The relative urinary saturation for calciumoxalate also reached its maximum on day 1 (13.2 relative units, normal < 5.2) (Table 1), with a persistent supersaturation until day 4 of treatment.…”

Section: Case Reportmentioning

confidence: 96%

Hyperoxaluria after ethylene glycol poisoning

2008

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Treatment of otherwise lethal ethylene glycol poisoning depends on rapid diagnosis, aggressive supportive care, appropriate use of alcohol dehydrogenase inhibitors and, in selected patients, hemodialysis. Next to that, specific measures to prevent renal or systemic calcium-oxalate deposition are important. We report the case of a 12-year-old girl who ingested more than five times the lethal dosis of ethylene glycol in a suicide attempt. At admission her serum ethylene glycol concentration was 88 mg/dl. Under treatment by ethanol infusions to block the alcohol dehydrogenase and by hemodialysis to eliminate ethylene glycol and its toxic metabolites, this level decreased to below 15 mg/dl within 36 h. The plasma oxalate level, however, rose to a maximum of 89 micromol/l (normal <6.3 +/- 1.1) on day 3 and only normalized on day 7 after ingestion. In addition, urinary oxalate excretion was elevated (maximum 1.16 mmol/1.73 m(2)/24 h). Both lead to calcium-oxalate oversaturation and hence to the risk of local (renal) or systemic crystal deposition. Therefore, alkaline citrate was given as a preventive measure to increase urinary oxalate solubility, but nephrocalcinosis still developed. Metabolic acidosis, hypocalcaemia, and neurological symptoms had not occurred. Four weeks after discharge, both plasma and urinary oxalate levels were normal.

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Urinary Calcium Oxalate Saturation in Healthy Infants and Children

Abstract: We recommend calculating urinary calcium oxalate saturation for diagnostic purposes as well as for therapy control. Normal age and sex related values must be considered.

Cited by 58 publications

References 16 publications

Role of urinary supersaturation in the evaluation of children with urolithiasis

Role of urinary supersaturation in the evaluation of children with urolithiasis

Enteric hyperoxaluria, recurrent urolithiasis, and systemic oxalosis in patients with Crohn’s disease

Hyperoxaluria after ethylene glycol poisoning

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