A study of the etiology of idiopathic calcium urolithiasis in children: Hypocitruria is the most important risk factor
A study of the etiology of idiopathic calcium urolithiasis in children: Hypocitruria is the most important risk factor
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DOI：
10.1016/s0022-5347(05)67487-3
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发表时间：
2000-07-01
影响因子：
6.6
通讯作者：
Bakkaloglu, M
中科院分区：
文献类型：
--
作者：
Tekin, A;Tekgul, S;Bakkaloglu, M
目的：为了确定代谢危险因素与儿童钙性尿石症的关系，我们比较了特发性钙性结石儿童和健康儿童的代谢评估数据。材料与方法：对78例1 ~ 15岁（平均7.2岁）无尿路感染、解剖异常、代谢、内分泌和肠道疾病的钙结石患者和24例健康儿童进行代谢评价。评估包括血清生化，以及每日尿钙、草酸、尿酸、磷、柠檬酸和镁排泄量的测定。结果：两组患者人口学特征、血清参数及日钙、尿酸、磷、镁排泄量无统计学差异。然而，尿草酸显著高于对照组，尿柠檬酸显著低于对照组（p分别= 0.002和0.028）。肾结石患者低钠尿和高草酸尿的发生率分别是对照组的4.3倍和3倍。多因素logistic回归分析显示，低钠尿是特发性钙结石的唯一显著危险因素（p = 0.008）。结论：低尿是本组患者最重要的危险因素。在许多结石患者中，高草酸尿也很常见，并伴有低钠尿。与之前的许多报道相反，我们未能证明高钙尿症是特发性钙结石的重要代谢缺陷，可能是因为我们的研究评估了不同的人群。
Purpose: To determine the association of metabolic risk factors with pediatric calcium urolithiasis we compared metabolic evaluation data on children with idiopathic calcium stones and those on healthy children.Materials and Methods: Metabolic evaluation was done in 78 calcium stone formers 1 to 15 years old (mean age 7.2) who were free of urinary tract infection, anatomical abnormalities, and metabolic, endocrinological and intestinal disorders, and in 24 healthy children. Evaluation included serum biochemistry, and measurement of daily excretion of urinary calcium, oxalate, urate, phosphorus, citrate and magnesium.Results: Demographic characteristics, serum parameters, and daily excretion of calcium, urate, phosphorus and magnesium did not differ statistically in the 2 groups. However, urinary oxalate was significantly higher and urinary citrate was significantly lower in stone formers than in controls (p = 0.002 and 0.028, respectively). Hypocitruria and hyperoxaluria were 4.3 and 3-fold more common in stone formers than in controls, respectively. Multivariate analysis using logistic regression showed that hypocitruria was the only significant risk factor for idiopathic calcium stones (p = 0.008).Conclusions: Hypocitruria was the most important risk factor in our patients. Hyperoxaluria was also common and accompanied hypocitruria in many stone formers. In contrast to many previous reports, we failed to show that hypercalciuria is an important metabolic defect for idiopathic calcium stones, possibly because our study evaluated a different population.