Evaluation of lithogenic elements in urine of healthy newborns

The determination of urinary excretion of lithogenic elements in healthy newborns involves factors ranging from urine collection and data handling to maternal influences, which can cause difficulties in analyzing the results. The objective of this study was to determine normal values of parameters related to lithogenesis, such as calcium, uric acid, citrate, and oxalate, in urine of healthy newborns using isolated samples, focusing on variations according to gender, weight, milk ingestion, and family history of lithiasis. Parameters measured in isolated urine samples from 104 healthy newborns (77 males and 27 females) were corrected by creatinine. The ratios were expressed as milligram/milligram of creatinine: calcium/creatinine of 0.10+/-0.01 (X+/-SE), uric acid/ creatinine of 1.10+/-0.10, citrate/creatinine of 0.56+/-0.04, and oxalate/creatinine of 0.07+/-0.01. Differences were observed between males and females, in terms of uric acid (0.80+/-0.07 vs. 1.10+/-0.10 mg/mg, P<0.05), citrate (0.05+/-0.06 vs. 0.17+/-0.05, P<0.05), sodium (0.17+/- 0.01 vs. 0.05+/-0.01, P<0.001), and potassium (0.05+/- 0.01 vs. 0.20+/-0.02, P<0.001). Interestingly, the urinary concentration of protector factors such citrate and potassium was higher in females than in males with low sodium excretion. Artificial milk feeding leads to higher calcium (0.10+/-0.06 vs. 0.06+/-0.01), uric acid (1.40+/-0.20 vs. 0.90+/-0.09, P<0.05), citrate (0.90+/-0.09 vs. 0.50+/-0.04, P<0.001), and oxalate (0.17+/-0.03 vs. 0.05+/-0.01, P<0.001) excretion when compared with breast feeding. There was higher excretion of calcium and sodium in patients under 3 kg. Children with familial antecedents presented some differences in urinary excretion, with higher uric acid (1.50+/-0.30 vs. 0.80+/-0.08, P<0.05) but lower calcium (0.05+/-0.02 vs. 0.10+/-0.01, P<0.05) and sodium (0.15+/-0.02 vs. 0.20+/-0.02, P<0.05) excretion, respectively. This report provides urinary parameters obtained in healthy newborns and correlates them with factors that could be involved in the genesis of osteopenia, renal stones, and/or nephrocalcinosis.