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Urinary citrate excretion in idiopathic nephrolithiasis
Simmi K Ratan1, V Bhatnagar, D K Mitra
1Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Indian Pediatrics
|October 9, 2002
Summary
Children with kidney stones have lower urinary citrate levels, especially males and older females. This suggests citrate deficiency is a key factor in pediatric nephrolithiasis, particularly in endemic regions.
Area of Science:
- Pediatric Nephrology
- Urology
- Biochemistry
Background:
- Nephrolithiasis (kidney stones) is a growing concern in children.
- Urinary citrate plays a crucial role in inhibiting stone formation.
- Understanding citrate levels in pediatric stone disease is vital for diagnosis and management.
Purpose of the Study:
- To compare urinary citrate excretion in children with nephrolithiasis and healthy controls.
- To investigate the relationship between urinary citrate levels and stone composition in pediatric patients.
Main Methods:
- Prospective study conducted at a tertiary care center.
- Involved 50 children (under 12 years) with idiopathic urinary calculi and 150 age/weight-matched controls.
- Urinary citrate estimated via colorimetric method in 24-hour urine samples; stone analysis performed.
Main Results:
- Significantly lower 24-hour urinary citrate excretion in stone-forming children compared to controls, particularly in males and older females.
- Hypocitraturia (low citrate) detected in 43% of cases, with higher incidence in calcium phosphate (76%) and calcium oxalate (87%) stones.
- Urinary citrate levels increased with age in both groups, but remained lower in patients.
Conclusions:
- Low urinary citrate is strongly associated with pediatric nephrolithiasis, even without obvious causes.
- Measurement of urinary citrate is recommended for all children diagnosed with kidney stones.
- Findings are particularly relevant for endemic areas with high stone incidence.