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Related Experiment Videos

Determining urinary calcium/creatinine cut-offs for the paediatric population using published data.

Michael P Metz1

  • 1Division of Laboratory Medicine, Core Laboratory, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia 5008, Australia. michael.metz@cywhs.sa.gov.au

Annals of Clinical Biochemistry
|October 7, 2006
PubMed
Summary

This study establishes normal urine calcium-to-creatinine (Ca/Cr) ratio cut-offs for children aged 0-18 years. These new reference values aid in identifying abnormal results in paediatric urine tests.

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Area of Science:

  • Pediatric Nephrology
  • Clinical Chemistry
  • Biomarker Discovery

Background:

  • Establishing abnormal cut-offs for spot urine calcium-to-creatinine ratio (Ca/Cr) in children is crucial but lacks well-defined reference values.
  • Existing literature contains numerous reports of urine Ca/Cr excretion, offering a basis for analysis rather than new primary studies.

Purpose of the Study:

  • To determine reliable cut-off values for abnormal spot urine Ca/Cr in the pediatric age group (0-18 years).
  • To synthesize existing published data to establish laboratory reference ranges for urine Ca/Cr.

Main Methods:

  • A systematic review and meta-analysis of 14 published studies reporting urine Ca/Cr ratios in children.
  • Data from reviewed studies were plotted to determine a line of best fit (y=-0.3175 ln(x) +1.46, r²=0.85).

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  • Age-specific cut-offs were recalculated using the derived function and validated against original and in-house data.

    • Main Results:

    • A regression model was established to correlate urine Ca/Cr (mmol/mmol) with age (years).
    • Age-specific cut-offs were derived: <1 year (1.50), 1-<2 years (1.25), 2-<5 years (1.00), 5-<10 years (0.70), and 10-18 years (0.60) in mmol/mmol.
    • These derived cut-offs were confirmed through consultation with pediatric nephrologists and comparison with in-house data.

    Conclusions:

    • Established age-specific spot urine Ca/Cr cut-offs for children from birth to 18 years.
    • These reference values provide a standardized method for interpreting urine Ca/Cr results in pediatric populations.