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Analysis of urinary parameters as risk factors for nephrolithiasis in children with celiac disease
Marco Deganello Saccomani1, Carla Pizzini, Giorgio L Piacentini
1Pediatric Department, University of Verona, Verona, Italy.
Insights
Children with celiac disease do not show increased oxalate in their urine, unlike adults. This suggests their risk for developing kidney stones is not elevated, and lower urinary calcium may offer protection.
Area of Science:
- Pediatric Nephrology
- Gastroenterology
- Celiac Disease Research
Background:
- Intestinal malabsorption, such as celiac disease, can lead to enteric hyperoxaluria and increase the risk of calcium oxalate kidney stones.
- While celiac disease is linked to kidney stones in adults, data on pediatric populations is lacking.
Purpose of the Study:
- To investigate urinary electrolyte excretion in children diagnosed with celiac disease.
- To assess the potential risk of nephrolithiasis in pediatric celiac disease patients.
Main Methods:
- Analyzed urinary variables in 115 children (ages 1-16) with biopsy-confirmed celiac disease.
- Performed blood tests to rule out metabolic disorders and assess renal function.
Main Results:
- All patients had confirmed celiac disease diagnoses.
- Urinary oxalate levels were normal in all studied children.
- Decreased urinary calcium levels were observed and inversely correlated with celiac disease severity (p = 0.0004).
Conclusions:
- Pediatric celiac disease does not appear to increase urinary oxalate excretion.
- The risk of nephrolithiasis in children with celiac disease is likely not elevated compared to healthy children.
- Observed hypocalciuria may further reduce the propensity for kidney stone formation.
Purpose:
Intestinal malabsorption can cause urinary stone disease via enteric hyperoxaluria. It has been shown that celiac disease, a common malabsorption disorder, is associated with an increased risk of calcium oxalate kidney stones in adults. Since no published data are available in the pediatric population, we analyzed urinary excretion of electrolytes in children with celiac disease to assess the risk of nephrolithiasis.
Materials And Methods:
The study population consisted of 115 children 1 to 16 years old (mean 5 years) with positive serological tests for celiac disease (anti-endomysium and anti-tissue transglutaminase antibodies) referred to us for jejunal biopsy to confirm the diagnosis. Assessment was requested because patients presented with poor growth, anemia, gastrointestinal disorders or a family history of celiac disease. After obtaining informed consent we performed urine tests to measure urinary variables and blood tests to exclude metabolic disorders and evaluate renal function.
Results:
All patients had a biopsy confirmed diagnosis of celiac disease. Oxaluria was normal in all children studied. However, levels of urinary calcium were decreased in patients with celiac disease and were inversely associated with disease severity (p = 0.0004).
Conclusions:
In contrast to adults, increased urinary excretion of oxalate was not detectable in children presenting with celiac disease. Therefore, the risk of nephrolithiasis appears not to be increased compared to healthy children. The observed hypocalciuria probably further decreases the tendency to form kidney stones.
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