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Urinary biomarker as a predictor of urolithiasis in children: a systematic review and meta-analysis

Derryl Texaga1, Saskia Ratna Desita2, Nadira Muthi Tsania3

  • 1Rantauprapat Regional General Hospital, Labuhanbatu.

Archivio Italiano Di Urologia, Andrologia : Organo Ufficiale [Di] Societa Italiana Di Ecografia Urologica E Nefrologica
|August 18, 2025
PubMed

Insights

Urinary citrate, oxalate, and calcium levels can help predict pediatric urolithiasis risk. Low citrate, high oxalate, and high calcium are key indicators of stone formation in children.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Biomarker Discovery

Background:

  • Pediatric urolithiasis poses long-term risks to kidney function and quality of life.
  • Previous studies on urinary biomarkers for pediatric urolithiasis risk have yielded inconsistent results.
  • This meta-analysis evaluates the diagnostic potential of urinary risk factors in children.

Purpose of the Study:

  • To assess the diagnostic value of urinary citrate/creatinine (Cit/Cr), oxalate/creatinine (Ox/Cr), calcium/creatinine (Ca/Cr), phosphorus/creatinine (P/Cr), magnesium/creatinine (Mg/Cr), and urea/creatinine (Ur/Cr) ratios in pediatric urolithiasis.
  • To identify reliable urinary biomarkers for predicting urolithiasis risk in children.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
  • Inclusion of six studies (1 cohort, 5 case-control) with 2,060 pediatric patients.
  • Analysis of urinary risk factors and calculation of Standard Mean Differences (SMD) with heterogeneity assessment.

Main Results:

  • Significant differences observed in Cit/Cr, Ca/Cr, Ox/Cr, and Mg/Cr ratios between children with and without urolithiasis.
  • Hypocitraturia (Cit/Cr), hyperoxaluria (Ox/Cr), hypercalciuria (Ca/Cr), and hypomagnesuria (Mg/Cr) are significantly associated with pediatric urolithiasis.
  • No significant associations found for P/Cr and Ur/Cr ratios.

Conclusions:

  • Cit/Cr, Ox/Cr, and Ca/Cr ratios show promise as urinary biomarkers for pediatric urolithiasis risk.
  • Hypocitraturia, hyperoxaluria, and hypercalciuria are key metabolic abnormalities linked to urinary stone formation in children.
  • Further research with standardized methods is needed to confirm findings and guide clinical practice.
Abstract

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