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Urinary Mineral Excretion in Healthy Saudi Infants and Toddlers

Khalid A Alhasan1,2,3, Walaa Alshammasi4, Suha Salim1

  • 1Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Nephrology (Carlton, Vic.)
|December 21, 2025
PubMed

Insights

This study established age-specific urinary solute-to-creatinine ratios for Saudi infants, finding significant differences between age groups. These reference values are crucial for accurate diagnosis of urinary calcium excretion issues in children.

Area of Science:

  • Pediatric Nephrology
  • Clinical Biochemistry
  • Biomarker Discovery

Background:

  • Urinary solute-to-creatinine ratios are vital for assessing renal function and electrolyte balance in infants.
  • Establishing age-specific reference values is essential for accurate interpretation of these ratios, particularly in diverse populations.
  • Previous studies have not comprehensively defined these values for healthy Saudi infants.

Purpose of the Study:

  • To determine age-related reference values for urinary solute-to-creatinine ratios in healthy Saudi infants aged 0-2 years.
  • To analyze urinary calcium, phosphate, sodium, magnesium, and potassium concentrations relative to creatinine.
  • To calculate the urinary calcium-to-urinary sodium ratio (UCa/UNa) to explore the relationship between sodium and calcium excretion.

Main Methods:

  • A longitudinal study involving 189 healthy Saudi infants (0-2 years) recruited from a Riyadh hospital.
  • Measurement of urine solute and creatinine concentrations using standardized laboratory methods.
  • Calculation of various urinary solute-to-creatinine ratios (UCa/Cr, UNa/Cr, UK/Cr, UMg/Cr, UP/Cr) and UCa/UNa, with statistical analysis comparing age groups.

Main Results:

  • Significant differences in UCa/Cr, UMg/Cr, UNa/Cr, UK/Cr, and UP/Cr were observed between infants aged 0-2 months and 2 months-2 years (p < 0.001).
  • No significant difference was found in the UCa/UNa ratio between the age groups (p = 0.163).
  • No significant gender-based differences were noted in either age group for the measured ratios (p > 0.05).

Conclusions:

  • Age-related reference values for urinary solute-to-creatinine ratios were successfully established for Saudi infants.
  • Elevated urinary calcium-to-creatinine (UCa/Cr) ratios in younger infants align with expected physiological patterns.
  • These population-specific reference values are critical for the accurate diagnosis and management of hypercalciuria in Saudi children, preventing over- or underdiagnosis.
Abstract

Keywords:
Saudi childrenhypercalciuria reference valuesurinary mineral excretionurinary solute excretionurinary solute ratios

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