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Published on: October 28, 2014
Urinary calcium excretion in Swedish children
1Department of Paediatrics, Orebro Medical Centre Hospital, Sweden.
Insights
This study established reference ranges for urinary calcium excretion in healthy Swedish children. Results show higher normal urinary calcium/creatinine ratios in younger children, with no link to milk intake.
Area of Science:
- Pediatric Nephrology
- Clinical Chemistry
Background:
- Establishing reference ranges for urinary calcium excretion is crucial for diagnosing hypercalciuria in children.
- Previous studies may not accurately reflect normal urinary calcium levels in pediatric populations.
Purpose of the Study:
- To determine normal urinary calcium/creatinine ratio (UCa/Cr) in a healthy Swedish pediatric population.
- To investigate the correlation between UCa/Cr and age, and cow's milk intake.
Main Methods:
- Measured urinary calcium and creatinine in 153 healthy Swedish children (aged 2-18 years) after an ordinary meal.
- Calculated UCa/Cr and analyzed data for distribution, age correlation, and milk intake correlation.
Main Results:
- The mean UCa/Cr was 0.44 ± 0.379, with 50th and 97th centiles at 0.33 and 1.5, respectively.
- A weak but significant negative correlation was found between UCa/Cr and age.
- No correlation was observed between UCa/Cr and cow's milk intake. Intra-individual variation was 30-40%.
Conclusions:
- The established upper normal limits for UCa/Cr in Swedish children are higher than previously reported.
- Hypercalciuria diagnosis in children requires age-related reference values and repeated measurements in symptomatic individuals.
Abstract:
Urinary calcium excretion was measured in an unselected population of 153 healthy Swedish children aged 2-18 years. Urine was collected after an ordinary meal. Urinary calcium excretion was measured as the calcium/creatinine concentration ratio (UCa/Cr) and expressed in mmol/l per mmol/l. UCa/Cr was 0.44 +/- 0.379 (mean +/- SD). As the UCa/Cr in this childhood population was not distributed in a normal manner, the results are more correctly presented as the 50th (0.33) and 97th (1.5) centiles. There was a weak but significant correlation between UCa/Cr and age, with higher values in the lower age groups. There was no correlation between UCa/Cr and the anamnestic intake of cow's milk. Repeated samples from some children showed a coefficient of variation between days of 30-40%. The upper limits of normal UCa/Cr (97th centile = 1.5; +2 SD = 1.2) in this investigation were higher than what is considered normal by others. In spite of this, none of the children had a history of renal stone disease or any other symptoms of hypercalciuria. Renal stone disease is thought to be rare in Swedish children although the real incidence is not known. The diagnosis of hypercalciuria should be based on repeated samples from an individual with symptoms and related to age-related reference values from the same population group.
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