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Determination of urine saturation with computer program EQUIL 2 as a method for estimation of the risk of
D Milosević1, D Batinić, N Blau
1Childrens' University Hospital Salata, Department of Pharmacology, Medical Faculty University of Zagreb, Croatia.
Insights
Children with urolithiasis show higher urinary calcium, oxalate, and urine saturation. Urine saturation is the best predictor for identifying children at increased risk of developing kidney stones.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Urolithiasis affects children, necessitating identification of risk factors.
- Isolated hematuria can be an early sign of kidney issues.
Purpose of the Study:
- To assess urinary risk factors for urolithiasis in children.
- To compare urinary profiles of children with urolithiasis, isolated hematuria, and healthy controls.
Main Methods:
- Measured 24-hour urinary excretion of various substances (calcium, oxalate, etc.) in 30 urolithiasis patients, 36 with hematuria, and 15 controls.
- Calculated urine saturation for calcium oxalate using EQUIL 2.
- Employed logistic regression to estimate urolithiasis risk.
Main Results:
- Children with urolithiasis exhibited significantly higher calcium, oxalate excretion, and urine saturation compared to controls.
- Children with isolated hematuria showed only increased calcium excretion.
- Urine saturation provided the highest classification accuracy (85.41%) for predicting urolithiasis risk.
Conclusions:
- Urinary calcium, oxalate, and saturation are key indicators in pediatric urolithiasis.
- Urine saturation is a superior predictor of urolithiasis risk in children compared to calcium or oxalate excretion alone.
- A urine saturation breakpoint of 4.29 effectively distinguishes children at risk for urolithiasis.
Abstract:
To investigate the risk for the development of urolithiasis in 30 children with urolithiasis, 36 children with isolated hematuria, and 15 healthy control children, 24-h urinary excretion of calcium, sodium, oxalate, citrate, sulfate, phosphate, magnesium, urate, chloride, ammonium, and glycosaminoglycans was determined and urine saturation for calcium oxalate was calculated with the computer program EQUIL 2. Compared with controls, children with urolithiasis had significantly increased calcium excretion, oxalate excretion, and urine saturation, whereas children with isolated hematuria had significantly increased calcium excretion only. The best estimation of the relative risk of urolithiasis can be made after urine saturation, using logistic regression. The percentage of patients correctly classified after urine saturation is 85.41% in comparison with 80.95% and 73.81% when the estimation was done by calcium excretion and oxalate excretion, respectively. Using the breakpoint value of 4.29 for urine saturation, it was possible to separate children with increased risk of urolithiasis development from the group of children with isolated hematuria.