Urinary citrate excretion in healthy children depends on age and gender |
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Authors: | Jan K Kirejczyk Tadeusz Porowski Jerzy Konstantynowicz Agata Kozerska Andrzej Nazarkiewicz Bernd Hoppe Anna Wasilewska |
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Institution: | 2. Department of Pediatric Surgery, Medical University of Bialystok, Bialystok, Poland 1. Department of Pediatric Nephrology, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland 3. Department of Pediatrics and Developmental Disorders, Medical University of Bialystok, Bialystok, Poland 4. Department of Urology, Regional Hospital of Bialystok, Bialystok, Poland 5. Department of Pediatrics, Division of Pediatric Nephrology, University of Bonn, Bonn, Germany
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Abstract: | Background Hypocitraturia is considered a major risk factor for calcium stone formation. However, there is no widely accepted reference database of urinary citrate excretion in children. The aim of our study was to determine the amount of citrate eliminated in the urine over a 24-h period in a pediatric cohort and to determine an optimal unit reflecting excretion. Methods The study cohort comprised 2,334 healthy boys and girls aged 2–18 years. The levels of urinary citrate were assessed by an enzymatic method in 24-hour urine and expressed in absolute values, as urinary concentration, citrate/creatinine ratio, per kilogram of body weight, in relation to 1.73 m2, and as the calcium/citrate index. Results Similar incremental age-related citraturia rates were observed in both male and female subjects until puberty during which time citrate excretion became significantly higher in girls. Urinary citrate adjusted for creatinine and for body weight showed a significantly decreasing trend with increasing age in both sexes. Urinary citrate corrected for body surface was weakly correlated with age. Thus, the assumption of 180 mg/1.73 m2/24 h for males and 250 mg/1.73 m2/24 h for females as lower cut-off values appeared to be reliable from a practical perspective. Conclusions We found distinct sex-dependent differences in citraturia at the start of puberty, with significantly higher values of urinary citrate in girls than in boys. Further prospective studies are warranted to elucidate whether this difference represents a differentiated risk of urolithiasis. |
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