Fractional excretion of sodium and urine lithogenic factors in children with urolithiasis
Abstract
The aim of the study was to investigate the fractional excretion of sodium and other electrolytes in children with urolithiasis compared to healthy children. The study included 66 children: 40 of them had urolithiasis (28 boys and 12 girls) from 7 months to 16 years old (mean 6,9 ± 4,9 years) and 26 healthy children (16 boys and 12 girls) from 6 months to 16 years old (mean 7,3 ± 5,0 years old). All children got the same diet with a salt content below 3 g/day. Stone samples (30) were examined by X-ray diffraction method using a Shimadzu XRD-6000 diffractometer. Spot urine samples and serum specimens were analyzed for sodium, potassium, calcium, phosphate, magnesium, uric acid, creatinine and urine oxalate levels. Metabolic disorders were revealed in 35% of children, hypercalciuria was found only in 10% of children. The most common stone component was calcium oxalate (61%). We found that the fractional excretion of sodium was significantly increased in children with nephrolithiasis compared to healthy children (0,88 ± 1,05% vs 0,31 ± 0,20%, p < 0,01). The fractional excretion of sodium did not depend on stone composition. A strong correlation between the fractional excretion of sodium and excretion of oxalate was revealed in children with nephrolithiasis only (r = 0,62, p < 0,01). No correlation between the fractional excretion of sodium and excretion of calcium was revealed in any group of children. Due to importance of the sodium excretion in stone formation we recommend to reduce salt intake for preventing stone recurrence in children.
About the Authors
A. M. Mazo
НЦЗД РАМН
Russian Federation
Russian Federation
A. I. Akopyan
НЦЗД РАМН
Russian Federation
Russian Federation
S. N. Zorkin
НЦЗД РАМН
Russian Federation
Russian Federation
E. M. Vasiljeva
НЦЗД РАМН
Russian Federation
Russian Federation
N. A. Mayanskiy
НЦЗД РАМН
Russian Federation
Russian Federation
R. M. Zacalucin
Институт кристаллографии РАН
Russian Federation
Russian Federation
A. N. Tsygin
НЦЗД РАМН
Russian Federation
Russian Federation
References
1. Детская нефрология: практическое руководство/ Под ред. Э. Лойманна, А.Н. Цыгина, А.А. Саркисяна. М.: Литера, 2010. с. 387.
2. Нефрология. Руководство для врачей/ Под ред. И.Е. Тареевой. М.: Медицина, 2000. С. 413–422.
3. Aladjem M., Modan M., Lusky A. et al. Idiopathic hypercalciuria: a familial generalized renal hyperexcretory state // Kidney Int. 1983. Vol. 24. P. 549–554.
4. Cirillo M., Ciacci C., Lauranzi M. et al. Salt intake, urinary sodium and hypercalciuria // Miner. Electrolyte Metab. 1997. Vol. 23. P. 265–268.
5. Friedman P. Codependence of renal calcium and sodium transport // Annual Review of Physiology. 1998. Vol. 60. P. 179–197.
6. Hoppe B., Hesse A. Metabolic disorders and molecular background of urolithiasis in children // Scanning Microscopy. 1999. Vol. 13 (2–3). P. 267–280.
7. Hoppe B., Kemper M.J. Diagnostic examination of the child with urolithiasis or nephrocalcinosis // Pediatr. Nephrol. 2010. Vol. 25. P. 403–413.
8. Hoppe B., Leumann E., Milliner D. Urolithiasis and nephrocalcinosis in childhood / In: Comprehensive pediatric nephrology. Geary D., Schaefer F., eds. Philadelphia: Mosby, 2008. P. 499–538.
9. Kovaceviс L., Kovaceviс S., Smoljanic Z. et al. Sodium excretion in children with lithogenic disorders // Srp. Arh. Celok. Lek. 1998. Vol. 126 (9–10). P. 321–326.
10. Lopez M., Hoppe B. History, epidemiology and regional diversities of urolithiasis // Pediatr. Nephrol. 2010. Vol. 25 (1). P. 49–59.
11. Martini L., Cuppari L., Cunha M. et al. Potassium and sodium intake and excretion in calcium stone forming patients // J. Ren. Nutr. 1998. Vol. 8 (3). P. 127–131.
12. Matos V., van Melle G., Boulat O. et al. Urinary phosphate/creatinine, calcium/creatinin, and magnesium/creatinin ratios in a healthy pediatric population // J. Pediatr. 1997. Vol. 131. P. 252–257.
13. Osorio A., Alon U. The relationship between urinary calcium, sodium, and potassium excretion and the role of potassium in treating idiopathic hypercalciuria // Pediatrics. 1997. Vol. 100. P. 675–681.
14. Ozkaya O., Buyan N., Erol I. et al. The relationship between urinary calcium, sodium, and potassium excretion in full-term healthy newborns // Turk. J. Pediatr. 2005. Vol. 47 (1). P. 39–45.
15. Polito C., La Manna A., Maiello R. et al. Urinary sodium and potassium excretion in idiopathic hypercalciuria of children // Nephron. 2002. Vol. 91. P. 7–12.
16. Sakhaee K., Harvey J., Padalino P. et al. The potential role of salt abuse on the risk for kidney stone formation // J. Urol. 1993. Vol. 150 (2 Pt 1). P. 310–312.
17. Sarkissian A., Babloyan A., Arikyants N. et al. Pediatric urolithiasis in Armenia: a study of 198 patients observed from 1991 to 1999 // Pediatr. Nephrol. 2001. Vol. 16. P. 728–732.
18. So N., Osorio A., Simon S. et al. Normal urinary calcium/creatinine ratios in African American and Caucasian children // Pediatr. Nephrol. 2001. Vol. 16. P. 133–139.
19. Stapleton F.B., Linshaw M.A., Hassanein K. et al. Uric acid excretion in normal children // J. Pediatr. 1978. Vol. 92. P. 911–914.
20. VanDervoort K., Wiesen J., Frank R. et al. Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome // J. Urol. 2007. Vol. 177. P. 2300–2305.
Review
For citations:
Mazo A.M., Akopyan A.I., Zorkin S.N., Vasiljeva E.M., Mayanskiy N.A., Zacalucin R.M., Tsygin A.N. Fractional excretion of sodium and urine lithogenic factors in children with urolithiasis. Nephrology and Dialysis. 2010;12(4):299-303. (In Russ.)
Views:
3
Email this article 