Skip to main content
SpringerLink
Log in

Reference values of plasma oxalate in children and adolescents

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Oxalate homeostasis is a derivative of absorption and transportation in the digestive system and renal/intestinal excretion of oxalate. The objective of this cross-sectional study was to determine normative values of plasma oxalate in relation to age, gender, and body size. A group of 1,260 healthy Caucasian children and adolescents aged 3 months to 18 years [mean ± standard deviation (SD) 10.5 ± 4.3] was studied. Each 1-year group comprised 70 subjects. Oxalate levels were assessed in blood plasma samples obtained from fasted individuals using the precipitation–enzymatic method with oxalate oxidase. Median oxalate levels in healthy infants was 3.20 µmol/L (5th–95th percentiles: 1.56–5.58) and was higher compared with older children [2.50 µmol/L (5th–95th percentiles: 0.95–5.74); p < 0.01]. No differences were found in plasma oxalate levels between boys and girls. There were no associations between plasma oxalate levels and anthropometric traits. In the healthy population aged 1–18 years, plasma oxalate concentration is independent of age, gender, and body size. Infants demonstrate higher plasma oxalate levels compared with older children, which suggests possible immature mechanisms of renal excretion. This study appears to be the first extensive report providing normative data for plasma oxalate in children and adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sarkissian A, Babloyan A, Arikyants N, Hesse A, Blau N, Leumann E (2001) Pediatric urolithiasis in Armenia: a study of 198 patients observed from 1991 to 1999. Pediatr Nephrol 16:728–732

    Article  CAS  PubMed  Google Scholar 

  2. Stapleton FB (2002) Childhood stones. Endocrinol Metab Clin North Am 31:1001–1015

    Article  CAS  PubMed  Google Scholar 

  3. Daudon M, Donsimoni R, Hennequin C, Fellahi S, Le Moel G, Paris M, Troupel S, Lacour B (2005) Sex- and age-related composition of 10 617 calculi analyzed by infrared spectroscopy. Urol Res 23:319–326

    Article  Google Scholar 

  4. Tiselius HG (1997) Risk formulas in calcium oxalate urolithiasis. World J Urol 15:176–185

    Article  CAS  PubMed  Google Scholar 

  5. Khan SR, Kok DJ (2004) Modulators of urinary stone formation. Front Biosci 9:1450–1482

    Article  CAS  PubMed  Google Scholar 

  6. Jiang Z, Asplin JR, Evan AP, Rajendran VM, Velazquez H, Nottoli TP, Binder HJ, Aronson PS (2006) Calcium oxalate urolithiasis in mice lacking anion transporter Slc26a6. Nat Genet 38:474–478

    Article  CAS  PubMed  Google Scholar 

  7. Kleta R (2006) A key stone cop regulates oxalate homeostasis. Nat Genet 38:403–404

    Article  CAS  PubMed  Google Scholar 

  8. Holmes RP, Assimos DG (1998) Glyoxylate synthesis, and its modulation and influence on oxalate synthesis. J Urol 160:1617–1624

    Article  CAS  PubMed  Google Scholar 

  9. Robertson WG (1999) Mild hyperoxaluria: a critical review and future outlook. In: Borghi L, Meschi T, Briganti A, Schianchi T, Novarini A (eds) Kidney stones, 8th European Symposium on Urolithiasis. Editoriale Bios, Cosenza, pp 33–42

    Google Scholar 

  10. Linster CL, Van Schaftingen E (2007) Vitamin C. Biosynthesis, recycling and degradation in mammals. FEBS J 274:1–22

    Article  CAS  PubMed  Google Scholar 

  11. Borghi L, Meschi T, Maggiore U, Prati B (2006) Dietary therapy in idiopathic nephrolithiasis. Nutr Rev 64:301–312

    Article  PubMed  Google Scholar 

  12. Hesse A, Schneeberger W, Engfeld S, Von Unruh GE, Sauerbruch T (1999) Intestinal hyperabsorption of oxalate in calcium oxalate stone formers: application of a new test using [13C2] oxalate. J Am Soc Nephrol 10:S329–S333

    CAS  PubMed  Google Scholar 

  13. Holmes RP, Goodman HO, Assimos DG (2001) Contribution of dietary oxalate to urinary oxalate excretion. Kidney Int 59:270–276

    Article  CAS  PubMed  Google Scholar 

  14. Massey LK (2003) Dietary influences on urinary oxalate and risk of kidney stones. Front Biosci 8:584–594

    Article  Google Scholar 

  15. Hatch M, Cornelius J, Allison M, Sidhu H, Peck A, Freel RW (2006) Oxalobacter sp. reduces urinary oxalate excretion by promoting enteric oxalate secretion. Kidney Int 69:691–698

    Article  CAS  PubMed  Google Scholar 

  16. Duncan S, Richardson AJ, Kaul P, Holmes RP, Allison MJ, Stewart CS (2002) Oxalobacter formigenes and its potential role in human health. Appl Environ Microbiol 68:3841–3847

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Zarembski PM, Hodgkinson A (1965) The fluorometric determination of oxalic acid in blood and other biological materials. Biochem J 96:717–721

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Zarembski PM, Hodgkinson A (1965) The fluorometric microdetermination of glyoxyclic acid in blood, urine and bacterial extracts. Biochem J 96:218–223

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Hodgkinson A, Zarembski PM (1968) Oxalic acid metabolism in man: a review. Calcif Tissue Res 2:115–132

    Article  CAS  PubMed  Google Scholar 

  20. Hatch M, Bourke E, Costello J (1977) New enzymatic method for serum oxalate determination. Clin Chem 23:76–78

    CAS  PubMed  Google Scholar 

  21. Akcay T, Rose GA (1980) The real and apparent plasma oxalate. Clin Chim Acta 101:305–311

    Article  CAS  PubMed  Google Scholar 

  22. Butz M, Kohlbecker E (1980) Oxalate urolithiasis: significance of serum and urinary oxalate. Urol Int 35:303–308

    Article  CAS  PubMed  Google Scholar 

  23. Gelot MA, Lvoue G, Belleville F, Nabet P (1980) Determination of oxalates in plasma and urine using gas chromatography. Clin Chim Acta 106:279–285

    Article  CAS  PubMed  Google Scholar 

  24. Boer P, van Leersum L, Endeman HJ (1984) Determination of plasma oxalate with oxalate oxidase. Clin Chim Acta 137:53–60

    Article  CAS  PubMed  Google Scholar 

  25. Kasidas GP, Rose GA (1986) Measurement of plasma oxalate in healthy subjects and in patients with chronic renal failure using immobilised oxalate oxidase. Clin Chim Acta 154:49–58

    Article  CAS  PubMed  Google Scholar 

  26. Berckmann RJ, Boer P (1988) An inexpensive method for sensitive enzymatic determination of oxalate in urine and plasma. Clin Chem 34:1451–1455

    Google Scholar 

  27. Costello J, Landwehr DM (1988) Determination of oxalate concentration in blood. Clin Chem 34:1540–1544

    CAS  PubMed  Google Scholar 

  28. Wilson DM, Smith LH, Erichson SB, Torres VE, Liedtke RR (1988) Renal oxalate handling in normal subjects and patients with idiopathic renal lithiasis: Primary and secondary hyperoxaluria. In: Walker VR (ed) Urolithiasis. Plenum Press, New York, pp 453–455

    Google Scholar 

  29. Rolton HA, McConnel KN, Modi KS, Macdougall AI (1989) A simple, rapid assay for plasma oxalate in uraemic patients using oxalate oxidase, which is free from Vitamin C interference. Clin Chim Acta 182:247–254

    Article  CAS  PubMed  Google Scholar 

  30. Petrarulo M, Bianco O, Marangella M, Pellegrino S, Linari F (1990) Ion chromatography determination of plasma oxalate in healthy subjects, in patients with chronic renal failure and in cases of hyperoxaluric syndromes. J Chromatogr 511:223–231

    Article  CAS  PubMed  Google Scholar 

  31. Petrarulo M, Marangella M (1990) Proper handling of blood samples in determination of oxalate. Clin Chimica Acta 189:249–252

    Article  CAS  Google Scholar 

  32. Fry JDR, Starkey BJ (1991) The determination of oxalate in urine and plasma by high performance liquid chromatography. Ann Clin Biochem 28:581–587

    Article  CAS  PubMed  Google Scholar 

  33. Wilson DM, Liedtke RR (1991) Modified enzyme-based colorimetric assay of urinary and plasma oxalate with improved sensitivity and no ascorbate interference: Reference values and sample handling procedures. Clin Chem 37:1229–1235

    CAS  PubMed  Google Scholar 

  34. Petrarulo M, Cerelli E, Marangella M, Maglienti F, Linari F (1993) Ion chromatographic determination of plasma oxalate reexamined. Clin Chem 39:537–539

    CAS  PubMed  Google Scholar 

  35. Petrarulo M, Cerelli E, Marangella M, Cosseddu D, Vitall C, Linari F (1994) Assay of plasma oxalate with soluble oxalate oxidase. Clin Chem 40:2030–2034

    CAS  PubMed  Google Scholar 

  36. Albrecht S, Zimmermann T, Beutner M, Distler W (1995) Chemiluminometric measurement of plasma and intercellular oxalate concentration in pediatric and adult septic patients. Eur J Clin Chem Clin Biochem 33:A32 (Abstracts of the 14th Int. Congress for Biochemical Analysis, Leipzig)

  37. Oehlschläger S, Albrecht S, Pilarshin Ch, Wirth MP (1998) Determination of serum and urine oxalate and oxalate concentration of red blood cells by chemiluminescence in idiopathic calcium oxalate nephrolithiasis. J Urol 159:175–177

    Google Scholar 

  38. Pundir CS, Kuchhal NK, Thakur M, Satyapal (1998) Determination of plasma oxalate with chloride ion insensitive oxalate oxidase. Indian J Biochem Biophys 35:120–122

    CAS  PubMed  Google Scholar 

  39. Gaulier JM, Lardet G, Cochat P, Vallon JJ (1998) A serum oxalate assay using chemiluminescence detection, adapted to a paediatric population. J Nephrol 11(Suppl 1):73–74

    PubMed  Google Scholar 

  40. Thakur M, Goyal L, Pundir CS (2000) Discrete analysis of plasma oxalate with alkylamine glass bound sorghum oxalate oxidase and horseradish peroxidase. J Biochem Biophys Methods 44:77–88

    Article  CAS  PubMed  Google Scholar 

  41. Ogura H (2000) Determinations of oxalate in urine and plasma by capillary electrophoresis. Nippon Hinyokika Gakkai Zasshi 91:547–555

    CAS  PubMed  Google Scholar 

  42. Hönow R, Hesse A (2002) Comparison of extraction methods for determination of soluble and total oxalate in foods by HPLC-enzyme-reactor. Food Chem 78:511–521

    Article  Google Scholar 

  43. Porowski T, Gałasiński W (2003) A semi-micromethod for determination of oxalate in human plasma. Acta Pol Pharm 60:239–245

    CAS  PubMed  Google Scholar 

  44. Harris AH, Freel RW, Hatch M (2004) Serum oxalate in human beings and rats as determined with the use of ion chromatography. J Lab Clin Med 144:45–52

    Article  CAS  PubMed  Google Scholar 

  45. Barratt TM, Kasidas GP, Murdock I, Rose GA (1991) Urinary oxalate and glycolate excretion and plasma oxalate concentration. Arch Dis Child 66:501–503

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Gaulier JM, Cochat P, Lardet G, Vallon JJ (1997) Serum oxalate determination in children by chemiluminescence detection. Proceedings of the 7th European Symposium on Urolithiasis 63:13

  47. Hoppe B, Kemper MJ, Hvizd MG, Sailer DE, Langman CB (1998) Simultaneous determination of oxalate, citrate and sulfate in plasma with ion chromatography: Normal values in childhood. Kidney Int 53:1348–1352

    Article  CAS  PubMed  Google Scholar 

  48. Kunachowicz H, Nadolna I, Przygoda B, Iwanow K (1998) Food composition tables. National and Nutrition Institute Warsaw

  49. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 320:1240–1243

    Article  CAS  Google Scholar 

  50. Palczewska I, Szilágyi-Pągowska I (2002) Ocena rozwoju somatycznego dzieci i młodzieży. Med Prakt Ped 3200:140–148

    Google Scholar 

  51. Aronson PS (2006) Role of SLC26-mediated Cl-/base exchange in proximal tubule NaCl transport. Novartis Found Symp 273:148–158 discussion 158–163, 261–264

    CAS  PubMed  Google Scholar 

  52. Aronson PS (2006) Essential roles of CFEX-mediated Cl(-)-oxalate exchange in proximal tubule NaCl transport and prevention of urolithiasis. Kidney Int 70:1207–1213

    Article  CAS  PubMed  Google Scholar 

  53. Worcester EM (2002) Stones from bowel disease. Endocrinol Metab Clin North Am 31:979–999

    Article  CAS  PubMed  Google Scholar 

  54. Porowski T, Zoch-Zwierz W, Porowska H, Jadeszko I (2006) The concentration of plasma anion oxalate in children treatment antibiotics beta lactam. Pol Merkur Lekarski 116:159–163

    Google Scholar 

  55. Siener R, Ebert D, Nicolay C, Hesse A (2003) Dietary risk factors for hyperoxaluria in calcium oxalate stone formers. Kidney Int 63:1037–1043

    Article  PubMed  Google Scholar 

  56. Danpure CJ (2005) Molecular etiology of primary hyperoxaluria type 1. Am J Nephrol 25:303–310

    Article  PubMed  Google Scholar 

  57. Webster KE, Ferree PM, Holmes RP, Cramer SD (2002) Identification of missense, nonsense, and deletion mutations in the GRHPR gene in patients with primary hyperoxaluria type II (PH2). Hum Genet 107:176–185

    Article  Google Scholar 

  58. Jadeszko I, Porowski T, Zoch-Zwierz WM, Wasilewska AM, Hackiewicz L (2005) Assessment of oxalate concentration in serum and urine of children with renal stones. Wiad Lek 58(Suppl 1):20–24

    PubMed  Google Scholar 

  59. Matos V, Van Melle G, Werner D, Bardy D, Guignard JP (1999) Urinary oxalate and urate to creatinine ratios in a healthy pediatric population. Am J Kidney Dis 34(2):e1

    Article  CAS  PubMed  Google Scholar 

  60. Sidhu HEL, Ogden S, Williams WN, Allison MJ, Peck AB (1997) Evaluating children in the Ukraine for colonization with the intestinal bacterium Oxalobacter formigenes, using a polymerase chain reaction-based detection system. Mol Diagn 2:89–97

    Article  CAS  PubMed  Google Scholar 

  61. Finkielstein VA, Goldfarb DS (2006) Strategies for preventing calcium oxalate stones. CMAJ 174:1407–1409

    Article  PubMed  PubMed Central  Google Scholar 

  62. Traxer O, Huet B, Poindexter J, Pak CY, Pearle MS (2003) Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 170:397–401

    Article  CAS  PubMed  Google Scholar 

  63. Ladwig PM, Liedtke RR, Larson TS, Lieske JC (2005) Sensitive spectrophotometric assay for plasma oxalate. Clin Chem 51:2377–2380

    Article  CAS  PubMed  Google Scholar 

  64. Holmes RP, Ambrosius WT, Assimos DG (2005) Dietary oxalate loads and renal oxalate handling. J Urol 174:943–947

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Department of Pediatrics, Medical University of Bialystok, Children’s Hospital, 17 Waszyngtona St., 15-274, Bialystok, Poland

    Tadeusz Porowski, Walentyna Zoch-Zwierz, Agata Korzeniecka-Kozerska & Joanna Michaluk-Skutnik

  2. Department of Pediatrics and Auxology, Medical University of Bialystok, Bialystok, Poland

    Jerzy Konstantynowicz

  3. Department of Medical Chemistry, Medical University of Bialystok, Bialystok, Poland

    Halina Porowska

Authors
  1. Tadeusz Porowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Walentyna Zoch-Zwierz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jerzy Konstantynowicz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Agata Korzeniecka-Kozerska
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joanna Michaluk-Skutnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Halina Porowska
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tadeusz Porowski.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Porowski, T., Zoch-Zwierz, W., Konstantynowicz, J. et al. Reference values of plasma oxalate in children and adolescents. Pediatr Nephrol 23, 1787–1794 (2008). https://doi.org/10.1007/s00467-008-0889-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-008-0889-8

Keywords

Search

Navigation