Exploring normal urinary biomarker ratios in a pediatric population: insights into age and gender variations
Abstract
Aims: The assessment of urinary biomarker ratios, such as sodium/creatinine (Na/Crea), potasium/creatinine (K/Crea), calcium/creatinine (Ca/Crea), phosphorus/creatinine (P/Crea), uric acid/creatinine (Uric acid/Crea), magnesium/creatinine (Mg/Crea), and sodium/potassium (Na/K), holds significant importance in clinical and research contexts as they offer insights into physiological and pathological processes. This study aimed to establish the normal ranges of urinarymineral ratios across age and gender groups in a Turkish pediatric cohort.
Methods: This cross-sectional study was conducted involving 162 healthy children, with ages ranging from 2 to 15 years, at the Department of Pediatrics, Selçuk University. Demographic information, urinary biomarker ratios, and dietary features were recorded. Participants were divided into three age groups (2-5, 6-10, and 11-15 years), and statistical analyses were performed to determine relationships and variations.
Results: Gender distribution was uniform across age groups (p>0.05). Urinary creatinine levels stabilized after age 6. The mean urinary Na/Crea ratio was 0.33±0.22 mEq/mg, showing correlations with age and other ratios (p<0.001). Urinary K/Crea ratio was 0.13±0.15 mEq/mg, with significant differences between Group 1 and Group 3 (p>0.05). Urinary Na/K ratio was 3.5±2.4 mEq/mEq and correlated with uric acid and Ca/Crea ratio (p<0.001). Urinary calcium levels were consistent (p<0.001). Ca/Crea ratio correlated with other ratios (p<0.001). Urine P/Crea ratio differed significantly among groups (p>0.05). Uric acid levels differed between Group 2 and Group 3 (p>0.05), while uric acid//Crea ratio correlated with age and other ratios (p<0.001).
Conclusion: The findings provide insights into the normal ranges of urinary biomarker ratios in a Turkish pediatric cohort. The results align with previous studies and emphasize the impact of age, gender, and dietary factors on these ratios.
Keywords
Urinary mineral ratios pediatric population normal ranges age and gender variations mineral metabolism
Ethical Statement
"I did not have any labour and work in the publication process of the thesis. I do not want my name to be listed as the author" He sent a disclaimer Prof Dr Ahmet Özel
Project Number
Proje numarası alınmamıştır.
Thanks
Tez danışmanım Prof Dr Ahmet Özele teşekkür ederim.
References
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- Simsek B, Islek I. Urinary excretions of calcium, magnesium, phospahate, uric acid in 2-16 years old healthy Turkish children Haydarpaşa Numune Med J. 2017;57(1):42-47.
- Poyrazoğlu HM, Düşünsel R, Yazici C, et al. Urinary uric acid: creatinine ratios in healthy Turkish children. Pediatr Int. 2009;51(4):526-529. doi:10.1111/j.1442-200X.2008.02785.x
- Portale AA. Calcium and phosphorus. In: Barrat TM, Avner ED, Harmon WE. editors. Pediatric nephrology. Pennsylvania:Lippincott Williams&Wilkins,1999:191-213.
- El Mallah C, Ghattas H, Shatila D, et al. Urinary magnesium, calcium, and phosphorus to creatinine ratios of healthy elementary school Lebanese children. Biol Trace Elem Res. 2016;170(2):264-270. doi:10.1007/s12011-015-0484-3
- Al Ghali R, El-Mallah C, Obeid O, El-Saleh O, Smail L, Haroun D. Urinary minerals excretion among primary schoolchildren in Dubai-United Arab Emirates. PLoS One. 2021;16(8):e0255195. doi:10.1371/journal.pone.0255195
- Chen YH, Lee AJ, Chen CH, Chesney RW, Stapleton FB, Roy S. Urinary mineral excretion among normal Taiwanese children. Pediatr Nephrol. 1994;8(1):36-39. doi:10.1007/BF00868256
- Kruse K, Kracht U, Kruse U. Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents. Eur J Pediatr. 1984;143(1):25-31. doi:10.1007/BF00442743
- Moore ES, Coe FL, McMann BJ, Favus MJ. Idiopathic hypercalciuria in children: prevalence and metabolic characteristics. J Pediatr. 1978;92(6):906-910. doi:10.1016/s0022-3476(78)80358-8
- Rathod A, Bonny O, Guessous I, et al. Association of urinary calcium excretion with serum calcium and vitamin D levels. Clin J Am Soc Nephrol. 2015;10(3):452-462. doi:10.2215/CJN.12511213
- Van Abel M, Hoenderop JG, Dardenne O, et al. 1,25-dihydroxyvitamin D(3)-independent stimulatory effect of estrogen on the expression of ECaC1 in the kidney. J Am Soc Nephrol. 2002;13(8):2102-2109. doi:10.1097/01.asn.0000022423.34922.2a
- Kimira M, Kudo Y, Takachi R, Haba R, Watanabe S. Nihon Eiseigaku Zasshi. 2004;59(1):23-30. doi:10.1265/jjh.59.23
- Kesteloot H, Joossens JV. The relationship between dietary intake and urinary excretion of sodium, potassium, calcium and magnesium: Belgian Interuniversity Research on Nutrition and Health. J Hum Hypertens. 1990;4(5):527-533.
- Muldowney FP, Freaney R, Ryan JG. The pathogenesis of idiopathic hypercalciuria: evidence for renal tubular calcium leak. Q J Med. 1980;49(193):87-94.
- Muldowney FP, Freaney R, Moloney MF. Importance of dietary sodium in the hypercalciuria syndrome. Kidney Int. 1982;22(3):292-296. doi:10.1038/ki.1982.168
- Hegsted M, Schuette SA, Zemel MB, Linkswiler HM. Urinary calcium and calcium balance in young men as affected by level of protein and phosphorus intake. J Nutr. 1981;111(3):553-562. doi:10.1093/jn/111.3.553
- Holl MG, Allen LH. Sucrose ingestion, insulin response and mineral metabolism in humans. J Nutr. 1987;117(7):1229-1233. doi:10.1093/jn/117.7.1229
- Cirillo M, Ciacci C, Laurénzi M, Mellone M, Mazzacca G, De Santo NG. Salt intake, urinary sodium, and hypercalciuria. Miner Electrolyte Metab. 1997;23(3-6):265-268.
- Simecková A, Zamrazil V, Cerovská J. The effect of age on levels of magnesium and creatinine in the urine. Cas Lek Cesk. 1998;137(24):753-756.
- Marwaha RK, Garg MK, Dang N, et al. Reference range of random urinary calcium creatinine ratio in North Indian children and adolescents. Ann Pediatr Endocrinol Metab. 2019;24(1):34-40. doi:10.6065/apem.2019.24.1.34
- Van den Bussche K, Herrmann D, De Henauw S, et al. Urinary mineral concentrations in European pre-adolescent children and their association with calcaneal bone quantitative ultrasound measurements. Int J Environ Res Public Health. 2016;13(5):471. doi:10.3390/ijerph13050471
- Liu Z, Ding X, Wu J, et al. Dose-response relationship between higher serum calcium level and higher prevalence of hyperuricemia: a cross-sectional study. Medicine. 2019;98(20):e15611. doi:10.1097/MD.0000000000015611
Abstract
Project Number
Proje numarası alınmamıştır.
References
- Safarinejad MR. Urinary mineral excretion in healthy Iranian children. Pediatr Nephrol. 2003;18(2):140-144. doi:10.1007/s00467-002-1020-1
- Simsek B, Islek I. Urinary excretions of calcium, magnesium, phospahate, uric acid in 2-16 years old healthy Turkish children Haydarpaşa Numune Med J. 2017;57(1):42-47.
- Poyrazoğlu HM, Düşünsel R, Yazici C, et al. Urinary uric acid: creatinine ratios in healthy Turkish children. Pediatr Int. 2009;51(4):526-529. doi:10.1111/j.1442-200X.2008.02785.x
- Portale AA. Calcium and phosphorus. In: Barrat TM, Avner ED, Harmon WE. editors. Pediatric nephrology. Pennsylvania:Lippincott Williams&Wilkins,1999:191-213.
- El Mallah C, Ghattas H, Shatila D, et al. Urinary magnesium, calcium, and phosphorus to creatinine ratios of healthy elementary school Lebanese children. Biol Trace Elem Res. 2016;170(2):264-270. doi:10.1007/s12011-015-0484-3
- Al Ghali R, El-Mallah C, Obeid O, El-Saleh O, Smail L, Haroun D. Urinary minerals excretion among primary schoolchildren in Dubai-United Arab Emirates. PLoS One. 2021;16(8):e0255195. doi:10.1371/journal.pone.0255195
- Chen YH, Lee AJ, Chen CH, Chesney RW, Stapleton FB, Roy S. Urinary mineral excretion among normal Taiwanese children. Pediatr Nephrol. 1994;8(1):36-39. doi:10.1007/BF00868256
- Kruse K, Kracht U, Kruse U. Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents. Eur J Pediatr. 1984;143(1):25-31. doi:10.1007/BF00442743
- Moore ES, Coe FL, McMann BJ, Favus MJ. Idiopathic hypercalciuria in children: prevalence and metabolic characteristics. J Pediatr. 1978;92(6):906-910. doi:10.1016/s0022-3476(78)80358-8
- Rathod A, Bonny O, Guessous I, et al. Association of urinary calcium excretion with serum calcium and vitamin D levels. Clin J Am Soc Nephrol. 2015;10(3):452-462. doi:10.2215/CJN.12511213
- Van Abel M, Hoenderop JG, Dardenne O, et al. 1,25-dihydroxyvitamin D(3)-independent stimulatory effect of estrogen on the expression of ECaC1 in the kidney. J Am Soc Nephrol. 2002;13(8):2102-2109. doi:10.1097/01.asn.0000022423.34922.2a
- Kimira M, Kudo Y, Takachi R, Haba R, Watanabe S. Nihon Eiseigaku Zasshi. 2004;59(1):23-30. doi:10.1265/jjh.59.23
- Kesteloot H, Joossens JV. The relationship between dietary intake and urinary excretion of sodium, potassium, calcium and magnesium: Belgian Interuniversity Research on Nutrition and Health. J Hum Hypertens. 1990;4(5):527-533.
- Muldowney FP, Freaney R, Ryan JG. The pathogenesis of idiopathic hypercalciuria: evidence for renal tubular calcium leak. Q J Med. 1980;49(193):87-94.
- Muldowney FP, Freaney R, Moloney MF. Importance of dietary sodium in the hypercalciuria syndrome. Kidney Int. 1982;22(3):292-296. doi:10.1038/ki.1982.168
- Hegsted M, Schuette SA, Zemel MB, Linkswiler HM. Urinary calcium and calcium balance in young men as affected by level of protein and phosphorus intake. J Nutr. 1981;111(3):553-562. doi:10.1093/jn/111.3.553
- Holl MG, Allen LH. Sucrose ingestion, insulin response and mineral metabolism in humans. J Nutr. 1987;117(7):1229-1233. doi:10.1093/jn/117.7.1229
- Cirillo M, Ciacci C, Laurénzi M, Mellone M, Mazzacca G, De Santo NG. Salt intake, urinary sodium, and hypercalciuria. Miner Electrolyte Metab. 1997;23(3-6):265-268.
- Simecková A, Zamrazil V, Cerovská J. The effect of age on levels of magnesium and creatinine in the urine. Cas Lek Cesk. 1998;137(24):753-756.
- Marwaha RK, Garg MK, Dang N, et al. Reference range of random urinary calcium creatinine ratio in North Indian children and adolescents. Ann Pediatr Endocrinol Metab. 2019;24(1):34-40. doi:10.6065/apem.2019.24.1.34
- Van den Bussche K, Herrmann D, De Henauw S, et al. Urinary mineral concentrations in European pre-adolescent children and their association with calcaneal bone quantitative ultrasound measurements. Int J Environ Res Public Health. 2016;13(5):471. doi:10.3390/ijerph13050471
- Liu Z, Ding X, Wu J, et al. Dose-response relationship between higher serum calcium level and higher prevalence of hyperuricemia: a cross-sectional study. Medicine. 2019;98(20):e15611. doi:10.1097/MD.0000000000015611
Details
| Primary Language | English |
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| Subjects | Pediatric Nephrology |
| Journal Section | Original Article |
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| Project Number | Proje numarası alınmamıştır. |
| Early Pub Date | January 15, 2024 |
| Publication Date | January 15, 2024 |
| Published in Issue | Year 2024 Volume: 7 Issue: 1 |
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