Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
권호 표지
DOI QR코드

DOI QR Code

Spot Urine Uric Acid to Creatinine Ratio used in the Estimation of Hyperuricosuria in the Young Korean Population

  • Choi, Hyowon (Department of Pediatrics, Yonsei University Wonju College of Medicine) ;
  • Namgoong, Meekyung (Department of Pediatrics, Yonsei University Wonju College of Medicine)
  • Received : 2021.08.05
  • Accepted : 2021.09.26
  • Published : 2021.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Uric acid levels in urine are measured using urine specimens 24 hours or by uric acid glomerular filtration rate (UAGFR) with spot urine, which additionally requires a blood sample. This study aimed to investigate whether urinary uric acid creatinine ratio (UUACr) obtained by spot urine alone could be recognized as a substitute for UAGFR value, and hyperuricosuria can be screened by UUACr. UUACr is known to vary with age and regional differences. This study focused on the reference value of each value in Korean young populations. Method: We enrolled Korean subjects 1-20 years with normal kidney function, from a single hospital, classified into 5 age groups, 1-5 years, 6-8 years, 9-12 years, 13-15 years, and 16-20 years. We checked spot urine uric acid, creatinine and serum uric acid, creatinine levels on the same day from February 2014 to December 2018. We measured the average of UAGFR and UUACr in each groups. The UUACr cut-off value of the upper 2 standard deviation (SD) of UAGFR were taken. Results: The upper 2 SD of UUACr (mg/mg) and UAGFR (mg/dL) were determined in all age groups. UUACr decreased with grown up (P=0.000), but UAGFR were not statistically different among the groups. UUACr and UAGFR were not significantly different by gender. UUACr and UAGFR were positively correlated; UUACr cut-off value of upper 2 SD UAGFR (0.54 mg/dL) was 0.65 mg/mg in total age. Conclusions: UUACr could potentially be used to screen for hyperuricosuria.

Keywords

Acknowledgement

This study was presented as a poster presentation at the 56th European Renal Association - European Dialysis and Transplant Association. Budapest, Hungary, 13-16 June 2019.

References

  1. Arrabal-Polo MA, Cano-Garcia MDC, Arrabal-Martin M. Lithogenic activity as a factor to consider in the metabolic evaluation of patients with calcium lithiasis. Iran J Kidney Dis 2015;9:469-71.
  2. Cillo AC, Cattini H, Boim MA, Schor N. Evaluation of lithogenic elements in urine of healthy newborns. Pediatr Nephrol 2001;16:1080-3. https://doi.org/10.1007/s004670100032
  3. Hartung R. The significance of uric acid in calcium oxalate nephrolithiasis. MMW 1975;117:387-90.
  4. La Manna A, Polito C, Marte A, Iovene A, Di Toro R. Hyperuricosuria in children: clinical presentation and natural history. Pediatrics 2001;107:86-90. https://doi.org/10.1542/peds.107.1.86
  5. Hodgkinson A. Uric acid disorders in patients with calcium stones. Br J Urol 1976;48:1-5. https://doi.org/10.1111/j.1464-410X.1976.tb02729.x
  6. Stapleton FB. Hematuria associated with hypercalciuria and hyperuricosuria: a practical approach. Pediatr Nephrol 1994;8:756-61. https://doi.org/10.1007/BF00869114
  7. Stapleton FB, Linshaw MA, Hassanein K, Gruskin AB. Uric acid excretion in normal children. J Pediatr 1978;92:911-4. https://doi.org/10.1016/s0022-3476(78)80359-x
  8. Stapleton FB, Nash DA. A screening test for hyperuricosuria. J Pediatr 1983;102:88-90. https://doi.org/10.1016/S0022-3476(83)80297-2
  9. Chen YH, Lee AJ, Chen CH, Chesney RW, Stapleton FB, Roy S. Urinary mineral excretion among normal Taiwanese children. Pediatr Nephrol 1994;8:36-9. https://doi.org/10.1007/BF00868256
  10. Safarinejad MR. Urinary mineral excretion in healthy Iranian children. Pediatr Nephrol 2003;18:140-4. https://doi.org/10.1007/s00467-002-1020-1
  11. Kompani F, Gaedi Z, Ahmadzadeh A, Seyedzadeh A, Bahadoram M. Values of urinary mineral excretion in healthy Iranian. J Ped Nephrol 2015;3:26-30.
  12. Marco RH, Gomez FN, Costa CM, Moreno JF, Vidal AP, Solanes JB. Excrecion urinaria de calcio, magnesio, acido urico y acido oxalico en ninos normales [Urinary excretion of calcium, magnesium, uric acid and oxalic acid in normal children]. An Esp Pediatr 1988;29:99-104.
  13. Matos V, Van Melle G, Werner D, Bardy D, Guignard JP. Urinary oxalate and urate to creatinine ratios in a healthy pediatric population. Am J Kidney Dis 1999;34:e1. https://doi.org/10.1053/S0272-6386(13)90018-4
  14. Oner A, Erdogan O, Camurdanoglu D, Demircin G, Bulbul M, Delibas A. Reference values for urinary calcium and uric acid excretion in healthy Turkish children. Int Pediatr 2004;19:154-7.
  15. Poyrazoglu HM, Dusunsel R, Yazici C, Durmaz H, Dursun I, Sahin H, et al. Urinary uric acid : Creatinine ratios in healthy Turkish children. Pediatr Int 2009;51:526-9. https://doi.org/10.1111/j.1442-200X.2008.02785.x
  16. Sweid HA, Bagga A, Vaswani M, Vasudev V, Ahuja RK, Srivastava RN. Urinary excretion of minerals, oxalate, and uric acid in north Indian children. Pediatr Nephrol 1997;11:189-92. https://doi.org/10.1007/s004670050257
  17. Moriwaki Y, Yamamoto T, Takahashi S, Yamakita J, Tsutsumi Z, Hada T. Spot urine uric acid to creatinine ratio used in the estimation of uric acid excretion in primary gout. J Rheumatol 2001;28:1306-10.
  18. Williams K, Thomson D, Seto I, Contopoulos-Ioannidis DG, Ioannidis JP, Curtis S, et al. Standard 6: age groups for pediatric trials. Pediatrics 2012;129:S153-60. https://doi.org/10.1542/peds.2011-0134
  19. Baldree LA, Stapleton FB. Uric Acid Metabolism in Children. Pediatr Clin North Am 1990;37:391-418. https://doi.org/10.1016/s0031-3955(16)36876-6
  20. Mantani N, Hoshino A, Ito K, Kogure T, Moridaira K, Sakamoto H, et al. Relationships among urine pH, serum uric acid and pyuria in hospitalized elderly patients. Nihon Ronen Igakkai Zasshi 2004;41:542-555. https://doi.org/10.3143/geriatrics.41.542
  21. Grivna M, Prusa R, Janda J. Urinary uric acid excretion in healthy male infants. Pediatr Nephrol 1997;11:623-4. https://doi.org/10.1007/s004670050350
  22. Penido MG, Diniz JS, Guimaraes MM, Cardoso RB, Souto MF, Penido MG. Urinary excretion of calcium, uric acid and citrate in healthy children and adolescents. J Pediatr (Rio J) 2002;78:153-60. https://doi.org/10.2223/JPED.826
  23. Hasday JD. Noctural increase of urinary uric acid:creatinine ratio. A biochemical correlate of sleep-associated hypoxemia. Am Rev Respir Dis 1987;134:534-8.
  24. Kaufman JM, Greene ML, Seegmiller JE. Urine uric acid to creatinine ratio-a screening test for inherited disorders of purine metabolism. Phosphoribosyltransferase (PRT) deficiency in X-linked cerebral palsy and in a variant of gout. J Pediatr 1968;73:583-92. https://doi.org/10.1016/s0022-3476(68)80274-4
  25. Zollner N. Influence of various purines on uric acid metabolism. Bibl Nutr Dieta 1973:34-43.
  26. Daniel CR, Cross AJ, Koebnick C, Sinha R. Trends in meat consumption in the USA. Public Health Nutr 2011;14:575-83. https://doi.org/10.1017/S1368980010002077
  27. Welfare MoHa. The Korean Nutrition Society. Dietary reference intakes for Koreans 2020 In: Welfare MoHa, editor. Sejong; 2020.