The comparability of oxalate excretion and oxalate:creatinine ratio in the investigation of primary hyperoxaluria: review of data from a referral centre
| Autor: | Oliver Clifford-Mobley, Gill Rumsby, Christopher Tims |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Clinical Biochemistry Urology Renal stone disease Oxalate Primary hyperoxaluria Excretion Kidney Calculi chemistry.chemical_compound Sex Factors Reference Values Oxalate/Creatinine Internal medicine medicine Humans Child Referral and Consultation Aged Aged 80 and over Oxalates Chemistry Age Factors General Medicine Middle Aged medicine.disease Endocrinology Oxalate Measurement Case-Control Studies Child Preschool Creatinine Hyperoxaluria Primary Referral centre Female Inherited metabolic disease |
| Zdroj: | Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 52:113-121 |
| ISSN: | 1758-1001 0004-5632 |
| DOI: | 10.1177/0004563214529937 |
| Popis: | Background Urine oxalate measurement is an important investigation in the evaluation of renal stone disease. Primary hyperoxaluria (PH) is a rare inherited metabolic disease characterised by persistently elevated urine oxalate, but the diagnosis may be missed in adults until renal failure has developed. Urine oxalate results were reviewed to compare oxalate:creatinine ratio and oxalate excretion, and to estimate the potential numbers of undiagnosed PH. Methods Urine oxalate results from August 2011 to April 2013 were reviewed. Oxalate excretion and oxalate:creatinine ratio were evaluated for 24 h collections and ratio alone for spot urine samples. Results Oxalate:creatinine ratio and oxalate excretion were moderately correlated (R = 0.63) in 24-h urine collections from patients aged 18 years and above. Sex-related differences were found requiring implementation of male and female reference ranges for oxalate:creatinine ratio. Of samples with both ratio and excretion above the reference range, 7% came from patients with confirmed PH. There were 24 patients with grossly elevated urine oxalate who had not been evaluated for PH. Conclusions Oxalate:creatinine ratio and oxalate excretion were discordant in many patients, which is likely to be a result of intra-individual variation in creatinine output and imprecision in the collection itself. Some PH patients had urine oxalate within the reference range on occasion, and therefore it is not possible to exclude PH on the finding of a single normal result. A significant number of individuals had urine oxalate results well above the reference range who potentially have undiagnosed PH and are consequently at risk of renal failure. |
| Databáze: | OpenAIRE |
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