Arrabal-Polo Miguel Angel, Arias-Santiago Salvador, Girón-Prieto María Sierra, Abad-Menor Felix, López-Carmona Pintado Fernando, Zuluaga-Gomez Armando, Arrabal-Martin Miguel
Urology Department, San Cecilio University Hospital, Granada, Spain.
Urol Res. 2012 Oct;40(5):511-5. doi: 10.1007/s00240-012-0474-2. Epub 2012 Apr 7.
Calcium lithiasis is the most frequently diagnosed renal lithiasis and is associated with a high percentage of patients with metabolic disorders, such as hypercalciuria, hypocitraturia, and hyperoxaluria. The present study included 50 patients with recurrent calcium lithiasis. We conducted a random urine test during nocturnal fasting and a 24-h urine test, and examined calcium, oxalate, and citrate. A study of the linear correlation between the metabolites was performed, and the receiver operator characteristic (ROC) curves were analyzed in the random urine samples to determine the cutoff values for hypercalciuria (excretion greater than 200 mg), hyperoxaluria (excretion greater than 40 mg), and hypocitraturia (excretion less than 320 mg) in the 24-h urine. Linear relationships were observed between the calcium levels in the random and 24-h urine samples (R = 0.717, p = 0.0001), the oxalate levels in the random and 24-h urine samples (R = 0.838, p = 0.0001), and the citrate levels in the random and 24-h urine samples (R = 0.799, p = 0.0001). After obtaining the ROC curves, we observed that more than 10.15 mg/dl of random calcium and more than 16.45 mg/l of random oxalate were indicative of hypercalciuria and hyperoxaluria, respectively, in the 24-h urine. In addition, we found that the presence of less than 183 mg/l of random citrate was indicative of the presence of hypocitraturia in the 24-h urine. Using the proposed values, screening for hypercalciuria, hyperoxaluria, and hypocitraturia can be performed with a random urine sample during fasting with an overall sensitivity greater than 86%.
钙结石是最常被诊断出的肾结石类型，且在患有代谢紊乱（如高钙尿症、低枸橼酸尿症和高草酸尿症）的患者中占比很高。本研究纳入了50例复发性钙结石患者。我们在夜间禁食期间进行了随机尿样检测和24小时尿样检测，并检测了钙、草酸盐和枸橼酸盐。对这些代谢物之间的线性相关性进行了研究，并分析了随机尿样中的受试者工作特征（ROC）曲线，以确定24小时尿样中高钙尿症（排泄量大于200毫克）、高草酸尿症（排泄量大于40毫克）和低枸橼酸尿症（排泄量小于320毫克）的临界值。随机尿样和24小时尿样中的钙水平之间（R = 0.717，p = 0.0001）、草酸盐水平之间（R = 0.838，p = 0.0001）以及枸橼酸盐水平之间（R = 0.799，p = 0.0001）均观察到线性关系。获得ROC曲线后，我们观察到随机钙含量超过10.15毫克/分升和随机草酸盐含量超过16.45毫克/升分别表明24小时尿样中存在高钙尿症和高草酸尿症。此外，我们发现随机枸橼酸盐含量低于183毫克/升表明24小时尿样中存在低枸橼酸尿症。使用所提出的值，在禁食期间通过随机尿样对高钙尿症、高草酸尿症和低枸橼酸尿症进行筛查，总体灵敏度大于86%。
