Miller L A, Noe H N, Stapleton F B
Department of Pediatrics, University of Tennessee, Memphis.
J Pediatr. 1989 Dec;115(6):923-6. doi: 10.1016/s0022-3476(89)80743-7.
Urinary uric acid excretion was assessed in 38 children to determine whether hyperuricuria was a risk factor in children with urolithiasis. Uric acid excretion (measured per deciliter glomerular filtration rate), and fractional excretion of uric acid were similar in 27 children with hypercalciuria and calcium oxalate urinary stones, in six children with idiopathic calcium oxalate urolithiasis, and in five with uric acid urolithiasis, of whom four were white boys and one was an Asian girl. One boy with a urate stone had cystinosis. Serum uric acid concentrations exceeded 6.0 mg/dl (360 mumol/L) in two children with hypercalciuria and in two patients with idiopathic calcium oxalate urolithiasis. None of the children with calcium urolithiasis had excessive urinary excretion of uric acid. In children with hypercalciuria, uric acid excretion did not change significantly when dietary sodium was increased from 1.0 to 5.0 gm/1.73 m2. We conclude that excessive urinary uric acid excretion is seldom an additional risk factor in children with calcium urolithiasis and that dietary sodium chloride does not have a strong influence on urinary excretion of uric acid in children with hypercalciuria.
对38名儿童的尿尿酸排泄情况进行了评估，以确定高尿酸尿症是否为儿童尿路结石的一个危险因素。27名高钙尿症合并草酸钙尿路结石的儿童、6名特发性草酸钙尿路结石的儿童以及5名尿酸尿路结石的儿童（其中4名是白人男孩，1名是亚洲女孩），其尿酸排泄量（每分升肾小球滤过率测量值）及尿酸排泄分数相似。1名患有尿酸盐结石的男孩患有胱氨酸病。2名高钙尿症儿童和2名特发性草酸钙尿路结石患者的血清尿酸浓度超过6.0mg/dl（360μmol/L）。所有钙尿路结石儿童的尿尿酸排泄均未过多。在高钙尿症儿童中，当饮食中的钠摄入量从1.0克/1.73平方米增加到5.0克时，尿酸排泄量无显著变化。我们得出结论，尿尿酸排泄过多很少是钙尿路结石儿童的额外危险因素，并且饮食中的氯化钠对高钙尿症儿童的尿酸排泄没有强烈影响。
