Quiñones-Vázquez Susana, Liriano-Ricabal María Del Rosario, Santana-Porbén Sergio, Salabarría-González José Reinaldo
Departamento de Estudios de la Función Renal, Servicio de Laboratorio Clínico, Hospital Pediátrico Docente Juan Manuel Márquez, La Habana, Cuba.
Bol Med Hosp Infant Mex. 2018;75(1):41-48. doi: 10.24875/BMHIM.M18000006.
Hypercalciuria might be revealed during the differential diagnosis of hematuria accompanying renal lithiasis (RL). In spite of this, diagnostic accuracy of calcium urinary excretion might be affected by incomplete 24-hour urine collections. In the present study, the diagnostic utility of calcium/creatinine (ICaCre) index for determining hypercalciuria associated with non-glomerular hematuria (NGH) and RL was assessed.
ICaCre (mg/mg) index was calculated from calcium (mmol/l) and creatinine (µmol/l) concentrations in an aliquot from a 24-hour urine collection in 169 children and adolescents with NGH or RL. Calciuria values > 4.0 mg/kg in 24 hours were distributed according to the presence of NGH or RL.
Mean ICaCre index was 0.2 ± 0.1 mg/mg. Calciuria values estimated from ICaCre were statistically higher to those from 24-hour urine collection (p < 0.05). The frequency of hypercalciuria was independent from the measurement method (estimated from ICaCre 39.5% vs. 24 h collection 32.1%; p > 0.05). Hypercalciuria distribution was as follows: no NGH + no RL: 59.0%; no NGH + RL: 60.0% (∆ = +1.0%); NGH + no RL: 68.2% (∆ = +9.2%); NGH + RL: 73.3% (∆ = +14.4%).
The use of ICaCre index for determining calcium urine excretion might be effective in the study of hypercalciuria associated with NGH and RL.
在伴有肾结石（RL）的血尿鉴别诊断过程中可能会发现高钙尿症。尽管如此，24小时尿液收集不全可能会影响尿钙排泄的诊断准确性。在本研究中，评估了钙/肌酐（ICaCre）指数在确定与非肾小球性血尿（NGH）和RL相关的高钙尿症中的诊断效用。
从169例患有NGH或RL的儿童和青少年24小时尿液收集的一份等分试样中的钙（mmol/l）和肌酐（µmol/l）浓度计算ICaCre（mg/mg）指数。根据是否存在NGH或RL对24小时尿钙值>4.0 mg/kg进行分布。
平均ICaCre指数为0.2±0.1 mg/mg。根据ICaCre估计的尿钙值在统计学上高于24小时尿液收集得到的值（p<0.05）。高钙尿症的发生率与测量方法无关（根据ICaCre估计为39.5%，而24小时收集为32.1%；p>0.05）。高钙尿症分布如下：无NGH+无RL：59.0%；无NGH+RL：60.0%（差值=+1.0%）；NGH+无RL：68.2%（差值=+9.2%）；NGH+RL：73.3%（差值=+14.4%）。
使用ICaCre指数来确定尿钙排泄在研究与NGH和RL相关的高钙尿症中可能是有效的。
