Oxalate is overestimated in alkaline urines collected during administration of bicarbonate with no specimen pH adjustment.
We compared measurements of daily urine oxalate excretion in urines collected at the prevailing urine pH with measurements of urine oxalate excretion in urines collected into 20 mL of 6 mol/L HCl. We studied eight healthy adults fed constant diets. Urines were collected during control conditions and, in each subject, during the administration of NaCl, KCl, NaHCO3, or KHCO3, 90 mmol/day. Daily urine oxalate excretion calculated for collections made in acid averaged 271 (SD 79) mumol/day and did not vary with any of the salt supplements. When urines were collected at ambient urine pH (average 5.94, SD 0.23) during control conditions, and during the administration of NaCl or KCl, urine oxalate excretion averaged 263 (SD 88) mumol/day, a value not different from that for collections in acid. However, when urine was collected with no pH adjustment during NaHCO3 or KHCO3 administration (average pH 6.90, SD 0.14), apparent urine oxalate excretion averaged 398 (SD 132) mumol/day, significantly (P less than 0.025) exceeding the mean observed when urines were collected in acid. Moreover, the percentage increase in apparent oxalate excretion increased with urinary pH. These observations reinforce recommendations that urine specimens for measurement of oxalate be collected in acid to avoid the increase in apparent oxalate content that occurs during collection of alkaline urines. This increase presumably results from the well-known in vitro nonenzymatic conversion of ascorbate to oxalate.
Lemann
J
J
Department of Medicine, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee 53226.
Hornick
L J
LJ
Pleuss
J A
JA
Gray
R W
RW
D000328:Adult; D001639:Bicarbonates / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001835:Body Weight; D004032:Diet; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D010070:Oxalates / Q000652:urine*; D011189:Potassium Chloride / Q000008:administration & dosage; D017680:Potassium Compounds; D012964:Sodium / Q000008:administration & dosage; D017693:Sodium Bicarbonate; D012965:Sodium Chloride / Q000008:administration & dosage
D001639:Bicarbonates; D010070:Oxalates; D017680:Potassium Compounds; D012965:Sodium Chloride; D011189:Potassium Chloride; D017693:Sodium Bicarbonate; D012964:Sodium; C026329:potassium bicarbonate