Analysis of urinary parameters as risk factors for nephrolithiasis in children with celiac disease.
OBJECTIVE
Intestinal malabsorption can cause urinary stone disease via enteric hyperoxaluria. It has been shown that celiac disease, a common malabsorption disorder, is associated with an increased risk of calcium oxalate kidney stones in adults. Since no published data are available in the pediatric population, we analyzed urinary excretion of electrolytes in children with celiac disease to assess the risk of nephrolithiasis.


METHODS
The study population consisted of 115 children 1 to 16 years old (mean 5 years) with positive serological tests for celiac disease (anti-endomysium and anti-tissue transglutaminase antibodies) referred to us for jejunal biopsy to confirm the diagnosis. Assessment was requested because patients presented with poor growth, anemia, gastrointestinal disorders or a family history of celiac disease. After obtaining informed consent we performed urine tests to measure urinary variables and blood tests to exclude metabolic disorders and evaluate renal function.


RESULTS
All patients had a biopsy confirmed diagnosis of celiac disease. Oxaluria was normal in all children studied. However, levels of urinary calcium were decreased in patients with celiac disease and were inversely associated with disease severity (p = 0.0004).


CONCLUSIONS
In contrast to adults, increased urinary excretion of oxalate was not detectable in children presenting with celiac disease. Therefore, the risk of nephrolithiasis appears not to be increased compared to healthy children. The observed hypocalciuria probably further decreases the tendency to form kidney stones.
Pediatric Department, University of Verona, Verona, Italy.
Marco Deganello
MD
Saccomani
Carla
C
Pizzini
Giorgio L
GL
Piacentini
Attilio L
AL
Boner
Diego G
DG
Peroni
D000293:Adolescent; D000367:Age Factors; D002118:Calcium / Q000652:urine; D002446:Celiac Disease / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D008274:Magnesium / Q000652:urine; D008297:Male; D053040:Nephrolithiasis / Q000652:urine*; D010070:Oxalates / Q000652:urine; D010758:Phosphorus / Q000652:urine; D012016:Reference Values; D012307:Risk Factors
D010070:Oxalates; D010758:Phosphorus; D003404:Creatinine; D008274:Magnesium; D002118:Calcium