Urine Calcium: Laboratory Measurement and Clinical Utility

Kevin F. Foley, PhD, DABCC; Lorenzo Boccuzzi, DO

Disclosures

Lab Med. 2010;41(11):683-686. 

In This Article

Use in Children

Determining urine CE in children can be a challenge since reference values for the urine/creatinine ratio are not well defined and vary according to diet. Timed 24-hour urine collections can be obtained in older children, but in younger children a random spot urine calcium creatinine ratio repeated on 2–3 occasions at the same time of day is frequently required to assess urine CE.[24] The calcium:creatinine ratio on the second voided urine sample of the day after an overnight fast most closely relates to a 24-hour urine calcium level.

Childhood rickets is an example in which urinary calcium measurements are beneficial. In the diagnosis of rickets, establishing an inappropriately high urinary CE in the face of low serum calcium levels is important.[24] Measuring a urine CR ratio is also part of the initial evaluation in children who have urinary tract calculi as it can help identify metabolic disease if it is present. Hypercalciuria is the most common metabolic cause of stones in Western children and no specific cause is ever determined in a quarter of the cases.[25]

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