Reference range of random urinary calcium creatinine ratio in North Indian children and adolescents

PURPOSE: Urinary calcium creatinine ratio (UCaCrR) is a reliable indicator for monitoring hypercalciuria following vitamin D supplementation. However, the reference range varies from region to region. Previous studies did not take vitamin D and parathyroid hormone status into account while evaluating UCaCrR. Hence, we undertook this study to establish the 95th percentile of UCaCrR as an indicator of hypercalciuria in North Indian children and adolescents. METHODS: Four hundred seventy-three participants (boys 62.2%, girls 37.8%) with adequate dietary calcium intake, normal serum levels of 25-hydroxy-vitamin D (>20 ng/mL), and without secondary hyperparathyroidism following supplementation were selected for evaluation of UCaCrR. RESULTS: The mean age and body mass index of subjects were 11.2±2.6 years and 18.0±3.6 kg/m2, respectively. The 95th percentile of UCaCrR in the study population was 0.126. The mean, median, and 95th percentile of UCaCrR was significantly higher in prepubertal children (age ≤10 years) (0.0586±0.0374, median=0.0548, 95th percentile=0.136) compared to those >10 years old (0.0503±0.0363, median=0.0407, 95th percentile=0.123, P=0.02). No significant difference in UCaCrR was observed between genders and different weight categories. CONCLUSIONS: UCaCrR of 0.13 defines the cutoff value for hypercalciuria in North Indian children and adolescents with adequate dietary intake of calcium and sufficient serum vitamin D levels.

A Comparative Study of High Sensitive C-Reactive Protein (hs-CRP) and Urinary Calcium/Creatinine Ratio in Normal Pregnancy and Pregnancy Induced Hypertension in Gujarat, India

Background:Pregnancy-induced hypertension (PIH) is a condition characterized by high blood pressure during pregnancy.It is the most common leading cause of maternal and perinatalmorbidity and mortality in females. Serum high sensitive C-reactive protein (hs-CRP) is one of the suitablemarkers for low grade inflammation evaluation.Urinary calcium-creatinine ratio (UCa/Cr) is a valuable marker for prediction of PIH Aim:To measure & correlate serum hs-CRP and urinary calcium-creatinine ratio in between pregnancy-induced hypertension and normal pregnancy.Material & Methods:In present study total 150 subjects attending Department of Obstetrics & Gynecology at Sir Takhtsinhji Hospital, Bhavnagar, Gujarat, were included which were categorized in two groups. Group A: 75 patients of pregnancy-induced hypertension; Group B: 75 normal pregnant women as a control group. They were primarily diagnosed based on measurement of bloodpressure, clinical examination followed by biochemical investigations like hs-CRP, urinary calcium & creatinine, RBS, urea, creatinine, uric acid, CK-MB. Written informed consent was obtained from all participants before enrolling in the study.Results:No significant change in the levels of biological parameters like RBS, urea, creatinine and CK-MB was observed in both the study groups (p>0.05) except serum uric acid shows a significant difference (p<0.001). The levels of hs-CRP were found to be significantly higher in patients of pregnancy-induced hypertension (7.81±3.681)as compared to the normal pregnant women (3.11±1.972)(p<0.0001) .UCa/Cr ratio had more sensitivity and specificity than hs-CRP for prediction of pregnancy-induced hypertension compared to normal pregnancy.Conclusion:UCa/Cr ratio can be used as a more sensitive and specific test to detect pregnancy induced hypertension