Monitoring therapy for kidney stones
Identifying increased urinary oxalate as a risk factor for stone formation
Diagnosis of primary or secondary hyperoxaluria
Only orderable as part of a profile. For more information see ROXUR / Oxalate, Random, Urine.
Enzymatic Using Oxalate Oxidase
Hyperoxaluria
Oxalate
Urine
Only orderable as part of a profile. For more information see ROXUR / Oxalate, Random, Urine.
Patient Preparation: Avoid taking large doses (>2 g orally/24 hours) of vitamin C prior to specimen collection.
Supplies: Urine Tubes, 10 mL tube (T068)
Container/Tube: 10-mL plastic tube or a clean, plastic container with no metal cap
Specimen Volume: 7 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
1 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 14 days | |
Frozen | 14 days | ||
Ambient | 72 hours |
Monitoring therapy for kidney stones
Identifying increased urinary oxalate as a risk factor for stone formation
Diagnosis of primary or secondary hyperoxaluria
Oxalate is an end product of glyoxalate and glycerate metabolism. Humans have no enzyme capable of degrading oxalate so it must be eliminated by the kidney.
In tubular fluid, oxalate can combine with calcium to form calcium oxalate stones. In addition, high concentrations of oxalate may be toxic for renal cells.
Increased urinary oxalate excretion results from inherited enzyme deficiencies (primary hyperoxaluria), gastrointestinal disorders associated with fat malabsorption (secondary hyperoxaluria), or increased oral intake of oxalate-rich foods or vitamin C.
Since increased urinary oxalate excretion promotes calcium oxalate stone formation, various strategies are employed to lower oxalate excretion.
Only orderable as part of a profile. For more information see ROXUR / Oxalate, Random, Urine.
No established reference values
An elevated urine oxalate (>0.46 mmol/day) may suggest disease states such as secondary hyperoxaluria (fat malabsorption), primary hyperoxaluria (alanine glyoxalate transferase enzyme deficiency, glyceric dehydrogenase deficiency), idiopathic hyperoxaluria, or excess dietary oxalate or vitamin C intake.
In stone-forming patients high urinary oxalate values, sometimes even in the upper limit of the normal range, are treated to reduce the risk of stone formation.
The urinary oxalate creatinine ratio varies widely in young children from <0.35 mmol/mL at birth, to <0.15 mmol/mL at 1 year, to <0.10 mmol/mL at 10 years, and <0.05 mmol/mL at 20 years of age (see table below).(1)
Oxalate/Creatinine (mg/mg) | |
Age (year) | 95th Percentile |
0-0.5 | <0.175 |
0.5-1 | <0.139 |
1-2 | <0.103 |
2-3 | <0.08 |
3-5 | <0.064 |
5-7 | <0.056 |
7-17 | <0.048 |
Ingestion of ascorbic acid (>2 g/day) may falsely elevate the measured urinary oxalate excretion.
1. Matos V, Van Melle G, Werner D, Bardy D, Guignard JP: Urinary oxalate and urate to creatinine ratios in a healthy pediatric population. Am J Kidney Dis. 1999;34:e1
2. Wilson DM, Liedtke RR: Modified enzyme-based colorimetric assay of urinary and plasma oxalate with improved sensitivity and no ascorbate interference: reference values and sample handling procedures. Clin Chem. 1991;37:1229-1235
3. Lieske JC, Wang X: Heritable traits that contribute to nephrolithiasis. Urolithiasis. 2019 Feb;47(1):5-10
4. Lieske JC, Turner ST, Edeh SN, Smith JA, Kardia SLR: Heritability of urinary traits that contribute to nephrolithiasis. Clin J Am Soc Nephrol. 2014 May;9(5):943-950. doi: 10.2215/CJN.08210813
5. Zhao F, Bergstralh EJ, Mehta RA, et al: Predictors of incident ESRD among patients with primary hyperoxaluria presenting prior to kidney failure. Clin J Am Soc Nephrol. 2016 Jan 7;11(1):119-126. doi: 10.2215/CJN.02810315
The assay utilizes oxalate oxidase, which oxidizes oxalate to carbon dioxide and peroxide. In the presence of peroxidase, the peroxide oxidatively couples 3-methyl-2-benzothiazolinone and 3-dimethylaminobenzoic acid to form indamine dye, which is measured spectrophotometrically at 580 nm.(Kasidas GP, Rose GA: Continuous-flow assay for urinary oxalate using immobilized oxalate oxidase. Ann Clin Biochem 1985;22:412-419; package insert: Oxalate kit. Trinity Biotech; V 07/2016)
Monday through Saturday
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
83945
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
OXCO1 | Oxalate, Random, U (mmol/L) | 15086-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
OXCO1 | Oxalate, Random, U (mmol/L) | 15086-2 |