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Clinical aspect

Formation of uric acid calculi: the uric acid content of urine is of importance in relation to the formation of uric acid calculi.

The administration of alkali carbonates and citrates or the feeding of base-forming foods, by decreasing the acidity of urine, increases its solvent power for uric acid and decreases the liability of formation of this type of calculus.

IV. Creatinine and creatine

Normal value: the quantity of creatinine excreted in urine by normal healthy adults is from 1.2 to 1.7gms per 24hrs.

Influence of diet: the excretion depends partly upon the amount of creatinine in the diet (meat and soups), since this is excreted unchanged in the urine.

Note:the quantity excreted on a “creatinine-free diet” is practically constant for a given individual for long periods of time and is independent of total N-output.

V. Oxalic Acid

Normal value: normal urine contains 10-30mg of oxalic acid as oxalates per 24hrs of urine sample.

Sources of oxalates: while some oxalic acid arises from the metabolism of glycine and ascorbic acid (vit.C), the larger proportion is generally derived from the oxalates present in foods (exogenous) such as spinach, lettuce, apples, rhubarb, asparagus and other vegetables and fruits. Oxalic acid may be produced in uronic acid pathway from xylitol.

Clinical significance

1. oxalic acid separates from urine as insoluble “Ca-oxalate” crystals which can be seen microscopically in centrifuged deposits of urine. If passed in excessive amounts can form “ urinary calculus” (stones) in genitourinary tract.

2. Increase – the oxalic acid content of urine is increased – a) in Diabetes Mellitus; b) In certain liver diseases and in various conditions involving deficient tissue oxidation

3. Primary hyperoxaluria – a metabolic disease characterized biochemically by a continuous high urinary excretion of urinary oxalates

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