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Licensed Unlicensed Requires Authentication Published by De Gruyter November 2, 2017

Reference intervals for stone risk factors in 24-h urine among healthy adults of the Han population in China

  • Zanlin Mai , Xiaoxia Li , Zelin Cui , Wenqi Wu , Yongda Liu , Lili Ou , Yueping Liang , Zhijian Zhao , Yang Liu , Xing Mai , Wei Zhu , Tao Zhang , Chao Cai , Houmeng Yang and Guohua Zeng EMAIL logo



The aim of the study was to establish reference intervals for 24-h urinary stone risk factors in the healthy Chinese Han population.


From May 2013 to July 2014, we collected and analyzed 24-h urine samples from healthy adult Han population during a cross-sectional study across China. The protocol for analysis of 24-h urine included volume, pH, oxalate, citrate, sodium, potassium, chloride, calcium, phosphorous, creatinine, urate, magnesium, the ion activity products of calcium oxalate (AP(CaOx) indexs) and calcium phosphate (AP(CaP) indexs). We calculated the reference intervals according to the Clinical and Laboratory Standards Institute (CLSI) 2008 guidelines and compared them with those recorded in other studies.


A total of 132 male and 123 female healthy subjects with a mean (SD, range) age of 52.4 (15.2, 19–89) years were eligible in the final analysis. Men had higher 24-h excretion of creatinine, calcium, urate and phosphorus and lower levels of citrate, magnesium, chloride, sodium and potassium than women. AP(CaOx) indexs and AP(CaP) indexs were significantly higher among men than women. When urinary findings were compared with the reference intervals, most of our data showed a high abnormality rate, especially for creatinine, calcium, citrate, magnesium, chloride, sodium and potassium.


The present study revealed the normal metabolic status for stone risk factors of the Chinese Han population. It is therefore necessary for each country or region to define their own reference intervals for comparison of stone risk factors between patients and healthy subjects.

Corresponding author: Guohua Zeng, MD, PhD, Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, 1# Kangda Road, Haizhu District, Guangzhou, Guangdong 510230, P.R. China, Phone: +(86)02-34296202
aZanlin Mai, Xiaoxia Li, Zelin Cui, Wenqi Wu and Yongda Liu contributed equally to this work.


We are grateful to Hans-Göran Tiselius, for his help in revising the manuscript.

  1. Author contributions: Zanlin Mai, Xiaoxia Li, Zelin Cui, Wenqi Wu and Yongda Liu have made identical contributions to this study as the co-first authors. Guohua Zeng conceived, designed and organized this study, interpreted the results and revised the manuscript. All authors contributed to collect the data. Zanlin Mai and Xiaoxia Li analyzed the data. Zanlin Mai wrote the first draft of the manuscript. Guohua Zeng and Wenqi Wu obtained funding. Guohua Zeng is the corresponding author. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This work was financed by grants from National Natural Science Foundation of China (no. 81370804, no. 81570633 and no. 81670643), the Science and Technology Project in Guangdong, China (no. 2014A020209085) and Guangzhou Science Technology and Innovation Commission (no. 201604020001 and no. 201704020193).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Supplemental Material:

The online version of this article offers supplementary material (

Received: 2017-5-9
Accepted: 2017-9-27
Published Online: 2017-11-2
Published in Print: 2018-3-28

©2018 Walter de Gruyter GmbH, Berlin/Boston

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