Infrared spectroscopic analysis of staghorn calculi obtained after open renal surgery in a urology unit of Sri Lanka.

K S N Wijayarathna,A S Weligamage,A M Abeygunasekera,R Chandrajith,G G A P Weerasingha

doi:10.4038/cmj.v61i2.8288

K S N Wijayarathna, A S Weligamage + Show 3 more

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https://doi.org/10.4038/cmj.v61i2.8288

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Abstract

The composition of renal stones varies widely among populations. The aim of our study was to determine the composition of staghorn renal stones using Fourier transform infrared (FTIR) spectroscopy in a cohort of Sri Lankan patients. Forty two staghorn calculi removed from kidneys of adult patients during open surgery were analysed. There were 32 men. Nineteen (45%) were calcium oxalate monohydrate (whewellite) stones. Stones containing a mixture of calcium oxalate and calcium hydroxyl phosphate (apatite) were found in 16 (38%). Only 4 (10%) staghorn calculi were coposed of struvite. Three (7%) were uric acid stones. So most staghorn renal stones in Sri Lanka are calcium oxalate. Contrary to the traditional view based on studies done in the western world, only 10% of staghorn calculi removed from patients in Sri Lanka are struvite or infection stones. This could be the reason for kidneys with staghorn calculi in Sri Lanka to retain their function.

Highlights

This study describes the composition of renal stones determined using infrared spectroscopic analysis in a group of patients from Sri Lanka
According to the study calcium oxalate monohydrate stones remain the commonest type of staghorn calculi in Sri Lankan patients
Mixed stones containing calcium oxalate and calcium hydroxyl phosphate are the second most common (38%) variety

Summary

Introduction

Sri Lanka belongs to the stone belt in Asia which includes India, Pakistan and Southern China [1]. The composition of renal stones has a direct impact on treatment, secondary prevention and prognostication [2]. Calcium oxalate monohydrate stones are hard and resistant to extracorporeal shock wave lithotripsy [3]. Struvite calculi are associated with destruction of renal tissues and more infective complications postoperatively [4]. The composition of stones varies widely among populations [1,5]. Even in the same country stone composition can change according to the geographical locality [6]

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