Abstract

Urinary stones are among the most common diseases in the world and in Algeria as well, because it is a complex and multifactorial disease. The saturation of solutes in the urine is considered as the main stage of the deposition of crystals and their rapid growth and aggregation lead to the formation of stones in different places of the urinary system. It is the consequence of excessive urinary supersaturation causing renal complications such as lithiasis, nephrocalcinosis, acute or chronic renal failure which may progress to the terminal stage. The purpose of the study was to identify the most common different forms of crystals in the urine of patients for further measures to prevent more serious complications of crystalluria. Materials and methods. The study focused on all lithiasis patients of the age group "from 20 years to 84 years". Three-day urine samples were collected at different urology departments which were referred by urologists, during the period from February 06, 2020 to March 21, 2020. Being the best method, crystalluria was used to determine the types of crystals, their number and their growth. Three criteria must be met for the study of crystalluria to be clinically interpretable. They are the choice of patients according to their metabolic state; how long urine is stored after it is released, and the storage temperature. Results and discussion. Thanks to this study it was possible to characterize many types of crystals, including calcium oxalates, in particular monohydrate, which is considered as a risk factor for stone formation. Also, the urinary acid crystals indicate a specific environmental pattern in many patients. In addition to the calcium phosphate crystals resulting from microbial infections, the results showed pure crystalline aggregates which will inevitably lead to lithiasis. The microscopic examination of patient urine samples is the preferred method for optimal patient assurance with the cooperation of therapists and doctors in addition to the epidemiological study. Conclusion. The relatively high rate of recurrent lithiasis illustrates the current limits of preventive measures which can be penalized by the lack of patient attendance but whose reduced effectiveness primarily suggests a lack of knowledge of one or more fundamental determinants of the lithogenic process. The experimental part showed a diversity of crystals in the urine of patients, pure calcium oxalate monohydrate, which was noticed in the majority of the subjects analyzed. The detection, in crystalluria, of a single crystal of whewellite can therefore be considered as a marker for hyperoxaluria. Weddellite was more common in the urine of subjects under analysis

Highlights

  • Crystalluria refers to the presence of crystals in the urine

  • In addition to the calcium phosphate crystals resulting from microbial infections, the results showed pure crystalline aggregates which will inevitably lead to lithiasis

  • The relatively high rate of recurrent lithiasis illustrates the current limits of preventive measures which can be penalized by the lack of patient attendance but whose reduced effectiveness primarily suggests a lack of knowledge of one or more fundamental determinants of the lithogenic process

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Summary

Introduction

Crystalluria refers to the presence of crystals in the urine. It is the consequence of excessive urinary supersaturation causing renal complications such as lithiasis, nephrocalcinosis, acute or chronic renal failure which may progress to the terminal stage. The distinction between a «physiological” crystalluria and a «pathological” crystalluria is due to the recognition of the different criteria which characterize it: pH of the urine, nature of the crystals, crystalline facies, abundance, aggregation, and frequency of crystalluria appreciated by the repetition of the examination on serial samples [1]. A large number of people around the world suffer from urolithiasis disease, which is expressed by the formation of stones in the kidney or urinary tract (calyxes, ureters, bladder, urethra) [2].

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