Abstract
BackgroundUrolithiasis is a multi-etiological disease resulting from a combination of environmental and genetic factors. One of the most challenging aspects of this disease is its high recurrence rate. For most patients, an in-depth metabolic evaluation may reveal the presence of urinary stones. The fact that different urinary stone-related compounds (USRCs) are measured by different methods renders the metabolic evaluation of urolithiasis quite tedious and complex.MethodsA three-channel ion chromatograph (IC) that automatically measures the concentration of common metabolic indicators of urolithiasis in urine (i.e., oxalate, citrate, uric acid, calcium, and magnesium) was developed to improve the efficiency. To validate its precision and specificity, standard curves were prepared using working solution of these indicators. 100 standard solutions of these indicators were measured with our new IC and three other ICs as the control instruments; analyte concentrations in 100 24-h urine samples from volunteers and 135 calculi patients were also measured.ResultsAll analytes had good linear relationships in concentration ranges of 0–10 mg/L. The precision experiments in the standard and urine samples showed that the measurement errors of the newly developed IC were all less than 5%. In urine, the recovery rate ranged from 99.6 to 100.4%, the coefficient of variation ranged from 1.39 to 2.99%, and the results matched between our newly developed IC and the control ICs. The results of the efficiency test showed that we can finish the analysis at the average number of 14 people per day with the new IC. While the average number in the control group is 3.85/day (p = 0.000).ConclusionsOverall, this multi-channel system significantly improves the efficiency of metabolic evaluation while retaining accuracy and precision.
Highlights
Urolithiasis is a multi-etiological disease resulting from a combination of environmental and genetic factors
The concentrations of all five urinary stone-related compounds (USRCs) in urine samples obtained over 24 h are calculated using the Etiological-Diagnosis Software developed by our research group, by comparing the relevant sample signals with the signals arising from standards of known concentration
Preparation of the standard curves The peaks of oxalate, citrate, magnesium, calcium, and uric acid appeared at 13.830 min, 23.718 min, 4.411 min, 6.031 min, and 22.26 min, respectively
Summary
Urolithiasis is a multi-etiological disease resulting from a combination of environmental and genetic factors. The chemical origins of urolithiasis stem from an oversaturation of stone formation factors such as oxalate ions, calcium ions, and uric acid in urine, and a deficiency of stone inhibition factors such as citrate and magnesium ions [5, 6]. An in-depth metabolic evaluation may reveal the presence of urinary stones. An in-depth metabolic evaluation includes the analysis of the output of stone formation factors (oxalate, calcium, and uric acid) and stone inhibition factors (magnesium and citrate) in urine collected over the course of 24 h [9, 10]. Some reports show that prevention aimed at etiology may protect ~ 80% of patients from recurrence, and with respect to patient outcome, there is a real need for increasing accessibility of in-depth metabolic evaluation [12]
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