Calcium Oxalate Dehydrate Research Articles

Spectroscopic investigation of phase transformation of calcium oxalate dehydrates (renal calculi) using acidic Bryophyllum pinnatom powder

Urolithiasis is one of most common renal disorders, characterized by the formation of kidney stones (renal calculi) through the crystallization process within the urinary system. The frequently observed renal calculi are calcium oxalate renal calculi and treatment is done by shock wave method or lithotripsy which is harmful for other cells of the internal system. The objective of this work was to evaluate in vitro diagnosis of calcium oxalate kidney stones in the aqueous solution of Bryophyllum pinnatum. The B. pinnatum powder was mixed in apple cider vinegar and lemon juice separately to make solution 1 and 2 respectively. Apple cider vinegar and lemon juice were used as solvents due to their acidic and body compatible nature. Two surgically removed stones was dipped in solution 1 and 2. After two weeks, kidney stone of weight 2.7 g is completely dissolved in solution 2 while a considerable weight reduction of other kidney stone has been observed in solution 1. Fourier transform infrared (FTIR) spectroscopy results show the presence of two strong absorption peaks at 610 and 912 (cm−1) in both solutions after dissolution of urinary stones are related to calcium oxalate dehydrate (COD). Raman spectra further confirm the dissolution of COD in solution having Raman shifts at 504 and 910 (cm−1). Cluster formation and aggregation of particles has been observed in scanning electron microscopy images. This in vitro study proves that a mixture of Bryophyllum pinnatum powder and lemon juice is a best remedy to remove kidney stones.

Bilateral same-session flexible ureteroscopy for renal stones: a feasible method.

A staged ureteroscopic procedure is generally preferred to treat bilateral renal stones. In this study, we evaluated the feasibility of bilateral same-session flexible ureteroscopy (BS-fURS) in renal stones. A total of 81 patients underwent bilateral BS-fURS between March 2014 and March 2021 for bilateral renal stones. The mean stone burden per patient was 17±4 (range 7–27 mm). The average stone density was 1240 HU (970 to 1510). We used 4 types of ureteroscopes: Olympus URF-V2 (34 cases), Storz Flex X2 (30 cases), single-use PUSEN PU 3022 (12 cases), and single-use PUSEN – PU 3033A (5 cases). We specifically set our Holmium laser for dusting, pop-corning, and fragmenting. We found 31 calcium oxalate monohydrate cases, 11 calcium oxalate dehydrate cases, 17 uric acid cases, and 22 magnesium ammonium phosphate cases. The mean operating time was 77 min. (range 52 to 85) for both renal units. The SFRs were evaluated between 1 and 3 months with computed tomography (fragments >3 mm were defined as residual). Double J stenting (6Fr.) was applied bilaterally in 8 cases (9.87%) and unilateral in 34 cases (41.97%). The overall SFRs after 1 and 2 procedures were 81.48% (66/81 cases) and 92.59% (75/81 cases), respectively. Postoperative complications after an overall 96 procedures were Clavien I-II (18.75%) and Clavien III (3.12%). Urinary tract infections were observed in 13 cases (16.04%) without any case of urosepsis. Our experience suggested some BS-fURS advantages as a single anesthetic session and potentially reduced cost associated with treatment. BS-fURS seem feasible, especially for medium-sized bilateral renal stones in high-volume centers.

Successful treatment of seminal vesicle calculi and prostatic utricle calculi by transurethral seminal vesiculoscopy.

To investigate the outcomes of transurethral seminal vesiculoscopy (TSV) for the treatment of seminal vesicle calculi (SVC), prostatic utricle calculi (PUC) and combination of them, a retrospective review on 27 patients with SVC and/or PUC who complained of intractable haematospermia was conducted. Patient demographics, disease duration, operation time, stone location and complications were recorded. The calculi in the seminal vesicle and/or prostatic utricle were removed by holmium laser lithotripsy and/or basket extraction. The stone composition was determined in 19 of 27 patients using Infrared spectroscopy. The average age and disease duration of patients were 39.4 years and 23.1 months respectively. The mean operative time was 78.5 min. We detected SVC, SVC and PUC, and PUC in 59.3% (16/27), 33.3% (9/27) and 7.4% (2/27) patients respectively. The stones were mainly composed of calcium oxalate dehydrate (COD), carbonate apatite (CA), COD and calcium oxalate monohydrate (COM), CA and magnesium ammonium phosphate, CA and COM, and COD and uric acid in 42.1% (8/19), 21.1% (4/19), 15.8% (3/19), 15.8% (3/19), 5.3% (1/19) and 5.3% (1/19) cases respectively. No intraoperative and post‐operative complications were noted. These results suggested that SVC and PUC can be diagnosed and treated using TSVs.

Urinary stone composition analysis of 4 423 cases in Zhejiang province

Objective To study the constituents of urinary stones in patients in Zhejiang, and analyze the composition difference between patients from northern Zhejiang province and southern Zhejiang province. Methods From October 2012 to October 2018, clinical data of 4 423 urinary stone patients treated in Sir Run Run Shaw Hospital, the Second Affiliated Hospital of Wenzhou Medical University, and Huzhou First People's Hospital was retrospectively analyzed. Infrared spectrum was used to analyze urinary calculi constituents. Among 4 423 patients, there were 3 041 males and 1 382 females, male to female ratio was 2.2∶1, and the mean age was (51.2±16.5) years. There were 2 974 northern Zhejiang patients and 1 449 southern Zhejiang patients. High incidence age group was 41- 60 years[48.2%(2 136/4 423)]. The distribution characteristics of urinary calculi constituents in different groups of sex, age, and region were analyzed. Results Among the 4 423 cases, the mixed urinary stones were dominant in the urinary calculus [73.1%(3 235/4 423)], in which, the most component was the calcium oxalate monohydrate+ calcium oxalate dehydrate+ carbonated apatite [36.2%(1 604/4 423)]; among the pure stones, the most component was the calcium oxalate monohydrate[16.3%(719/4 423)]. Carbonated apatite stones [70.1%(970/1 382) vs. 61.0%(1 856/3 041), P 60 years group, however, uric acid stones were more frequent in >60 years group [3.5%(38/1 060) vs. 17.0%(209/1 227), P<0.05]. The proportion of calcium oxalate stones in southern Zhejiang was lower than northern Zhejiang [79.0%(1 145/1 449) vs. 89.4%(2 661/2 974), P<0.05]. However, carbonated apatite stones [71.5%(1 037/1 449) vs. 60.1%(1 789/2 974), P<0.05], magnesium ammonium phosphate stones [15.1%(220/1 449) vs. 3.5%(106/2 974), P<0.05], and uric acid stones [10.7%(156/1 449) vs. 8.4%(250/2 974), P<0.05] were more prevalent in southern Zhejiang than northern Zhejiang. Conclusions The distribution of constituents of urinary stones in Zhejiang was different in genders, age, and regions. Carbonated apatite stones and magnesium ammonium phosphate stones were more prevalent in females and young people, and uric acid stones were more common in males and old people. Calcium oxalate stones were more common in youths. Moreover, calcium oxalate stones were more frequent in northern Zhejiang, and carbonated apatite stones, magnesium ammonium phosphate stones and uric acid stones were common in southern Zhejiang. Key words: Urinary calculi; Analysis of constituents; Gender; Age; Region

Composition of urinary stones in Taizhou of Zhejiang province

Objective To analyze the composition of urinary stones in Taizhou of Zhejiang province. Methods Clinical data of 1 022 patients with urinary stones admitted in Taizhou Hospital of Zhejiang province were retrospectively reviewed. The samples of urinary stones were collected and analyzed by infrared spectrophotometry. Results There were 722 males and 300 females with a male to female ratio of 2.4∶1 and with a mean age of (53.4±13.6) years (14-88 years). Among 1 022 patients, the stones with single composition were found in 299 cases (29.3%); the most common single-component was anhydrous uric acid (15.9%), followed by calcium oxalate monohydrate (12.0%). The mixed stones were found in 723 cases (70.7%); the most common mixture was calcium oxalate monohydrate, calcium oxalate dehydrate and carbonate apatite mixture (316 cases, 30.9%). Calcium oxalate (58.9%, 602/1 022) was the most common major component and frequently seen in upper urinary tract stones, followed by uric acid (21.8%, 223/1 022). Uric acid calculi was predominant component in male patients(χ2=30.97, P=0.00), while the rate of infection stones was higher in women (χ2=60.69, P=0.00). The mean age of patients with uric acid stones was 59.4 years, which was older than that with other components (t=7.62, P=0.00). The uric acid stones were more common in upper urinary tract stones(χ2=42.97, P=0.00). The mean age of patients with infection stones was 49 years, which was younger than that with other types of stones(t=4.87, P=0.00). Conclusion Mixed stones with calcium oxalate monohydrate, calcium oxalate dehydrate and carbonate apatite are the predominant urinary stones in Taizhou of Zhejiang province, while the most common single-component stones are anhydrous uric acid stones. Location, age and sex are associated with the types of urinary stones. Key words: Urinary calculi; Stone composition; Spectrum

Clinical Presentation, Diagnosis, and Treatment of Cholelithiasis in a Pet Guinea Pig (Cavia porcellus)

A 2.5-year-old female guinea pig (Cavia porcellus) presented for reduced appetite, signs of abdominal pain, increased respiratory effort, and a distended abdomen. Cholelithiasis was diagnosed by radiography and ultrasonography. The cholelith was surgically removed using cholecystectomy. After surgery the animal recovered quickly and clinical signs resolved. Stone analysis revealed a composition of 20% weddellite (calcium oxalate dehydrate) and 80% apatite (calcium phosphate). Histologic examination of the gallbladder revealed no significant pathologic changes. Three months after the surgical procedure the patient continued to do well and diagnostic imaging revealed no abnormalities. Surgical therapy was straightforward and effective.

Urolithiasis in male patients: A pilot study on the ethnic differences and clinical profile

Background Ethnicity play a role in the occurrence of urinary stones, probably related to climatic, environmental and dietary factors in ethnic groups. The association between ethnicity, age, clinical profile, stone size with type of ureteric stones among males with urolithiasis was studied. Materials and Methods Male patients (&gt;18 years) with lower ureteral stones size &lt;10mm attending outpatient department of Urology, at a private hospital, Ajman over a period of one year were included. Ethics approval was obtained from Institutional Ethics Committee. Data was retrieved from the case records which included socio-demographic variables (age, ethnicity), clinical profile (ureteric colic, duration of pain, other complaints), and laboratory investigations (type of stone, stone size). Descriptive and inferential statistics were performed with SPSS-20 and p values &lt;0.05 considered significant. Results 185 male patients were included. Mean age was 41.5 (7.3) years, range (22-71) years. Out of the total, 81 (43.8%) patients were Asians, 81(43.8%) Arabs and 23 (12.4%) were of other ethnicity. Most patients (95.1%) presented with ureteric pain. 49 (26.5%) had family history of stone disease where calcium oxalate monohydrate and uric acid stones were common, with majority being first degree relation. Data on stone type was available for 90 patients; of which, 21 were calcium oxalate monohydrate, 33-calcium oxalate dehydrate, 24-uric acid and remaining 12 other form of stones. Average age for different types of stone was 38.3, 41.6, 39.4 and 42.8 years for calcium oxalate monohydrate, calcium oxalate dehydrate, uric acid and other types respectively. Conclusion Uric acid stones were more prevalent among Asians and calcium oxalate-dehydrate stones among Arabs. Future studies can be conducted among multiethnic population focusing on dietary pattern and stone analysis.DOI: http://dx.doi.org/10.3126/nje.v4i4.11359 Nepal Journal of Epidemiology 2014; 4(4):393-98

Analysis of Kidney and Gall Stones of Patients from North-East Bangladesh by FTIR

Kidney and gallstones represent a prevalent and costly health problem. This study aimed to define patterns of stones and identify chemical compositions in the sample of symptomatic kidney and gallstones from North-East part of Bangladesh (Sylhet City, Sylhet) using infrared spectroscopy. Kidney and gallstones were recovered from patients of Osmani Medical College and Hospital, Sylhet, Bangladesh. A total of 5 kidney and 3 gall stone samples were collected randomly and analyzed for composition by Fourier Transform Infrared Spectroscopy (FTIR). Among the five kidney stone samples, KDS 01 was mixture of calcium oxalate monohydrate and calcium phosphate, KDS 02 and 03 were calcium oxalate and uric acid stones, KDS 04 was uric acid stone and KDS 05 was calcium oxalate dehydrate and calcium phosphate. Among the three gall stone samples, GBS 01 was cholesterol stone, GBS 02 was mixed stone and GBS 03 was pigment stone. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.16721 J. Sci. Res. 6 (3), 553-561 (2014)

Fast identification and differentiation of mineral components in prostate stones using a portable fiber-optic Raman spectroscopy

We report a potential application of a portable fiber-optic Raman spectroscopy for fast prostatic calculi diagnosis. A portable Raman analyzer with a fiber-optic probe was first used to identify and differentiate the mineral components of prostate stones. The study indicates that three types of stones, hydroxyapatite (HA) stone, calcium oxalate dehydrate (COD) stone and mixed stone including HA, calcium oxalate monohydrate (COM) and COD, were directly detected from 15 patients with prostatic calculi in a short time. The present study reveals that this portable fiber-optic Raman spectroscopic technique was an easy and fast real-time tool to differentiate the mineral components in prostatic calculi.

Role of E. coli-Secretion and Melamine in Selective Formation of CaC2O4·H2O and CaC2O4·2H2O Crystals

The influence of Escherichia coliform secretion (E. coli-secretion) and melamine on the crystallization of calcium oxalate has been investigated in order to determine its role in morphological control and the effects on the kinetics of the calcium oxalate crystals. The crystals obtained were characterized by scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray powder diffraction, and thermal gravimetric analyzer. At the same time, conductivity meter and zeta potentiometer have been used to study the kinetic process of the crystal formation. The results show that, in the absence of E. coli-secretion, calcium oxalate monohydrate (COM) was obtained, which is the most stable crystal form of calcium oxalate and the major component of urinary stones, while in the presence of the secretion, the obtained crystals were calcium oxalate dehydrate (COD) instead of COM. Simulation experiments under artificial urine circumstance further demonstrated the drastic effect of E. coli-secretion on the calcium oxalate dihydrate crystal form. Furthermore, the acceleration effect of melamine on the formation of stones was also studied. Additionally, a slight influence of melamine on the crystallization of calcium oxalate has been found for the first time. Thus, a method to inhibit stone has been found and is expected to provide important data for the development of the calculi treatment.

Abstract P4-03-06: Non-invasive classification of microcalcifications by the use of X-ray phase contrast mammography as a novel tool in breast diagnostics

Abstract Purpose: Phase-contrast and scattering-based x-ray imaging are known to provide additional and complementary information to conventional, absorption-based methods. The goal of this study is to evaluate this method to distinguish between benign and malignant microcalcifications with the benefit to increase accuracy of early breast cancer diagnosis. Phase-contrast mammography has been shown to increase image quality of native breast samples when compared to conventional mammography. Two major types of microcalcifications are found within breast tissue. Type I consist of calcium oxalate dehydrate and type II microcalcifications are composed of calcium phosphates. Type I is seen most frequently in benign lesions whereas type II is indicative for proliferative lesions, including carcinomas. Phase contrast mammography is shown here to distinguish between the two types of microcalcifications and therefore indicates a step forward to improve early breast cancer diagnosis. Material and Methods: Freshly dissected breast specimens (n = 50) were imaged using a Talbot-Lau interferometer equipped with a conventional x-ray tube; the interferometer was operated at the fifth Talbot distance, tube voltage of 40 kVp with mean energy of 28 keV, and current of 25 mA. The device simultaneously recorded absorption, differential phase and small-angle scattering signals. These quantities were combined into novel, high-frequency-enhanced radiographic images. Histopathological analysis was performed and regions of interests correlated with the findings of phase contrast mammography. Results: Our novel imaging approach yields complementary and otherwise inaccessible information on electron density distribution and small-angle scattering power of the sample at microscopic scale. Recently we generated the world's first phase contrast mammograms of native, not-fixed human whole breast samples. Our results indicate the superiority of the new technique with respect to image quality and lesion conspicuity. A clinical reader study is currently carried out. Exploiting the multiple, complementary information obtained by grating-based interferometry, we are able to classify microcalcifications by a non-invasive technique within the clinical environment. By considering the small-angle scattering signal as a complement to the absorption signal, our method can analyze the differences in the attenuation coefficient as well as in the crystal structure of the microcalcifications. Further, the scattering signal is used to decouple the thickness parameter. We demonstrate that type I and type II microcalcifications give opposite absorption and scattering signals and in addition the small-angle scattering signal helps to determine the type of microcalcification. Conclusions: The potential clinical significance of phase-contrast enhanced mammography has been evaluated by our team. This technique yields improved diagnostic capabilities when compared with conventional mammography, can provide superior contrast, inaccessible and complementary information, and potentially also reduce dose deposition. The non-invasive classification of microcalcifications is an important step toward early diagnosis and differentiation of breast lesions. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-03-06.

FT-Raman spectral analysis of human urinary stones

FT-Raman spectroscopy is the most useful tool for the purpose of bio-medical diagnostics. In the present study, FT-Raman spectral method is used to investigate the chemical composition of urinary calculi. Urinary calculi multi-components such as calcium oxalate, hydroxyl apatite, struvite and uric acid are studied. FT-Raman spectrum has been recorded in the range of 3500–400cm−1. Chemical compounds are identified by Raman spectroscopic technique. The quantitative estimations of calcium oxalate monohydrate (COM) 1463cm−1, calcium oxalate dehydrate (COD) 1478cm−1, hydroxyl apatite 959cm−1, struvite 575cm−1, uric acid 1283cm−1 and oxammite (ammonium oxalate monohydrate) 2129cm−1 are calculated using particular peaks of FT-Raman spectrum. The quantitative estimation of human urinary stones suitable for the single calibration curve was performed.

Quantitative and multicomponent analysis of prevalent urinary calculi using Raman spectroscopy

This study established a quantitative micro‐Raman spectroscopic (MRS) method for measuring multicomponents (binary and ternary compositions) of prevalent urine calculi extracted from the ureter after the ureteroscopic lithotripsy (URSL) procedure. The analysis used calibration curves of known mixtures of synthetically prepared calcium oxalate monohydrate (COM), hydroxyapatite (HAP), calcium oxalate dehydrate (COD), dicalcium phosphate dehydrate (DCPD), and uric acid. A variety of samples of binary and ternary mixtures including COM/HAP, COM/COD, COD/HAP, COM/uric acid, COD/uric acid, HAP/uric acid, HAP/DCPD, and COM/COD/HAP were prepared in various concentration ratios for use as the basis of the quantitative analysis. Intensities of the characteristic bands at 961 cm−1 (IHAP), 986 cm−1 (IDCPD), 1402 cm−1 (IUricAcid), 1462 cm−1 (ICOM), and 1477 cm−1 (ICOD) were used for the calculation. We derived a set of quantitative analysis equations for the ternary composition COD/COM/HAP group by combining two binary equations from the groups COM/COD and the HAP/COM. This study quantitatively measured 18 urine samples extracted from the 18 patients' ureters after the URSL procedure. Fifteen samples were binary mixtures, whereas three samples were ternary mixtures. This research successfully applied the quantitative MRS‐based analysis technique from bench to bedside. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Studies on the in vitro and in vivo antiurolithic activity of Holarrhena antidysenterica

Holarrhena antidysenterica has a traditional use in the treatment of urolithiasis, therefore, its crude extract has been investigated for possible antiurolithic effect. The crude aqueous-methanolic extract of Holarrhena antidysenterica (Ha.Cr) was studied using the in vitro and in vivo methods. In the in vitro experiments, Ha.Cr demonstrated a concentration-dependent (0.25-4mg/ml) inhibitory effect on the slope of aggregation. It decreased the size of crystals and transformed the calcium oxalate monohydrate (COM) to calcium oxalate dehydrate (COD) crystals, in calcium oxalate metastable solutions. It also showed concentration-dependent antioxidant effect against 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radicals and lipid peroxidation induced in rat kidney tissue homogenate. Ha.Cr (0.3mg/ml) reduced (p<0.05) the cell toxicity and LDH release in renal epithelial cells (MDCK) exposed to oxalate (0.5mM) and COM (66μg/cm(2)) crystals. In male Wistar rats, receiving 0.75% ethylene glycol (EG) for 21days along with 1% ammonium chloride (AC) in drinking water, Ha.Cr treatment (30-100mg/kg) prevented the toxic changes caused by lithogenic agents; EG and AC, like loss of body weight, polyurea, oxaluria, raised serum urea and creatinine levels and crystal deposition in kidneys compared to their respective controls. These data indicate that Holarrhena antidysenterica possesses antiurolithic activity, possibly mediated through the inhibition of CaOx crystal aggregation, antioxidant and renal epithelial cell protective activities and may provide base for designing future studies to establish its efficacy and safety for clinical use.

Influence of thermal treatment on CTO wettability

Calcium–titanium–oxygen precipitate (CTO) is well known for its notable electrorheological performance. The two main components of CTO particle are calcium oxalate dehydrate (COD) and titanium–oxygen precipitates (HTO). We systematically studied the wettability of these three compounds with silicon oil at different thermal treatment temperatures. We found that the wetting performance of the HTO decreases with increasing heating temperature, the same tendency as that of CTO particles. This discovery inferred that the wettability of CTO particles is dominated by HTO component. Thermal gravity analysis, X-ray diffraction, X-ray photoelectron spectroscopy as well as the wettability analysis were applied to demonstrate our proposition. The results revealed that HTO is decomposed into inorganic compounds like free carbon by thermal treatment, resulting in a decrease of the wettability of the CTO particles.

Infrared spectrophotometry for crystalline composition of staghorn calculi

To provide theoretic rationales for treatment and prevention of staghorn calculi by analyzing stone composition and studying the relationship between stone and urinary tract infections. The clinical data of 51 staghorn calculi patients were analyzed retrospectively. The stone compositions were studied by infrared spectrophotometry. Six types of stone compositions were obtained. There were calcium oxalate monohydrate, calcium oxalate dehydrate, carbonate apatite, magnesium ammonium phosphate hexahydrate, uric acid and L-cystine. The majority of stones were of mixed compositions, pure stones were found in 15 cases (29.4%). Among all stones, calcium oxalate stones were found in 41 cases (80.4%) and uric stones in 10 cases (19.6%). Infectious stones were found in 26 cases (51.0%). Urinary tract infections were found in 40 (78.4%) patients and positive urine/stone culture was detected in 33 (64.7%) patients. With multiple crystalline compositions and etiological factors, the staghorn calculi are closely correlated with urinary tract infections.

Macroscaled mesoporous calcium carbonate tetragonal prisms: top-down solid-phase fabrication and applications of phase-change material support matrices

In this article, we have demonstrated top-down solid-phase transformation from calcium oxalate dehydrate (COD) tetragonal prisms into highly macroscaled mesoporous calcium carbonate tetragonal prisms. Also, being a promising C2O42− source, L-ascorbic acid (AA) was first applied to obtain high-quality COD tetragonal prisms. The high crystal quality of COD is critical for the successful fabrication of porous CaCO3 microcrystals with predetermined morphology and well-controlled internal structure. Calcined at different heating rates, porous CaCO3 with different pore sizes was obtained. This novel, simple thermal transformation strategy is convenient for preparing nanoporous materials at a large scale, and it is also useful to further extend to convert salt carbonate into such porous nanostructures. The as-obtained porous CaCO3 tetragonal prisms are nontoxic, cheap and environmentally friendly, and the application of such porous CaCO3 with different pore sizes as support matrices successfully mitigates the common problems for phase-change materials (PCMs) of inorganic salts, such as phase separation phenomena and super-cooling effect. Our experiments clearly reveal that the confinement effect of the porous structure plays a more dominant role in mitigation of the phase separation while the mesoporous CaCO3 microcrystals with the smaller mesopore sizes used PCMs as supporters. However, heterogeneous nucleation will be responsible for the mitigation of the phase separation in the macroporous CaCO3 support matrix, while in this case, size confinement effect is negligible. Thereby, the designed porous nanostructures can bring significant improvements to the heat-storage performance in future “smart house” wall materials.

X-ray diffraction analysis of urinary tract stones

To analyze urinary tract stones obtained in our clinic using various methods and to determine the spectrum of stone composition in the Eastern Anatolia Region, Turkey. Materials and methods: A total of 300 stones were obtained at Atatürk University, Faculty of Medicine Urology Clinic through open surgery, percutaneous nephrolithotomy (PNL), ureterorenoscopy (URS), and extracorporeal shock-wave lithotripsy (ESWL) between 1 January 2005 and 30 December 2008. Stones were analyzed in the laboratory of Ankara General Directorate of Mineral Research Exploration using X-ray diffraction (XRD). Results: It was found that 218 (72.7%) of the 300 stones were calcium oxalate (CaOx); 170 (56.7%) of which were calcium oxalate monohydrate (COM), 12 (4%) were calcium oxalate dehydrate (COD), and 36 (12%) were COM and COD combined stones; 23 (7.7%) were uric acid (UA), 6 (2%) were magnesium ammonium phosphate (MAP), 3 (1%) were dahllite (DAH/hydroxyl apatite), 2 (0.6%) were cystine (CYS) stones, and 34 (11.3%) were a combination of UA and COM stones. The remaining 14 (4.7%) stones were a combination of other stones. Conclusion: The stone analysis study was carried out using the XRD method on 300 samples in the Eastern Anatolia Region, where the prevalence of urinary tract stones is relatively high. The analysis showed that 72.7% of all stones were CaOx stone and 56.7% were pure COM stones.

Stone composition and metabolic status

This paper aims to study the correlation between biochemical risk factors of the stone former and the type of oxalate stone formed, namely calcium oxalate monohydrate (COM) and calcium oxalate dehydrate (COD). A retrospective study of 487 patients who had been attending the urinary stone clinic, Trivandrum during 1998-2007 was conducted. The stones retrieved from them were subjected to chemical analysis and FTIR spectrographic analysis. They were categorized into COM, COD, mixed COM+COD and others. Of 142 pure calcium oxalate stone patients, 87 were predominantly COM stone formers and 55 COD stone formers. Their metabolic status of 24 h urine and serum was assessed. The values of urine calcium, phosphorus, uric acid, magnesium, creatinine, oxalate, citric acid, sodium and potassium, serum values of calcium, phosphorus, uric acid, magnesium and creatinine and calculated values of creatinine clearance, tubular reabsorption of phosphate, calcium magnesium ratio and calcium oxalate ratio were recorded. Comparison was made between the COM stone group and the COD stone group. Patients forming COM stones had significantly higher mean values for urine calcium (P < 0.05), oxalate (P < 0.01) and magnesium (P < 0.05) levels and significantly lower level of urine calcium-oxalate ratio (P < 0.01) and urine calcium-magnesium ratio (P < 0.01) compared to COD stone forming patients. All other values failed to show significant difference. Patients, with higher urine oxalate, formed COM stones. Those with low magnesium (which is an inhibitor) formed more of COD stones. Urine calcium was high in both groups without showing significant variation from the mean. In patients with high calcium-oxalate and calcium-magnesium ratios, there is higher chance of forming a COD stone than COM. Identification of the crystallization pattern of the calcium stone will help in selecting treatment modalities.

Leaving No Stone Unturned

Leaving No Stone Unturned