Calcium stone disease: a multiform reality
| Autor: | Alberto Trinchieri, Giampaolo Zanetti, Chiara Castelnuovo, Renata Lizzano |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Calcium Phosphates Male medicine.medical_specialty Urology Inorganic chemistry Calcium oxalate chemistry.chemical_element engineering.material Calcium Oxalate Kidney Calculi chemistry.chemical_compound medicine Humans Aged Calcium Oxalate Whewellite Hydrogen-Ion Concentration Middle Aged Phosphate Urinary calcium chemistry engineering Uric acid Female Weddellite |
| Zdroj: | Urological Research. 33:194-198 |
| ISSN: | 1434-0879 0300-5623 |
| DOI: | 10.1007/s00240-004-0459-x |
| Popis: | In calcium renal stones, calcium oxalate and calcium phosphate in various crystal forms and states of hydration can be identified. Calcium oxalate monohydrate (COM) or whewellite and calcium oxalate dihydrate (COD) or weddellite are the commonest constituents of calcium stones. Calcium oxalate stones may be pure or mixed, usually with calcium phosphate or sometimes with uric acid or ammonium urate. The aim of this study was to compare the clinical and urinary patterns of patients forming calcium stones of different composition according to infrared spectroscopic analysis in order to obtain an insight into their etiology. The stones of 84 consecutive calcium renal stone formers were examined by infrared spectroscopy. In each patient, a blood sample was drawn and analysed for serum biochemistry and a 24-h urine sample was collected and analysed for calcium, phosphate, oxalate, citrate and other electrolytes. We classified 49 patients as calcium oxalate monohydrate (COM) stone formers, 32 as calcium oxalate dihydrate (COD) stone formers and three as apatite stone formers according to the main component of their stones. Patients with COM stones were significantly older than patients with COD stones (P0.002). Mean daily urinary calcium and urinary saturation with respect to calcium oxalate were significantly lower in patients with COM than in those with COD stones (P0.000). Patients with calcium oxalate stones containing a urate component (or = 10%) presented with higher saturation (P0.012) with respect to uric acid in their urine (and lower with respect to calcium oxalate and calcium phosphate, respectively P0.024 and P0.003) in comparison with patients without a urate component in the stone. Patients with calcium oxalate stones with a calcium phosphate component (or = 15%) showed higher (P0.0016) urinary saturation levels with respect to calcium phosphate (and lower with respect to uric acid (P0.009), compared with patients forming stones without calcium phosphate or with a low calcium phosphate component. Patients with calcium stones mixed with urate had a significantly lower urinary pH (P0.002) and urinary calcium (P0.000), and patients with calcium phosphate15%, higher urinary pH (P0.004) and urinary calcium (P0.000). In conclusion, in the evaluation of the individual stone patient, an accurate analysis of the stone showing its exact composition and the eventual presence of minor components of the stone is mandatory in order to plan the correct prophylactic treatment. Patients with "calcium stones" could require various approaches dependent on the form and hydration of the calcium crystals in their stones, and on the presence of "minor" crystalline components that could have acted as epitaxial factors. |
| Databáze: | OpenAIRE |
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