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Tian Y, Han G, Zhang S, Ding Z, Qu R. The key role of major and trace elements in the formation of five common urinary stones. BMC Urol 2024; 24:114. [PMID: 38816700 PMCID: PMC11138091 DOI: 10.1186/s12894-024-01498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Urolithiasis has emerged as a global affliction, recognized as one of the most excruciating medical issues. The elemental composition of stones provides crucial information, aiding in understanding the causes, mechanisms, and individual variations in stone formation. By understanding the interactions between elements in various types of stones and exploring the key role of elements in stone formation, insights are provided for the prevention and treatment of urinary stone disease. METHODS This study collected urinary stone samples from 80 patients in Beijing. The chemical compositions of urinary stones were identified using an infrared spectrometer. The concentrations of major and trace elements in the urinary stones were determined using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS), respectively. The data were processed using correlation analysis and Principal Component Analysis (PCA) methods. RESULTS Urinary stones are categorized into five types: the calcium oxalate (CO) stone, carbonate apatite (CA) stone, uric acid (UA) stone, mixed CO and CA stone, and mixed CO and UA stone. Ca is the predominant element, with an average content ranging from 2.64 to 27.68% across the five stone groups. Based on geochemical analysis, the high-content elements follow this order: Ca > Mg > Na > K > Zn > Sr. Correlation analysis and PCA suggested significant variations in the interactions between elements for different types of urinary stones. Trace elements with charges and ionic structures similar to Ca may substitute for Ca during the process of stone formation, such as Sr and Pb affecting the Ca in most stone types except mixed stone types. Moreover, the Mg, Zn and Ba can substitute for Ca in the mixed stone types, showing element behavior dependents on the stone types. CONCLUSION This study primarily reveals distinct elemental features associated with five types of urinary stones. Additionally, the analysis of these elements indicates that substitutions of trace elements with charges and ion structures similar to Ca (such as Sr and Pb) impact most stone types. This suggests a dependence of stone composition on elemental behavior. The findings of this study will enhance our ability to address the challenges posed by urinary stones to global health and improve the precision of interventions for individuals with different stone compositions.
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Affiliation(s)
- Yu Tian
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Guilin Han
- Institute of Earth Sciences, China University of Geosciences, No. 29 Xueyuan Road, Haidian District, Beijing, 100083, China.
- Frontiers Science Center for Deep-time Digital Earth, Institute of Earth Sciences, China University of Geosciences, Beijing, 100083, China.
| | - Shudong Zhang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China.
| | - Ziyang Ding
- Institute of Earth Sciences, China University of Geosciences, No. 29 Xueyuan Road, Haidian District, Beijing, 100083, China
- Frontiers Science Center for Deep-time Digital Earth, Institute of Earth Sciences, China University of Geosciences, Beijing, 100083, China
| | - Rui Qu
- Institute of Earth Sciences, China University of Geosciences, No. 29 Xueyuan Road, Haidian District, Beijing, 100083, China
- Frontiers Science Center for Deep-time Digital Earth, Institute of Earth Sciences, China University of Geosciences, Beijing, 100083, China
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Zhang J, Li K, Chen H, Hu X, Guo Z, Chen S, Zheng F, Cheng W, Mu Q, Lan Y, Chen P. Retrospective analysis of urinary tract stone composition in a Chinese ethnic minority colony based on Fourier transform infrared spectroscopy. Sci Rep 2023; 13:13453. [PMID: 37596395 PMCID: PMC10439141 DOI: 10.1038/s41598-023-40603-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023] Open
Abstract
To analyze the relationship between the composition of urinary stones and various influencing factors in the Enshi region. We used FT-IR to examine the composition of 1092 stone samples. Combined with the relevant clinical materials, the data were analyzed using both one-dimensional statistical methods and multivariate statistical methods. The study included 1092 stone samples, classified as follows: 457 (41.8%) with a single component, 453 (41.5%) with two components, 149 (13.6%) with three components, and 33 (3.0%) with four components. Stones were categorized into five types: Calcium Oxalate (CaOx) (76.4%), carbapatite (CaP) (9.3%), Struvite (ST) (8.3%), Uric Acid (UA) (4.9%), and Others (1.0%). Age, gender, urinary tract infection (UTI), family history of urinary stones (FH), hyperuricemia (HUA) and stone location were significantly associated with stone type. Logistic regression revealed that females and UTI were relative risk factors for predicting CaP and ST, while FH and HUA were relative risk factors for predicting UA. Our study indicates that the overall composition of urinary tract stones in the Enshi region is consistent with that of the entire China. Additionally, the predisposing factors for stone formation vary in terms of gender, age, FH, UTI, hyperuricemia HUA, and stone location.
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Affiliation(s)
- Junfeng Zhang
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Kailing Li
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Hongbo Chen
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Xiaohui Hu
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Zicheng Guo
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Su Chen
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Fu Zheng
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Wusong Cheng
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Qian Mu
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Yong Lan
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China.
| | - Peng Chen
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China.
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3
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Zhang D, Li S, Zhang Z, Li N, Yuan X, Jia Z, Yang J. Urinary stone composition analysis and clinical characterization of 1520 patients in central China. Sci Rep 2021; 11:6467. [PMID: 33742013 PMCID: PMC7979884 DOI: 10.1038/s41598-021-85723-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/03/2021] [Indexed: 11/09/2022] Open
Abstract
A total of 1520 patients with urinary stones from central China were collected and analysed by Fourier transform infrared spectroscopy between October 1, 2016 and December 31, 2019. For all patients, age, sex, comorbidities, stone location, laboratory examination and geographic region were collected. The most common stone component was calcium oxalate (77.5%), followed by calcium phosphate (8.7%), infection stone (7.6%), uric acid (UA) stone (5.3%)and cystine (0.9%). The males had more calcium oxalate stones (p < 0.001), while infection stone and cystine stones occurred more frequently in females (p < 0.001). The prevalence peak occurred at 41-60 years in both men and women. UA stones occurred frequently in patients with lower urinary pH (p < 0.001), while neutral urine or alkaline urine (p < 0.001) and urinary infection (p < 0.001) were more likely to be associated with infection stone stones. Patients with high levels of serum creatinine were more likely to develop UA stones (p < 0.001). The proportion of UA stones in diabetics was higher (p < 0.001), and the incidence of hypertension was higher in patients with UA stones (p < 0.001). Compared to the other types, more calcium oxalate stones were detected in the kidneys and ureters (p < 0.001), whereas struvite stones were more frequently observed in the lower urinary tract (p = 0.001). There was no significant difference in stone composition across the Qinling-Huaihe line in central China except UA stones, which were more frequently observed in patients south of the line (p < 0.001).
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Affiliation(s)
- Daling Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Songchao Li
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Zhengguo Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Ningyang Li
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Xiang Yuan
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
| | - Zhankui Jia
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China. .,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China.
| | - Jinjian Yang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Rd., Zhengzhou, 450052, People's Republic of China.,Urological Institute of Henan, Zhengzhou, 450052, Henan Province, People's Republic of China
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Y W, F H, L A F, M H, H H. A Spatial Distribution Analysis on the Deposition Mechanism Complexity of the Organic Material of Kidney Stone. J Biomed Phys Eng 2020; 10:273-282. [PMID: 32637371 PMCID: PMC7321398 DOI: 10.31661/jbpe.v0i0.1104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/05/2019] [Indexed: 11/22/2022]
Abstract
Background: Kidney stones in the urinary system are formed from complex minerals that can interfere with the function of the kidney. This formation occurs gradually and can be observed from the appearance of the kidney stones cross-section which are cut along its longitudinal axis resembling a tree cambium. A deeper study on the composition of these layers will provide etiological and pathophysiological information on the mechanism of the formation and development of kidney stones. In addition, an accurate analysis on the composition of the kidney stone can provide a scientific basis to determine the choice of medical treatment and efforts to prevent from forming of kidney stones in humans. Objective: This study aimed to analyze the organic material that makes up kidney stones in each layer. Material and Methods: In this analytical study, the components and morphological properties of five kidney stones in each layer were characterized using Fourier transform infrared-attenuated total reflection (FTIR-ATR) and Scanning Elecron Microscope-Element Distribution Analysis (SEM-EDS). Results: FTIR-ATR displayed the typical absorption peaks for each stone constituent component. The components of each layer showed the same peak value for each absorption peak which consisted of calcium oxalate monohydrate, struvite, ammonium ion calcium oxalate monohydrate, calcium oxalate monohydrate-calcium phosphate and uric acid. Meanwhile, the difference in the percentage and composition of the elements in each stone can be observed by SEM-EDS. Conclusion: From this study, it can be concluded that each layer of the kidney stones has a different percentage and composition of elements.
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Affiliation(s)
- Warty Y
- MSc, Nuclear Physics and Biophysics Research Division, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung Jl. Ganesha 10 Bandung 40132, Indonesia
| | - Haryanto F
- PhD, Nuclear Physics and Biophysics Research Division, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung Jl. Ganesha 10 Bandung 40132, Indonesia
| | - Fitri L A
- MSc, Nuclear Physics and Biophysics Research Division, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung Jl. Ganesha 10 Bandung 40132, Indonesia
| | - Haekal M
- PhD, Nuclear Physics and Biophysics Research Division, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung Jl. Ganesha 10 Bandung 40132, Indonesia
| | - Herman H
- PhD, Magnetic and Photonic Physics Research Division, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung Jl. Ganesha 10 Bandung 40132, Indonesia
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Svoboda R, Olmrová Zmrhalová Z, Galusek D, Brandová D, Chovanec J. Thermal decomposition of mixed calcium oxalate hydrates - kinetic deconvolution of complex heterogeneous processes. Phys Chem Chem Phys 2020; 22:8889-8901. [PMID: 32289819 DOI: 10.1039/c9cp06867h] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Differential scanning calorimetry (DSC), thermogravimetry (TG) and in situ XRD were used to study dehydration and consequent decomposition reactions of mixed calcium oxalate hydrates. As the complex dehydration kinetics exhibited certain trends with respect to the applied heating rate, the modified multivariate kinetic analysis approach (based on averaged curve-by-curve optimizations) was employed to obtain a full kinetic description of the data. The Šesták-Berggren equation was used to model the two consequent dehydration reactions. Good agreement was found between the kinetic parameters calculated from the DSC and TG data - approximate values of activation energies were 68 and 81 kJ mol-1 for the trihydrate → monohydrate and monohydrate → anhydride transformations, respectively. A procedural methodology was developed to predict both dehydration kinetics and hydrate content ratios. For the calcium oxalate decomposition the TG technique provided very precise single-step prediction with an activation energy of 180 kJ mol-1. DSC on the other hand provided complex information on joint decomposition and carbon monoxide oxidation reactions - the proposed reaction mechanism includes completion of two reaction paths composed of consequent chemical reactions. A mechanistic view of the complex reaction path is discussed in terms of the diffusion barrier limiting the oxidation step.
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Affiliation(s)
- Roman Svoboda
- University of Pardubice, Faculty of Chemical Technology, Department of Physical Chemistry, Studentska 573, 532 10 Pardubice, Czech Republic.
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High prevalence of pediatric urinary tract stones in Xinjiang Uyghur. Urolithiasis 2018; 47:265-272. [PMID: 29980798 DOI: 10.1007/s00240-018-1074-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
The aim of the study was to report the characteristics of urolithiasis in Uyghur patients from Xinjiang, China. The composition of stones collected from 1863 patients in the Uyghur region of Xinjiang was analyzed. The median age of patients was 17 years [25th and 75th percentiles: 2, 36]. The stones were delivered by 1299 males (69.7%) and 564 females (30.3%). Calcium oxalate was the predominant stone component in 42.1% of the patients, followed by ammonium urate in 20.6%. Females had formed more stones of magnesium ammonium phosphate 8.9 vs. 5.6% (p = 0.010) and carbonate apatite 6.2 vs. 3.3% (p = 0.004). In contrast uric acid was more common in males than in females; 21.6 vs. 15.1% (p = 0.001). In this series, pediatric patients (age range 0-18) were more likely to present with a stone (51.5%, p < 0.001). Moreover, the largest number of pediatric stones was recorded in children 1-2 years old (37.9%, p < 0.001). The occurrence of ammonium urate stones was extremely high (52.4%) in children with an age below 1 year. There was a downward trend for ammonium urate with age in both children and adults (p for trend < 0.001, respectively). In contrast the frequency of uric acid declined with age in pediatric patients, but increased in adults (p for trend < 0.001, respectively). This study provides a basis for further considerations on the management of Xinjiang Uyghur patients and emphasize the severity of pediatric stone problems.
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Luo J, Tuerxun A, Shataer A, Batuer A, Jiang C, Zhou Y, Li Z, Chen D, Liu Y. Kidney Stone Composition in Third-World Areas: What Kashgar Tells Us? J Endourol 2018; 32:465-470. [PMID: 29649901 DOI: 10.1089/end.2017.0860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze urinary stone compositions in patients from Kashgar, China. MATERIALS AND METHODS We analyzed the components of urinary stones in 732 consecutive patients with urolithiasis admitted to the First and Second People's Hospital of Kashgar Prefecture, Xinjiang, from July 2014 to November 2016. The patients were divided into two groups by ages: group A, 0 to 18 years and group B, >18 years old. The distributions of various stone compositions were analyzed and correlated with the gender and age. RESULTS The mean age of group A was 3.90 ± 4.09 years and that of group B was 39.88 ± 16.40 years. The overall gender ratio (male:female) was 2.27:1. Ammonium acid urate (AAU) stone was the most frequent stone, male 35.83% and female 33.48%. Female patients were significantly more common than male patients in calcium apatite stone (p = 0.004). Of all 732 cases, patients younger than 18 years were more than patients older than 18 years (58.47% vs 41.53%). The majority of the patients (77.87%) had the stone located in the upper urinary tract. Two peak ages for both genders were noted in 1 to 3 years and 19 to 40 years group of the patients. In group of 1 to 3 years patients, male were more than female (37.60% vs 24.55%, p = 0.001), whereas in the group of 10 to 18 years patients, female were more than male (10.71% vs 4.13%). AAU was the predominant stone component in group <1 year (70. 5%, p < 0.01, as compared with other groups.). Uric acid stone was more prevalent in group >60 years (66.8%, p < 0.01) than in other groups. Patients in 1 to 3 years were in the peak age group of AAU stones in both the upper and lower urinary tract. CONCLUSION Most of the patients with urolithiasis diagnosed and treated in Kashgar are <18 years old, especially younger than 3 years old. The most frequent stone component in this area was AAU. More than 50% patients <18 years old had AAU stone. The mechanisms that could trigger the high prevalence of AAU stone in patients <18 years old are worth further investigation.
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Affiliation(s)
- Jiawei Luo
- 1 Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou, China
| | - Aierken Tuerxun
- 2 Department of Urology, Kashgar Prefecture First People's Hospital of Kashi , Xinjiang, China
| | - Abuduwupuer Shataer
- 3 Department of Urology, Kashgar Prefecture Second People's Hospital of Kashi , Xinjiang, China
| | - Abudukahaer Batuer
- 2 Department of Urology, Kashgar Prefecture First People's Hospital of Kashi , Xinjiang, China
| | - Chonghe Jiang
- 4 Department of Urology, The Sixth Affiliated Hospital of Guangzhou Medical University , Qingyuan, China
| | - Yizhou Zhou
- 5 Department of Urology, Shantou Central Hospital , Shantou, China
| | - Zhilin Li
- 1 Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou, China
| | - Donglong Chen
- 1 Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou, China
| | - Yongda Liu
- 1 Department of Urology, Guangdong Key Laboratory of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou, China
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He Z, Jing Z, Jing-Cun Z, Chuan-Yi H, Fei G. Compositional analysis of various layers of upper urinary tract stones by infrared spectroscopy. Exp Ther Med 2017; 14:3165-3169. [PMID: 28912866 DOI: 10.3892/etm.2017.4864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 02/03/2017] [Indexed: 11/06/2022] Open
Abstract
The objective of the present study was to determine the composition of various layers of upper urinary stones and assess the mechanisms of stone nucleation and aggregation. A total of 40 integrated urinary tract stones with a diameter of >0.8 cm were removed from the patients. All of the stones were cut in half perpendicularly to the longitudinal axis. Samples were selected from nuclear, internal and external layers of each stone. Fourier transform infrared spectroscopy (FT-IR) was adopted for qualitative and quantitative analysis of all of the fragments and compositional differences among nuclear, internal and external layers of various types of stone were subsequently investigated. A total of 25 cases of calcium oxalate (CaOx) stones and 10 cases of calcium phosphate (CaP) stones were identified to be mixed stones, while 5 uric acid (UA) calculi were pure stones (purity, >95%). In addition, the contents of CaOx and carbapatite (CA.AP) crystals in various layers of the mixed stones were found to be variable. In CaOx stones, the content of CA.AP in nuclear layers was significantly higher than that of the outer layers (32.0 vs. 6.8%; P<0.05), while the content of CaOx was lower in the inner than in the outer layers (57.6 vs. 86.6%; P<0.05). In CaP stones, the content of CA.AP in the nuclear layers was higher than that in the outer layers (74.0 vs. 47.3%; P<0.05), while the content of CaOx was lower in the inner than in the outer layers (7.0 vs. 40.0%; P<0.05). The UA stones showed no significant differences in their composition among different layers. In conclusion, FT-IR analysis of various layers of human upper urinary tract stones revealed that CaOx and CaP stones showed differences in composition between their core and surface, while all of the UA calculi were pure stones. The composition showed a marked variation among different layers of the stones, indicating that metabolism has an important role in different phases of the evolution of stones. The present study provided novel insight into the pathogenesis of urinary tract stones and may contribute to their prevention and treatment.
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Affiliation(s)
- Zhang He
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Zhang Jing
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Zheng Jing-Cun
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Hu Chuan-Yi
- Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, P.R. China
| | - Gao Fei
- Department of Urology, The Second People's Hospital of Yulin, Yulin, Shaanxi 719000, P.R. China
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Rizvi SAH, Hussain M, Askari SH, Hashmi A, Lal M, Zafar MN. Surgical outcomes of percutaneous nephrolithotomy in 3402 patients and results of stone analysis in 1559 patients. BJU Int 2017; 120:702-709. [PMID: 28303631 DOI: 10.1111/bju.13848] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report our experience of a series of percutaneous nephrolithotomy (PCNL) procedures in a single centre over 18 years in terms of patient and stone characteristics, indications, stone clearance and complications, along with the results of chemical analysis of stones in a subgroup. PATIENTS AND METHODS We retrospectively analysed the outcomes of PCNL in 3402 patients, who underwent the procedure between 1997 and 2014, obtained from a prospectively maintained database. Data analysis included patients' age and sex, laboratory investigations, imaging, punctured calyx, duration of operation, volume of irrigation fluid, radiation exposure time, blood transfusion, complications and stone-free status at 1-month follow-up. For the present analysis, outcomes in relation to complications and success were divided in two eras, 1997-2005 and 2006-2014, to study the differences. RESULTS Of the 3402 patients, 2501 (73.5%) were male and 901 (26.5%) were female, giving a male:female ratio of 2.8:1. Staghorn (partial or complete) calculi were found in 27.5% of patients, while 72.5% had non-staghorn calculi. Intracorporeal energy sources used for stone fragmentation included ultrasonography in 917 patients (26.9%), pneumatic lithoclast in 1820 (53.5%), holmium laser in 141 (4.1%) and Lithoclast® master in 524 (15.4%). In the majority of patients (97.4%) a 18-22-F nephrostomy tube was placed after the procedure, while 69 patients (2.03%) underwent tubeless PCNL. The volume of the irrigation fluid used ranged from 7 to 37 L, with a mean of 28.4 L. The stone-free rate after PCNL in the first era studied was 78%, vs 83.2% in the second era, as assessed by combination of ultrasonography and plain abdominal film of the kidney, ureter and bladder. The complication rate in the first era was 21.3% as compared with 10.3% in the second era, and this difference was statistically significant. Stone analysis showed pure stones in 41% and mixed stones in 58% of patients. The majority of stones consisted of calcium oxalate. CONCLUSIONS This is the largest series of PCNL reported from any single centre in Pakistan, where there is a high prevalence of stone disease associated with infective and obstructive complications, including renal failure. PCNL as a treatment method offers an economic and effective option in the management of renal stone disease with acceptable stone clearance rates in a resource-constrained healthcare system.
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Affiliation(s)
- Syed Adibul Hasan Rizvi
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan
| | - Manzoor Hussain
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan
| | - Syed Hassan Askari
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan
| | - Altaf Hashmi
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan
| | - Murli Lal
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan
| | - Mirza Naqi Zafar
- Department of Pathology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan
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Combining field effect scanning electron microscopy, deep UV fluorescence, Raman, classical and synchrotron radiation Fourier transform Infra-Red Spectroscopy in the study of crystal-containing kidney biopsies. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Dessombz A, Coulibaly G, Kirakoya B, Ouedraogo RW, Lengani A, Rouziere S, Weil R, Picaut L, Bonhomme C, Babonneau F, Bazin D, Daudon M. Structural elucidation of silica present in kidney stones coming from Burkina Faso. CR CHIM 2016. [DOI: 10.1016/j.crci.2016.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kocademir M, Baykal A, Kumru M, Tahmaz ML. Structural characterization and vibrational studies of human urinary stones from Istanbul, Turkey. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2016; 160:1-7. [PMID: 26890204 DOI: 10.1016/j.saa.2016.01.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/25/2016] [Accepted: 01/28/2016] [Indexed: 06/05/2023]
Abstract
Seven human urinary stones were collected from urinary bladders of patients hailing from Istanbul, Turkey. Their XRD, EDX, FT-IR and FT-Raman spectra as well as SEM images have been recorded to determine their chemical compositions, morphologies, crystal structures, and crystallite sizes. XRD and vibrational (FT-IR and FT-Raman) analyses indicate that six out of the seven stones have identical contents. The ratios of organic and inorganic contents of the stones have been determined by their thermogravimetric analyses. The stones have been found to contain calcium oxalate monohydrate and apatite as the major components.
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Affiliation(s)
- Mustafa Kocademir
- Department of Physics, Faculty of Arts and Sciences, Fatih University, 34500 Büyükçekmece, Istanbul, Turkey
| | - Abdulhadi Baykal
- Department of Chemistry, Faculty of Arts and Sciences, Fatih University, 34500 Büyükçekmece, Istanbul, Turkey
| | - Mustafa Kumru
- Department of Physics, Faculty of Arts and Sciences, Fatih University, 34500 Büyükçekmece, Istanbul, Turkey.
| | - M Lutfu Tahmaz
- Department of Urology, Medical Faculty Hospital, Fatih University, 34180 Sirinevler-Bahcelievler, Istanbul, Turkey
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Stone heterogeneity index as the standard deviation of Hounsfield units: A novel predictor for shock-wave lithotripsy outcomes in ureter calculi. Sci Rep 2016; 6:23988. [PMID: 27035621 PMCID: PMC4817509 DOI: 10.1038/srep23988] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/08/2016] [Indexed: 11/24/2022] Open
Abstract
We investigated whether stone heterogeneity index (SHI), which a proxy of such variations, was defined as the standard deviation of a Hounsfield unit (HU) on non-contrast computed tomography (NCCT), can be a novel predictor for shock-wave lithotripsy (SWL) outcomes in patients with ureteral stones. Medical records were obtained from the consecutive database of 1,519 patients who underwent the first session of SWL for urinary stones between 2005 and 2013. Ultimately, 604 patients with radiopaque ureteral stones were eligible for this study. Stone related variables including stone size, mean stone density (MSD), skin-to-stone distance, and SHI were obtained on NCCT. Patients were classified into the low and high SHI groups using mean SHI and compared. One-session success rate in the high SHI group was better than in the low SHI group (74.3% vs. 63.9%, P = 0.008). Multivariate logistic regression analyses revealed that smaller stone size (OR 0.889, 95% CI: 0.841–0.937, P < 0.001), lower MSD (OR 0.995, 95% CI: 0.994–0.996, P < 0.001), and higher SHI (OR 1.011, 95% CI: 1.008–1.014, P < 0.001) were independent predictors of one-session success. The radiologic heterogeneity of urinary stones or SHI was an independent predictor for SWL success in patients with ureteral calculi and a useful clinical parameter for stone fragility.
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Messaoudi N, Sennour K, Daudon M, Omar ZK, Attar A, Addou A. Prediction of successful treatment by extracorporeal shock wave lithotripsy based on crystalluria-composition correlations of urinary calculi. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(15)60969-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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An epidemiological study on the composition of urinary stones in Morocco in relation to age and sex. AFRICAN JOURNAL OF UROLOGY 2015. [DOI: 10.1016/j.afju.2015.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Keshavarzi B, Yavarashayeri N, Irani D, Moore F, Zarasvandi A, Salari M. Trace elements in urinary stones: a preliminary investigation in Fars province, Iran. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2015; 37:377-389. [PMID: 25433503 DOI: 10.1007/s10653-014-9654-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 11/04/2014] [Indexed: 06/04/2023]
Abstract
In view of the high incidence rate of urinary stones in the south and southwest of Iran, this paper investigates trace elements content including heavy metals in 39 urinary stones, collected from patients in Fars province, Iran. The mineralogy of the stones is investigated using X-ray diffractometry. The samples are classified into five mineral groups (calcium oxalate, uric acid, cystine, calcium phosphate and mixed stone). Major and trace elements in each group were determined using ICP-MS method. P and Ca constitute the main elements in urinary stones with Ca being more affine to oxalates while other alkali and alkaline earths precipitate with phosphate. Significant amounts of trace elements, especially Zn and Sr, were found in urinary calculi (calcium oxalate and phosphates) relative to biominerals (uric acid and cystine). Among urinary calculi, calcium phosphate contains greater amounts of trace metal than calcium oxalate. Phosphates seem to be the most important metal-bearing phases in urinary stones. Results indicate that concentrations of elements in urinary stones depend on the type of mineral phases. Significant differences in elements content across various mineralogical groups were found by applying statistical methods. Kruskal-Wallis test reveals significant difference between Ca, P, K, Na, Mg, S, Zn, Sr, Se, Cd, and Co content in different investigated mineral groups. Moreover, Mann-Whitney test differentiates Ca, Na, Zn, Sr, Co, and Ni between minerals in oxalate and uric acid stones. This study shows that urinary stone can provide complementary information on human exposure to elements and estimate the environmental risks involved in urinary stones formation.
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Affiliation(s)
- Behnam Keshavarzi
- Department of Earth Sciences, College of Sciences, Shiraz University, 71454, Shiraz, Iran,
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Selvaraju R, Raja A, Thiruppathi G. FT-IR spectroscopic, thermal analysis of human urinary stones and their characterization. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2015; 137:1397-1402. [PMID: 25306135 DOI: 10.1016/j.saa.2014.09.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 08/25/2014] [Accepted: 09/18/2014] [Indexed: 06/04/2023]
Abstract
In the present study, FT-IR, XRD, TGA-DTA spectral methods have been used to investigate the chemical compositions of urinary calculi. Multi-components of urinary calculi such as calcium oxalate, hydroxyl apatite, struvite and uric acid have been studied. The chemical compounds are identified by FT-IR spectroscopic technique. The mineral identification was confirmed by powder X-ray diffraction patterns as compared with JCPDS reported values. Thermal analysis techniques are considered the best techniques for the characterization and detection of endothermic and exothermic behaviors of the urinary stones. The percentages of each hydrate (COM and COD) are present together, in the presences of MAPH or UA. Finally, the present study suggests that the Urolithiasis is significant health problem in children, and is very common in some parts of the world, especially in India. So that present study is so useful and helpful to the scientific community for identification of latest human health problems and their remedies using spectroscopic techniques.
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Affiliation(s)
- R Selvaraju
- Department of Engineering Physics, Annamalai University, Annamalai Nagar 608 002, Tamil Nadu, India.
| | - A Raja
- Department of Engineering Physics, Annamalai University, Annamalai Nagar 608 002, Tamil Nadu, India
| | - G Thiruppathi
- Department of Engineering Physics, Annamalai University, Annamalai Nagar 608 002, Tamil Nadu, India
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Moses R, Pais VM, Ursiny M, Prien EL, Miller N, Eisner BH. Changes in stone composition over two decades: evaluation of over 10,000 stone analyses. Urolithiasis 2015; 43:135-9. [DOI: 10.1007/s00240-015-0756-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 02/05/2015] [Indexed: 10/24/2022]
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Inhibition of urinary macromolecule heparin on aggregation of nano-COM and nano-COD crystals. Molecules 2015; 20:1626-42. [PMID: 25608044 PMCID: PMC6272453 DOI: 10.3390/molecules20011626] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 12/29/2014] [Indexed: 02/02/2023] Open
Abstract
Purpose: This research aims to study the influences of heparin (HP) on the aggregation of nano calcium oxalate monohydrate (COM) and nano calcium oxalate dihydrate (COD) with mean diameter of about 50 nm. Method: The influences of different concentrations of HP on the mean diameter and Zeta potential of nano COM and nano COD were investigated using a nanoparticle size Zeta potential analyzer. Results: HP could be adsorbed on the surface of nano COM and nano COD crystals, leading to an increase in the absolute value of Zeta potential on the crystals and an increase in the electrostatic repulsion force between crystals. Consequently, the aggregation of the crystals is reduced and the stability of the system is improved. The strong adsorption ability of HP was closely related to the -OSO3− and -COO− groups contained in the HP molecules. X-ray photoelectron spectroscopy confirmed the coordination of HP with Ca2+ ions of COM and COD crystals. Conclusion: HP could inhibit the aggregation of nano COM and nano COD crystals and increase their stability in aqueous solution, which is conducive in inhibiting the formation of calcium oxalate stones.
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Aslin Shamema A, Thanigai Arul K, Senthil Kumar R, Narayana Kalkura S. Physicochemical analysis of urinary stones from Dharmapuri district. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2015; 134:442-448. [PMID: 25033236 DOI: 10.1016/j.saa.2014.05.088] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/12/2014] [Accepted: 05/25/2014] [Indexed: 06/03/2023]
Abstract
Nephrolithiasis is a common disease caused by the multifactorial components such as geographical location, bacterial infection, low urine volume, and low intake of water. This disease induces severe metabolic abnormalities in the human body. As the prevalence of this disease was high in Dharmapuri district located in Tamil Nadu, urinary stones removed from the patients pertaining to this district were collected and to identify the toxic elements present in the stones. The presence of functional groups and phases of the stones were analyzed using X-ray diffraction (XRD), Fourier transform Raman spectroscopy and Fourier transform infrared spectroscopy (FT-IR). The majority of stones were found to be calcium oxalate monohydrate (COM) and mixed stones having minor existence of struvite and uric acid. Hexagonal shaped COM crystals, needle shaped uric acid crystals and layered arrangement of struvite crystals in the core region were revealed by Scanning Electron Microscopy (SEM). Thermo Gravimetric Analysis (TGA) was used to determine the thermal stability and the hardness of the stone which was measured using Vickers hardness (HV). The presence of toxic elements in stones such as zirconium and mercury was identified using Energy Dispersive X-ray Spectroscopy (EDS). The EDS analysis showed higher concentration of zirconium in the core region compared to the periphery. The percentage of zirconium was relatively high compared to other toxic elements in the stones. The Vickers hardness results indicated that high HV values in the core region than the periphery and this might be due to the presence of zirconium.
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Affiliation(s)
- A Aslin Shamema
- Crystal Growth Centre, Anna University, Chennai 600 025, Tamil Nadu, India
| | - K Thanigai Arul
- Crystal Growth Centre, Anna University, Chennai 600 025, Tamil Nadu, India
| | - R Senthil Kumar
- Thangam Hospital, Bharathipuram, Dharmapuri 636705, Tamil Nadu, India
| | - S Narayana Kalkura
- Crystal Growth Centre, Anna University, Chennai 600 025, Tamil Nadu, India.
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Wumaner A, Keremu A, Wumaier D, Wang Q. Variation in urinary stone composition between adult Uyghur and Han patients with urolithiasis in Xinjiang, China. Urology 2014; 84:772-8. [PMID: 25109561 DOI: 10.1016/j.urology.2014.04.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 03/20/2014] [Accepted: 04/26/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze variations in urinary stone composition between Uyghur and Han patients with urolithiasis in Xinjiang, China, and to explore the possible factors associated with urinary stone composition in Uyghur and Han patients. MATERIALS AND METHODS We analyzed the components of urinary stones in 317 adults (152 Uyghur and 165 Han) with urolithiasis admitted to our hospital from March 2009 to June 2011. Urinary stones were collected by endoscopic or open surgical procedures and analyzed by infrared spectroscopy. Also analyzed were clinical data, including patient's age, sex, geographic distribution, blood tests, and urine tests. Logistic regression was performed to analyze the association between stone components and the clinical characteristics of the patients. RESULTS There were significant differences between Uyghur and Han patients in age, geographic distribution, serum concentrations of uric acid, potassium, and phosphorus, urine magnesium concentrations, 24-hour volumes of urine, and in stone components of calcium oxalate monohydrate, calcium oxalate dihydrate plus carbapatite, and uric acid. Differences in sex, family history, complications, sites of calculi, or other blood and urine test results were not significant. Logistic regression analysis revealed that geographic location, ethnicity, blood potassium concentration, and urine volume were significantly correlated with the calcium oxalate dihydrate plus carbapatite component of urinary stones. CONCLUSION Urinary stone composition differs between Uyghur and Han patients with urolithiasis, possibly as a result of geographic distribution.
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Affiliation(s)
- Aikebaier Wumaner
- Department of Urology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, China
| | - Aziguli Keremu
- Department of Clinical Laboratory, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, China
| | - Dilixiati Wumaier
- Department of Urology First People's Hospital of Kashi, Kashi, Xinjiang, China
| | - Qing Wang
- Department of Urology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, China.
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Wumaner A, Keremu A, Wumaier D, Wang Q. High incidence of urinary stones in Uyghur children may be related to local environmental factors. J Pediatr Urol 2014; 10:289-93. [PMID: 24095687 DOI: 10.1016/j.jpurol.2013.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 09/01/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze the causes of urolithiasis in Uyghur children from Xinjiang. PATIENTS AND METHODS We retrospectively evaluated the clinical features and characteristics of urinary stone composition of 220 Uyghur pediatric patients with urolithiasis between March 2009 and June 2011. The data were compared with that of 100 Uyghur children without urolithiasis who visited the Child Care Clinic for regular health check-ups. The stones were collected by endoscopy or open surgery, and analyzed using infrared spectroscopy. RESULTS The mean age of the 220 Uyghur children was 7.48 ± 4.73 years (range, 0.8-17.0 years). The overall sex ratio (male:female) was 2.23:1. The predominant pure stone was ammonium urate (58.9%), whereas the predominant mixed stone was calcium oxalate mixture (91.1%). Uric acid stones comprised 54% of all stones. Urinary tract infections were observed in 42.3% and 4.0% of the patient and control groups, respectively. The mean urinary pH values were 5.77 ± 0.67 and 6.42 ± 0.67, respectively (p < 0.001). pH values were <5.5 in 52.7% and 6% of the patient and control groups, respectively. On 24-h urine analysis, we found metabolic disturbances in these patients: hypercalciuria in 6.8% cases, hyperphosphaturia in 16.8% cases, hyperuricosuria in 21.4% cases, and hypomagnesiuria in 34.1% cases. CONCLUSIONS Urolithiasis in Uyghur children may be primarily related to local environmental factors.
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Affiliation(s)
- Aikebaier Wumaner
- Xinjiang Clinic College, Anhui Medical University, No. 84 Meishan Road, Chushan Area, Hefei 200135, China
| | - Aziguli Keremu
- Department of Clinical Laboratory, People's Hospital of Xinjiang Uyghur Autonomous Region, No. 91 Tianchi Roud, Tianshan Area, Urumqi 830001, Xinjiang, China
| | - Dilixiati Wumaier
- Department of Urology, First People's Hospital of Kashi, No. 66 Yingbin Road, Kashi 844000, Xinjiang, China
| | - Qing Wang
- Xinjiang Clinic College, Anhui Medical University, No. 84 Meishan Road, Chushan Area, Hefei 200135, China.
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Kumar S, R, Chaudhary S, S, Jain DC. Vibrational Studies of Different Human Body Disorders Using FTIR Spectroscopy. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojapps.2014.43012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wu W, Yang B, Ou L, Liang Y, Wan S, Li S, Zeng G. Urinary stone analysis on 12,846 patients: a report from a single center in China. Urolithiasis 2013; 42:39-43. [DOI: 10.1007/s00240-013-0633-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 12/10/2013] [Indexed: 01/06/2023]
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Concave urinary crystallines: direct evidence of calcium oxalate crystals dissolution by citrate in vivo. Bioinorg Chem Appl 2013; 2013:637617. [PMID: 24363634 PMCID: PMC3855932 DOI: 10.1155/2013/637617] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 09/30/2013] [Accepted: 10/17/2013] [Indexed: 11/18/2022] Open
Abstract
The changes in urinary crystal properties in patients with calcium oxalate (CaOx) calculi after oral administration of potassium citrate (K3cit) were investigated via atomic force microscopy (AFM), scanning electron microscopy (SEM), X-ray powder diffractometry (XRD), and zeta potential analyzer. The AFM and SEM results showed that the surface of urinary crystals became concave, the edges and corners of crystals became blunt, the average size of urinary crystallines decreased significantly, and aggregation of urinary crystals was reduced. These changes were attributed to the significant increase in concentration of excreted citrate to 492 ± 118 mg/L after K3cit intake from 289 ± 83 mg/L before K3cit intake. After the amount of urinary citrate was increased, it complexed with Ca2+ ions on urinary crystals, which dissolved these crystals. Thus, the appearance of concave urinary crystals was a direct evidence of CaOx dissolution by citrate in vivo. The XRD results showed that the quantities and species of urinary crystals decreased after K3cit intake. The mechanism of inhibition of formation of CaOx stones by K3cit was possibly due to the complexation of Ca2+ with citrate, increase in urine pH, concentration of urinary inhibitor glycosaminoglycans (GAGs), and the absolute value of zeta potential after K3cit intake.
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Zhang GN, Ouyang JM, Xue JF, Shang YF. Property changes of urinary nanocrystallites and urine of uric acid stone formers after taking potassium citrate. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:4039-45. [DOI: 10.1016/j.msec.2013.05.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/05/2013] [Accepted: 05/23/2013] [Indexed: 12/24/2022]
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Stone Compositions in Turkey: An Analysis According to Gender and Region. Urology 2013; 82:532-7. [DOI: 10.1016/j.urology.2013.04.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/29/2013] [Accepted: 04/07/2013] [Indexed: 11/19/2022]
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Duan CY, Xia ZY, Zhang GN, Gui BS, Xue JF, Ouyang JM. Changes in urinary nanocrystallites in calcium oxalate stone formers before and after potassium citrate intake. Int J Nanomedicine 2013; 8:909-18. [PMID: 23467267 PMCID: PMC3589116 DOI: 10.2147/ijn.s39642] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Indexed: 11/23/2022] Open
Abstract
The property changes of urinary nanocrystallites in 13 patients with calcium oxalate (CaOx) stones were studied before and after ingestion of potassium citrate (K3cit), a therapeutic drug for stones. The analytical techniques included nanoparticle size analysis, transmission electron microscopy, X-ray diffraction, and Fourier-transform infrared spectroscopy. The studied properties included the components, morphologies, zeta potentials, particle size distributions, light intensity autocorrelation curves, and polydispersity indices (PDIs) of the nanocrystallites. The main components of the urinary nanocrystallites before K3cit intake included uric acid, β-calcium phosphate, and calcium oxalate monohydrate. After K3cit intake, the quantities, species, and percentages of aggregated crystals decreased, whereas the percentages of monosodium urate and calcium oxalate dehydrate increased, and some crystallites became blunt. Moreover, the urinary pH increased from 5.96 ± 0.43 to 6.46 ± 0.50, the crystallite size decreased from 524 ± 320 nm to 354 ± 173 nm, and the zeta potential decreased from -4.85 ± 2.87 mV to -8.77 ± 3.03 mV. The autocorrelation curves became smooth, the decay time decreased from 11.4 ± 3.2 ms to 4.3 ± 1.7 ms, and the PDI decreased from 0.67 ± 0.14 to 0.53 ± 0.19. These changes helped inhibit CaOx calculus formation.
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Affiliation(s)
- Chao-Yang Duan
- Department of Nephrology, the Second Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
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Renal Stone Disease in Different Racial Groups. Urolithiasis 2012. [DOI: 10.1007/978-1-4471-4387-1_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Moslemi MK, Saghafi H, Joorabchin SMA. Evaluation of biochemical urinary stone composition and its relationship to tap water hardness in Qom province, central Iran. Int J Nephrol Renovasc Dis 2011; 4:145-8. [PMID: 22163171 PMCID: PMC3234153 DOI: 10.2147/ijnrd.s25006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to evaluate the biochemical stone composition in general population of Qom province, central Iran, and its relationship with high tap water hardness. Materials and methods In a prospective study, from March 2008 to July 2011, biochemical analysis of urinary stones in patients living in Qom province for at least 5 years was performed. Stones were retrieved by spontaneous passage, endoscopic or open surgery, and after extracorporeal shockwave lithotripsy. Demographic findings and the drinking water supply of patients were evaluated and compared with biochemical stone analysis. Results Stone analysis was performed in 255 patients. The most dominant composition of urinary stones was calcium oxalate (73%), followed by uric acid (24%), ammonium urate (2%), and cystine (1%). The peak incidence of urinary stone was in patients in their forties. Overall male to female ratio was 4.93:1. Conclusion The dominant stone composition in inhabitants of central Iran, where tap water hardness is high, was calcium oxalate stones. On the basis of this study, biochemical urinary stone composition of Qom does not differ from other regions of Iran with lower water hardness.
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Millán F, Gracia S, Sánchez-Martín F, Angerri O, Rousaud F, Villavicencio H. [A new approach to urinary stone analysis according to the combination of the components: experience with 7949 cases]. Actas Urol Esp 2011; 35:138-43. [PMID: 21349601 DOI: 10.1016/j.acuro.2010.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 10/12/2010] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate a new approach to urinary stone analysis according to the combination of the components. MATERIALS AND METHODS A total of 7949 stones were analysed and their main components and combinations of components were classified according to gender and age. Statistical analysis was performed using the chi-square test. RESULTS Calcium oxalate monohydrate (COM) was the most frequent component in both males (39%) and females (37.4%), followed by calcium oxalate dihydrate (COD) (28%) and uric acid (URI) (14.6%) in males and by phosphate (PHO) (22.2%) and COD (19.6%) in females (p=0.0001). In young people, COD and PHO were the most frequent components in males and females respectively (p=0.0001). In older patients, COM and URI (in that order) were the most frequent components in both genders (p=0.0001). COM is oxalate dependent and is related to diets with a high oxalate content and low water intake. The progressive increase in URI with age is related mainly to overweight and metabolic syndrome. Regarding the combinations of components, the most frequent were COM (26.3%), COD+Apatite (APA) (15.5%), URI (10%) and COM+COD (7.5%) (p=0.0001). CONCLUSIONS This study reports not only the composition of stones but also the main combinations of components according to age and gender. The results prove that stone composition is related to the changes in dietary habits and life-style that occur over a lifetime, and the morphological structure of stones is indicative of the aetiopathogenic mechanisms.
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Millán F, Gracia S, Sánchez-Martín F, Angerri O, Rousaud F, Villavicencio H. A new approach to urinary stone analysis acccording to the combination of the components: experience with 7,949 cases. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s2173-5786(11)70037-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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