Elemental analysis of urinary calculi by laser induced plasma spectroscopy

Environmental Conditions as Determinants of Kidney Stone Formation

Urolithiasis is a disease characterized by the presence of stones in the urinary tract, whether in the kidneys, ureters, or bladder. Its origin is multiple, and causes can be cited as hereditary, environmental, dietary, anatomical, metabolic, or infectious factors. A kidney stone is a biomaterial that originates inside the urinary tract, following the principles of crystalline growth, and in most cases, it cannot be eliminated naturally. In this work, 40 calculi from the Don Benito, Badajoz University Hospital are studied and compared with those collected in Madrid to establish differences between both populations with the same pathology and located in very different geographical areas. Analysis by cathodoluminescence offers information on the low crystallinity of the phases and their hydration states, as well as the importance of the bonds with the Ca cation in all of the structures, which, in turn, is related to environmental and social factors of different population groups such as a high intake of proteins, medications, bacterial factors, or possible contamination with greenhouse gases, among other factors.

Analysis of stones formed in the human gall bladder and kidney using advanced spectroscopic techniques

Stone diseases (gallstones and kidney stones) are extremely painful and often cause death. The prime aim of biomedical research in this area has been determination of factors resulting in stone formation inside the gallbladder and urinary tract. Many theories have been put forward to explain the mechanism of stone formation and their growth; however, their complete cycle of pathogenesis is still under debate. Several factors are responsible for stone formation; however, much emphasis is placed on the determination of elemental and molecular composition of the stones. In the present review article, we describe different kinds of spectroscopic techniques such as Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence (XRF) spectroscopy, time-of-flight secondary ion mass spectrometry (TOF-SIMS), and laser-induced breakdown spectroscopy (LIBS) and highlight their use in the analysis of stone diseases. We have summarized work done on gallstones and kidney stones using these advanced techniques particularly over the last 10 years. We have also briefly elaborated the basics of stone formations inside the human body and their complications for a better understanding of the subject.

Laser-induced breakdown spectroscopy is a reliable method for urinary stone analysis

OBJECTIVE

We compared laser-induced breakdown spectroscopy (LIBS) with the traditionally used and recommended X-ray diffraction technique (XRD) for urinary stone analysis.

MATERIAL AND METHODS

In total, 65 patients with urinary calculi were enrolled in this prospective study. Stones were obtained after surgical or extracorporeal shockwave lithotripsy procedures. All stones were divided into two equal pieces. One sample was analyzed by XRD and the other by LIBS. The results were compared by the kappa (κ) and Spearman's correlation coefficient (rho) tests.

RESULTS

Using LIBS, 95 components were identified from 65 stones, while XRD identified 88 components. LIBS identified 40 stones with a single pure component, 20 stones with two different components, and 5 stones with three components. XRD demonstrated 42 stones with a single component, 22 stones with two different components, and only 1 stone with three different components. There was a strong relationship in the detection of stone types between LIBS and XRD for stones components (Spearman rho, 0.866; p<0.001). There was excellent agreement between the two techniques among 38 patients with pure stones (κ index, 0.910; Spearman rho, 0.916; p<0.001).

CONCLUSION

Our study indicates that LIBS is a valid and reliable technique for determining urinary stone composition. Moreover, it is a simple, low-cost, and nondestructive technique. LIBS can be safely used in routine daily practice if our results are supported by studies with larger numbers of patients.

The elementome of calcium-based urinary stones and its role in urolithiasis

Urolithiasis affects around 10% of the US population with an increasing rate of prevalence, recurrence and penetrance. The causes for the formation of most urinary calculi remain poorly understood, but obtaining the chemical composition of these stones might help identify key aspects of this process and new targets for treatment. The majority of urinary stones are composed of calcium that is complexed in a crystalline matrix with organic and inorganic components. Surprisingly, mitigation of urolithiasis risk by altering calcium homeostasis has not been very effective. Thus, studies to identify other therapeutic stone-specific targets, using proteomics, metabolomics and microscopy techniques, have been conducted, revealing a high level of complexity. The data suggest that numerous metals other than calcium and many nonmetals are present within calculi at measurable levels and several have distinct distribution patterns. Manipulation of the levels of some of these elemental components of calcium-based stones has resulted in clinically beneficial changes in stone chemistry and rate of stone formation. The elementome--the full spectrum of elemental content--of calcium-based urinary calculi is emerging as a new concept in stone research that continues to provide important insights for improved understanding and prevention of urinary stone disease.

Elemental Content of Calcium Oxalate Stones from a Canine Model of Urinary Stone Disease

One of the most common types of urinary stones formed in humans and some other mammals is composed of calcium oxalate in ordered hydrated crystals. Many studies have reported a range of metals other than calcium in human stones, but few have looked at stones from animal models such as the dog. Therefore, we determined the elemental profile of canine calcium oxalate urinary stones and compared it to reported values from human stones. The content of 19 elements spanning 7-orders of magnitude was quantified in calcium oxalate stones from 53 dogs. The elemental profile of the canine stones was highly overlapping with human stones, indicating similar inorganic composition. Correlation and cluster analysis was then performed on the elemental profile from canine stones to evaluate associations between the elements and test for potential subgrouping based on elemental content. No correlations were observed with the most abundant metal calcium. However, magnesium and sulfur content correlated with the mineral hydration form, while phosphorous and zinc content correlated with the neuter status of the dog. Inter-elemental correlation analysis indicated strong associations between barium, phosphorous, and zinc content. Additionally, cluster analysis revealed subgroups within the stones that were also based primarily on barium, phosphorous, and zinc. These data support the use of the dog as a model to study the effects of trace metal homeostasis in urinary stone disease.

Trace elements in urinary stones: a preliminary investigation in Fars province, Iran

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.

Detection of carcinogenic metals in kidney stones using ultraviolet laser-induced breakdown spectroscopy

The UV single-pulsed (SP) laser-induced breakdown spectroscopy (LIBS) system was developed to detect the carcinogenic metals in human kidney stones extracted through the surgical operation. A neodymium yttrium aluminium garnet laser operating at 266 nm wavelength and 20 Hz repetition rate along with a spectrometer interfaced with an intensified CCD (ICCD) was applied for spectral analysis of kidney stones. The ICCD camera shutter was synchronized with the laser-trigger pulse and the effect of laser energy and delay time on LIBS signal intensity was investigated. The experimental parameters were optimized to obtain the LIBS plasma in local thermodynamic equilibrium. Laser energy was varied from 25 to 50 mJ in order to enhance the LIBS signal intensity and attain the best signal to noise ratio. The parametric dependence studies were important to improve the limit of detection of trace amounts of toxic elements present inside stones. The carcinogenic metals detected in kidney stones were chromium, cadmium, lead, zinc, phosphate, and vanadium. The results achieved from LIBS system were also compared with the inductively coupled plasma-mass spectrometry analysis and the concentration detected with both techniques was in very good agreement. The plasma parameters (electron temperature and density) for SP-LIBS system were also studied and their dependence on incident laser energy and delay time was investigated as well.

Kidney stone analysis techniques and the role of major and trace elements on their pathogenesis: a review

Kidney stone disease is a polygenic and multifactorial disorder with a worldwide distribution, and its incidence and prevalence are increasing. Although significant progress has been made in recent years towards identifying the specific factors that contribute to the formation of kidney stone, many questions on the pathogenesis of kidney stones remain partially or completely unanswered. However, none of the proposed mechanisms specifically consider the role(s) of the trace elements and, consequently, the contribution of trace constituents to the pathogenesis of kidney stones remains unclear and under debate. The findings of some studies seem to support a role for some major and trace elements in the initiation of stone crystallization, including as a nucleus or nidus for the formation of the stone or simply as a contaminant of the stone structure. Thus, the analysis of kidney stones is an important component of investigations on nephrolithiasis in order to understand the role of trace constituents in the formation of kidney stones and to formulate future strategies for the treatment and prevention of stone formation and its recurrence. The aim of this review is to compare and evaluate the methods/procedures commonly used in the analysis of urinary calculi. We also highlight the role of major and trace elements in the pathogenesis of kidney stones.

Composition and distribution of elements and ultrastructural topography of a human cardiac calculus

Trace elements (TEs) may contribute to the formation of calculi or stones or be involved in the aetiopathogenesis of stone diseases. The compositions and spatial distribution of elements from the inner nucleus to outer crust of the cardiac calculus were investigated by energy-dispersive X-ray fluorescence (EDXRF) spectrometer. The surface topograph, distribution map of elements, elemental and chemical compositions were also determined by environmental scanning electron microscope (ESEM)-energy-dispersive X-ray (EDX) analysis. Twenty-five elements were identifiable from 18 positions on the cardiac calculus by EDXRF spectrometer, in which the highest concentrations of toxic TEs (Ni, Pt, Hg, Sn, Pb, W, Au, Al, Si) and higher levels of essential TEs (Ca, Sr, Cr, P) were detected. A moderate positive Pearson's correlation between TEs concentrations of Mg, Ca or P and location differences from centre to periphery in the cardiac calculus was observed. A positive correlation was also found for Ca/Zn and Ca/Cu, indicating the gradual increase of calcium concentration from inner nucleus to outer crust of cardiac calculus. The drop-like nodules/crystals on the surface of petrous part of cardiac calculus were observed from ESEM analysis. ESEM-EDX analysis determined the calculus to be predominantly composed of calcium hydroxyapatite and cholesterol, as indicated by the petrous surface and drop-like nodules/crystals, respectively. This composition was confirmed using a portable Raman analyser. The spatial distribution analysis indicated a gradual increase in Mg, P and Ca concentrations from the inner nucleus to the outer crust of the cardiac calculus. The major chemical compositions of calcium hydroxyapatite and cholesterol were detected on this cardiac calculus.

Analysis and classification of heterogeneous kidney stones using laser-induced breakdown spectroscopy (LIBS)

Kidney stones were analyzed using laser-induced breakdown spectroscopy (LIBS), utilizing a high resolution multi-channel charge-coupled device (CCD) spectrometer and a nanosecond-pulse Nd : YAG laser. The kidney stones were also characterized using X-ray diffraction (XRD) and X-ray fluorescence (XRF) techniques for comparative analysis. It was found that the ratio of hydrogen (H) to carbon (C) was an important indicator of organic compounds such as uric acid. Advantages of LIBS, especially with regards to amount of sample required and sample preparation as well as the ability to carry out elemental analysis and classification of kidney stones simultaneously, over other analytical techniques such as XRD and XRF are discussed. The common minor elements detected in the kidney stones include P, S, Si, Ti, and Zn. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) of broadband LIBS spectra were employed for classifying different types of kidney stones. The results are beneficial in understanding kidney stone formation processes, which can lead to preventive therapeutic strategies and treatment methods for urological patients.

Laser-induced breakdown spectroscopy (LIBS): an overview of recent progress and future potential for biomedical applications

The recent progress made in developing laser-induced breakdown spectroscopy (LIBS) has transformed LIBS from an elemental analysis technique to one that can be applied for the reagentless analysis of molecularly complex biological materials or clinical specimens. Rapid advances in the LIBS technology have spawned a growing number of recently published articles in peer-reviewed journals which have consistently demonstrated the capability of LIBS to rapidly detect, biochemically characterize and analyse, and/or accurately identify various biological, biomedical or clinical samples. These analyses are inherently real-time, require no sample preparation, and offer high sensitivity and specificity. This overview of the biomedical applications of LIBS is meant to summarize the research that has been performed to date, as well as to suggest to health care providers several possible specific future applications which, if successfully implemented, would be significantly beneficial to humankind.

Quantitative analysis of gallstones using laser-induced breakdown spectroscopy

The utility of laser-induced breakdown spectroscopy (LIBS) for categorizing different types of gallbladder stone has been demonstrated by analyzing their major and minor constituents. LIBS spectra of three types of gallstone have been recorded in the 200-900 nm spectral region. Calcium is found to be the major element in all types of gallbladder stone. The spectrophotometric method has been used to classify the stones. A calibration-free LIBS method has been used for the quantitative analysis of metal elements, and the results have been compared with those obtained from inductively coupled plasma atomic emission spectroscopy (ICP-AES) measurements. The single-shot LIBS spectra from different points on the cross section (in steps of 0.5 mm from one end to the other) of gallstones have also been recorded to study the variation of constituents from the center to the surface. The presence of different metal elements and their possible role in gallstone formation is discussed.