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Objective:To investigate the predictive value of stone composition prediction method based on dual-source stone energy spectrum CT for uric acid stones.Methods:The clinical data of 204 patients with urinary stones, 159 males and 45 females, admitted to Shanghai Sixth People's Hospital from July 2020 to July 2022 were retrospectively analyzed. The average age was (50.7±14.3) years. There were 187 cases of upper urinary tract (kidney, ureter) stones and 17 cases of lower urinary tract (bladder, urethra) stones. All patients underwent preoperative dual-source stone energy spectroscopy CT, measuring CT values at 150 kV and 100 kV, respectively, and the calculated dual energy ratio (Ratio) was used to predict stone composition. Of the 204 cases in this group, 33 cases underwent percutaneous nephrolithotomy and 171 cases underwent ureteroscopic lithotripsy. Postoperative stone specimens were analyzed for stone composition by infrared spectroscopy. Subject work characteristic (ROC) curves were used to analyze the efficacy of preoperative dual-source stone energy spectrum CT to predict uric acid stones.Results:In 204 patients, preoperative CT predicted 28 cases of uric acid stones and 176 cases of non-uric acid stones, including 136 cases of calcium oxalate stones, 38 cases of hydroxyapatite, and 2 cases of cystine stones. Postoperative IR spectral analysis detected 26 cases of uric acid stones and 178 cases of non-uric acid stones, including 129 cases of calcium oxalate stones, 47 cases of hydroxyapatite, and 2 cases of cystine stones. Compared with the preoperative CT results, there were 2 false positives and no false negatives in the classification of uric acid stones. The ROC curve showed that the sensitivity of the CT value for predicting uric acid stones at 100 kV was 96.2%, the specificity was 99.5%, and the area under the ROC curve (AUC) was 0.995, with the best prediction value of 620 HU.The sensitivity of the CT value for predicting uric acid stones at 150 kV was 96.2%, specificity was 85.5%, AUC was 0.916, and the best predictive value was 597.5 HU. The sensitivity of using Ratio values for predicting uric acid stones was 100.0%, specificity was 97.9%, AUC was 0.996, and the best predictive value was 1.14. The CT values for uric acid stones at 100 kV and 150 kV were (558.58±77.07) HU and (521.12±83.54) HU, CT values for calcium oxalate stones were (1 335.26±301.82) HU and (878.21±200.21) HU, CT values for hydroxyapatite were (1 104.09±203.61) HU and (710.38±178.44) HU, respectively.The CT values of cystine stones were (684.5±67.18) HU and (573.5±67.10) HU, respectively, and the differences between uric acid stones and other components were statistically significant ( P<0.01). The Ratio values of uric acid stones, calcium oxalate stones, hydroxyapatite, and cystine stones were 1.08±0.06, 1.52±0.08, 1.62±0.40, and 1.19±0.02, respectively, and the differences were statistically significant ( P<0.01) when comparing uric acid stones with other components. Conclusion:The CT and Ratio values of dual-source stone energy spectrum CT can effectively distinguish uric acid stones from other types of stones, and the accuracy, sensitivity, and specificity of this method for predicting uric acid stones are high.
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Objective:To analyze the composition and clinical characteristics of urinary calculi in infants in Xinjiang.Methods:The clinical data of 75 infants with urinary calculi admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2021 were retrospectively analyzed, including the general situation of the children, stone-related parameters, random urine pH value, urine culture and biochemical examination results. The serum uric acid, serum calcium, urine pH value, positive rate of urine culture, and stone length between infants with and without ammonium urate stones were compared. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used for inter-group comparison. Measurement data that did not conform to the normal distribution were expressed as the median (interquartile distance) [ M ( Q1, Q3)], and Mann-Whitney U test was used for comparison between groups. The Chi-square test, continuity-corrected Chi-square test or Fisher exact probability method were used for the comparison of count data. Results:The median age of infants with urinary calculi was 23.04 months, and the ratio of male to female was 3.2∶1. More than half of the infants (81.3%, 61/75) came from rural areas, 57.3% (43/75) were malnourished, 33.3% (25/75) were complicated with urinary tract infection, and 8.0% (6/75) were combined with urinary system congenital malformation. The calculi were found in 53 cases (70.67%) of kidney, 27 cases (36.0%) of ureter, 17 cases (22.67%) of urethra and 16 cases (21.33%) of bladder. The analysis of calculi composition showed that there were 44 cases (58.67%) of ammonium urate, 39 cases (52.0%) of calcium oxalate, 14 cases (18.67%) of apatite carbonate and 7 cases (9.33%) of uric acid. Kidney calculi was more common in female infants ( P=0.011). Compared with the infant group ( n=19), calcium oxalate stones were more common in the preschooler group ( n=56) ( P=0.039), but there were not statistical difference in the incidence of ammonium urate, apatite carbonate and uric acid stones. There were not statistical difference in gender, age, place of residence, nutritional status, serum uric acid, serum calcium, urine pH value, positive rate of urine culture, stone maximum diameter and incidence of bladder stones between ammonium urate group and non-ammonium urate group. Conclusions:The incidence of urinary calculi in infants is higher in boys, and the most common site of calculi is the upper urinary tract, especially in female kidney calculi. Ammonium urate is the main component of urinary calculi in infants. Calcium oxalate stones are more common in preschooler group. Infants with urinary calculi are mostly rural residents, and malnutrition and urinary tract infection are more common.
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Objective:To study the relationship of pathogenic bacteria in midstream urine culture and stone composition of patients characteristics with infection stones.Methods:Between January 2016 and December 2020, 989 patients with infectious stones who attended Tsinghua Chang Gung Hospital, affiliated with Tsinghua University, for surgical treatment were enrolled in the study. There were 545 male and 444 female patients, with the mean age (48±14) years. The left and right side stones were 396 and 333, respectively. There were 260 bilateral stones, 264 single stones, 334 multiple stones, and 391 deer-stalker-shaped stones. The maximum diameter of stones was (33.4±26.5)mm, combined with diabetes in 109 cases and hypertension in 235 cases. Clean middle-urine was collected for bacterial culture, and intraoperative stone specimens were collected by percutaneous nephrolithotomy (PCNL). Personal characteristics of the patient such as gender, age, body mass index, clinical information such as stone size, location, comorbidities, results of urine culture and stone composition were recorded. The differences of infectious stone composition was analyzed between urease-producing, non-urease-producing bacteria.Results:Among the 989 patients with infectious stones, 259 were pure infectious stones, 131 were mixed infectious stones, and 599 were combined with infectious stone components. Urine cultures were positive in 627(63.4%) patients with infectious stones. The predominant urease-producing bacteria included Ureaplasma urealyticum(94 case), Proteus mirabilis(58 case), and Staphylococcus spp.(36 case). Pure infectious stones were common in Proteus mirabilis, while combined with infectious stone components were common in Ureaplasma urealyticum and Staphylococcus spp. The predominant non-urease-producing bacteria included Escherichia coli(175 case), Enterococcus spp.(76 case) and Streptococcus spp.(35 case). Escherichia coli commonly contained in infectious stone components and pure infectious stones, whereas Enterococcus spp. and Streptococcus spp. commonly contained in infectious stone components. Escherichia coli (61 case), Proteus mirabilis (44 case) and Enterococcus spp.(20 case) were the most common bacteria in 259 cases of pure infectious stones. Escherichia coli (36 case), Enterococcus spp. (14 case) and Ureaplasma urealyticum (10 case) were the most common bacteria in 131 cases of mixed infectious stones. The most common bacteria in 599 cases of combined infectious stones were Escherichia coli (78 case), Ureaplasma urealyticum (68 case) and Enterococcus spp. (42 case).Conclusions:Urease producing bacteria were not common in infectious stones. It was common for the Ureaplasma urealyticum in combined infectious stone components, while Escherichia coli was common in pure and combined infectious stone components.
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Objective:To investigate the characteristics of urinary stones composition in children and the differences in their distribution among different sexes and age groups.Methods:The clinical data of 592 children with urinary stones who underwent stone composition analysis using infrared spectroscopy at Hunan Children's Hospital from October 2015 to October 2019 were retrospectively analyzed. There were 430 males and 162 females.The median age was 4.0 (0.3 to 18.0) years old. The stone composition and the differences in its distribution in different sex and age groups were analyzed.Results:A total of 643 urinary stones were analyzed in 592 cases, with 419 (65.2%) single-component stones and 224 (34.8%) mixed-component stones. The main stone components were calcium oxalate in 361 cases (56.1%), ammonium hydrogen urate in 130 cases (20.0%), cystine in 56 cases (8.7%), calcium phosphate in 33 cases (5.1%), uric acids in 33 cases (5.1%), magnesium ammonium phosphate in 25 cases (3.9%), and xanthine in 5 cases (0.8%). The percentage of calcium oxalate stones was higher in women than in men [65.6% (118/180) vs. 52.5% (243/463), P<0.05]. The proportion of upper urinary tract stones was higher in girl than in boy[93.4%(168/180) vs. 73.2%(339/463), P<0.05]. The differences in the composition ratios of calcium oxalate stones, ammonium hydrogen urate, cystine, and magnesium ammonium phosphate stones in different age groups were statistically significant ( P<0.05), with the highest proportion of calcium oxalate stones (35.6%) at 6 to 10 years of age, ammonium hydrogen urate and cystine stones at 1 to 2 years of age (45.4% and 42.9%), and magnesium ammonium phosphate stones at 3 to 5, 6 to 10, and 11 to 18 years of age, the percentage of urinary stones in children was 24%. Conclusions:The main component of urinary stones in children is calcium oxalate, followed by ammonium hydrogen urate and cystine. Age and gender correlate with the distribution of stone components. Calcium oxalate stones are common in females and in children aged 6 to 10 years, ammonium hydrogen urate and cystine stones are common in children aged 1 to 2 years, and magnesium ammonium phosphate stones are more common in children aged 3 to 5 years, 6 to 10 years, and 11 to 18 years.
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Objective:To investigate the composition characteristics of urolithiasis patients in Chongqing.Methods:From May 2017 to July 2021, clinical data of 1 972 urinary stone patients treated in the Second Affiliated Hospital of Chongqing Medical University was retrospectively analyzed. Among 1 972 patients, there were 1 323 males and 649 females, the average age was (52.7±13.8) years (aged 14-92 years). In this study, all of the patients were first divided into the central and western areas of Chongqing group ( n=1 532) and southeastern areas of Chongqing group ( n=440) according to regional differences; then according to the difference of economic development level, all patients were divided into the more developed area of Chongqing group ( n=1 491) and the less developed area of Chongqing group ( n=481). To study and analyze the influence of gender, age, region and economic development level on stone composition in patients. The distribution characteristics of urinary calculi constituents in different groups of region, gender and age were analyzed by Chi-square test, and analysis of the proportion of various urinary calculi with age were conducted by Cochran-Armitage trend test. Results:The results of stone composition analysis showed that, among the 1 972 cases, the mixed urinary stones were dominant in the urinary stones [92.9%(1 832/1 972)], in which, the most component was the calcium oxalate monohydrate+ calcium oxalate dehydrate [40.8%(805/1 972)]; among the pure stones, the most component was the calcium oxalate dehydrate [2.5%(50/1 972)]. The proportion of carbonated apatite stones [53.6%(348/649) vs 43.5%(576/1 323), P<0.05], hydroxyapatite stones [25.1%(163/649) vs 17.2%(228/1 323), P<0.05] and magnesium ammonium phosphate stones [20.6%(134/649) vs 6.3%(83/1 323), P<0.05] in female patients were significantly higher than those in male patients, but the proportion of calcium oxalate stones [91.4%(1 209/1 323) vs 80.7%(524/649), P<0.05] and uric acid stones [9.4%(125/1 323) vs 1.5%(10/649), P<0.05] in male patients were significantly higher than those in female patients. Compared with patients aged 40-70 years and ≥70 years, the proportion of carbonated apatite stones [39.6%(155/391) vs 48.4%(673/1 391), 50.5%(96/190), P<0.05], magnesium ammonium phosphate stones [6.1% (24/391) vs 12.0% (167/1 391), 13.7% (26/190), P<0.05] and uric acid stones [3.3% (13/391) vs 7.4% (103/1 391), 10.0% (19/190), P<0.05] was significantly lower for patients aged <40 years; but the proportion of calcium oxalate stones in patients aged < 40 years was significantly higher [93.6%(366/391) vs 87.2%(1 213/1 391), 81.0%(154/190), P<0.05]. In this study, there were no significant difference in stone composition between the central and western areas of Chongqing and the southeastern areas of Chongqing, and between the more developed areas of Chongqing and the less developed areas of Chongqing ( P>0.05). Conclusions:There are gender and age differences in the distribution of urinary stone components in Chongqing, but the regional and economic development level differences are not particularly obvious. Carbonated apatite stones, hydroxyapatite stones and magnesium ammonium phosphate stones were more prevalent in females, calcium oxalate stones and uric acid stones were more common in males. Calcium oxalate stones were the most common in patients aged< 40 years, carbonate apatite, magnesium ammonium phosphate and uric acid stones were more common in patients aged ≥40 years.
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Abstract Introduction: Large variations in demographic, economic and environmental factors might influence the worldwide distribution of urolithiasis, but scarce data are available concerning their associations with stone composition. We aimed to evaluate the frequency and composition of kidney stones and their associations with temperature, humidity, and human development index (HDI). Materials and Methods: A total of 1,158 stones from distinct patients (47±14 years old, male/female 2:1) were included. The mean annual temperature and relative humidity of each town were considered separately. Results: Calcium oxalate monohydrate (COM) was disclosed in 38.8% of patients, calcium oxalate dihydrate (COD) in 22.1%, mixed COD/apatite in 9.4%, pure apatite in 1.9%, brushite in 1.8%, struvite in 8.3%, pure uric acid in 11.1%, mixed uric acid/COM in 5.6%, and cystine/rare types in 0.8%. Mean HDI of all pooled cities was 0.780±0.03. However, people living in HDI<0.800 regions had twice the odds of having a struvite stone versus those living in HDI>0.800 (OR=2.14, 95% CI 1.11-4.11). Furthermore, a progressive increase in the struvite stones frequency from 4.5 to 22.8% was detected from HDI>0.800 through HDI<0.700. No significant difference for other stone types was disclosed. Separate logistic regression models assessed the association of each stone composition with gender, temperature, humidity and HDI as covariates. Conclusion: Patients living in low HDI areas are more prone to develop struvite stones, possibly due to lower access to healthcare. Temperature and humidity did not represent a specific risk factor for any stone type in the present sample.
Resumo Introdução: Grandes variações em fatores demográficos, econômicos e ambientais podem influenciar a distribuição mundial da urolitíase, mas há muito pouco dado disponível sobre suas associações com a composição do cálculo renal. Nosso objetivo foi avaliar a frequência e composição dos cálculos renais e suas associações com temperatura, umidade e índice de desenvolvimento humano (IDH). Materiais e Métodos: Foram incluídos 1.158 cálculos de pacientes distintos (47 ± 14 anos, masculino / feminino 2:1). A temperatura média anual e a umidade relativa de cada cidade foram consideradas separadamente. Resultados: O oxalato de cálcio monohidratado (COM) foi detectado em 38,8% dos pacientes; oxalato de cálcio dihidratado (COD) em 22,1%; mistos de COD/apatita em 9,4%; apatita pura em 1,9%; brushita em 1,8%; estruvita em 8,3%, ácido úrico puro em 11,1%; mistos de ácido úrico /COM em 5,6% e cistina/tipos raros em 0,8%. O IDH médio de todas as cidades em conjunto foi de 0,780 ± 0,03. No entanto, indivíduos que vivem em regiões com IDH <0,800 apresentaram duas vezes a razão de chances de ter cálculo de estruvita do que aqueles que vivem em cidades com IDH > 0,800 (OR = 2,14; IC 95% 1,11-4,11). Além disso, um aumento progressivo na frequência de cálculos de estruvita de 4,5 para 22,8% foi detectado em IDH> 0,800 até IDH <0,700. Não foi observada nenhuma diferença significante para outros tipos de cálculos. Modelos separados de regressão logística foram utilizados para avaliar a associação de cada tipo de cálculo com gênero, temperatura, umidade e IDH como covariáveis. Conclusão: Pacientes que vivem em áreas com baixo IDH são mais propensos a desenvolverem cálculos de estruvita, possivelmente devido ao menor acesso à assistência médica. A temperatura e a umidade não representaram um fator de risco específico para qualquer tipo de cálculo na presente amostra.
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Humanos , Masculino , Femenino , Adolescente , Cálculos Renales/epidemiología , Factores Socioeconómicos , Temperatura , Oxalato de Calcio , HumedadRESUMEN
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.
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Nephrolithiasis is one of the most frequent urologic diseases. The aim of this paper is to study the composition and frequency of 8854 patient kidney stones and in a subset of them their metabolic risk factors to be related to their type of calculi. Physicochemical and crystallographic methods were used to assess kidney stone composition. In a subset of 715 patients, we performed an ambulatory metabolic protocol with diagnostic purposes. From the total sample 79% of stones were made of calcium salts (oxalate and phosphate), followed by uric acid stones in 16.5%, calcium salts and uric acid in 2%, other salts in 1.9% and cystine in 0.6%. Male to female ratio was almost three times higher in calcium salts and other types of stones, reaching a marked male predominance in uric acid stones, M/F 18.8 /1.0. The major risk factors for calcium stones are idiopathic hypercalciuria, followed by unduly acidic urine pH and hyperuricosuria. In uric acid stones unduly acidic urine pH and less commonly hyperuricosuria are the most frequent biochemical diagnosis. Our results show that analysis of kidney stones composition and the corresponding metabolic diagnosis may provide a scientific basis for the best management and prevention of kidney stone formation, as well as it may help us to study the mechanisms of urine stone formation.
La litiasis renal es una de las enfermedades urológicas más frecuentes. El objetivo de este trabajo fue estudiar la composición y frecuencia de 8854 cálculos renales y evaluar en un subgrupo de ellos la relación de los factores de riesgo metabólicos con el tipo de cálculo hallado. Se utilizaron métodos fisicoquímicos y cristalográficos para evaluar la composición de los cálculos renales. En un subgrupo de 715 pacientes, se pudo realizar un protocolo metabólico ambulatorio con fines diagnóstico. De la muestra total, 79.0% de los cálculos fueron de sales de calcio (oxalato y fosfato), seguido por cálculos de ácido úrico en 16.5%, sales de calcio y ácido úrico en 2.0%, otras sales en 1.9% y cistina en 0.6%. La relación hombre/mujer fue casi tres veces mayor en las sales de calcio y otros tipos de cálculos, alcanzando un marcado predominio en varones con cálculos de ácido úrico, M/F 18.8/1.0. Los principales factores de riesgo para los cálculos de calcio fueron la hipercalciuria idiopática, seguida del pH urinario excesivamente ácido y la hiperuricosuria. En los cálculos de ácido úrico el pH urinario excesivamente ácido y con menor frecuencia la hiperuricosuria fueron los diagnósticos más frecuentes. Nuestros resultados muestran que el análisis de la composición de los cálculos renales y el correspondiente diagnóstico metabólico pueden proporcionar una base científica para el mejor manejo y prevención en la formación de cálculos renales, así como que nos puede ayudar a estudiar los mecanismos de formación de los mismos.
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Humanos , Masculino , Adulto , Persona de Mediana Edad , Adulto Joven , Cálculos Renales/etiología , Cálculos Renales/metabolismo , Cálculos Renales/epidemiología , Enfermedades Metabólicas/complicaciones , Enfermedades Metabólicas/epidemiología , Argentina/epidemiología , Valores de Referencia , Ácido Úrico/metabolismo , Cálculos Renales/química , Factores Sexuales , Calcio/metabolismo , Factores de Riesgo , Factores de Edad , Cristalografía por Rayos X/métodos , Medición de Riesgo , Riñón/metabolismoRESUMEN
Introdução: Nefrolitíase é uma doença multifatorial que se relaciona com desordens genéticas e fatores ambientais. Cálculos são mais comuns em adultos e são associados com diversas desordens metabólicas. Os cálculos de oxalato de cálcio são os mais comuns. O objetivo deste estudo é realizar a análise química dos cálculos urinários em nossa região. Materiais e Métodos: Realizamos um estudo retrospectivo em 1.342 pacientes com evidência recente de formação de litíase urinária. A investigação laboratorial consistiu da análise química dos cálculos que estiveram disponíveis. Resultados: Foram atendidos 1.342 pacientes com nefrolitíase, sendo que somente 109 (8,1%) foram submetidos à análise química do cálculo. Nestes, a idade média era de 38,9 ± 13,4 anos, sendo 55 (50,5%) do sexo masculino. História familiar positiva ocorreu em 65% dos casos. Cálculos de oxalato de cálcio foram encontrados em 87% dos casos analisados. Hipercalciúria foi o distúrbio metabólico mais encontrado nos pacientes com cálculos de oxalato de cálcio (60%). Conclusões: A análise química do cálculo mostrou que o oxalato de cálcio é o constituinte mais encontrado em nossa região, e estes dados estão de acordo com a literatura.
Introduction: Nephrolithiasis is a multifactorial disease and it has relation with genetic disorders and environmental factors. Stones are most common in adults and are associated with several metabolic disorders. Calcium oxalate is the most common type of stone. The objective of this study is to evaluate chemical analysis of calculi in our region. Methods: We made a retrospective study on 1,342 patients with evidence of recent formation of renal stones. Laboratory investigation included chemical analysis when the stones were available. Results: 1,342 patients with nephrolithiasis were consulted, among whom only 109 (8.1%) were submitted to chemical analysis of stones. Mean age of those patients were 38.9+13.4 years, and 55 (50.5%) were male. Familial history occurred in 65% of the cases. Calcium oxalate stones were found in 87% of the cases. Hypercalciuria and hyperuricosuria were the most associated metabolic disturb in patients with calcium oxalate and uric acid in the stones (60%). Conclusions: Chemical analysis has demonstrated that calcium oxalate is the most common component found in our region, according to the literature.
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Humanos , Masculino , Femenino , Adulto , Cálculos Urinarios/etiología , Cálculos Urinarios/química , Nefrolitiasis/etiología , Nefrolitiasis/metabolismoRESUMEN
Objective: The etiology of kidney stone is multifactorial including environmental, behavioral and genetic. Insights about predisposing causes and mineral composition are mandatory for better management of kidney stone disease. The present hospital-based study aims to explore the mineral constituents and etiologic risks of kidney stones in Thai patients from the four geographic regions of the country. Method: Two hundred and fifty six kidney stone patients from four geographic regions of Thailand, including the northeastern (n=103), the northern (n=81), the central (n=47) and the southern (n=25) were recruited in this study. Of these, 144 patients completed the food frequency questionnaire to assess the kidney stone risk. Mineral composition of stones were analyzed by Fourier transformed infrared spectrometry. Results: Kidney stone frequently affected peoples aged 40-49 years. Only 31.9 % of patients had a positive family history of renal stone. Calcium oxalate (CaOx) stone was the most prevalent type (73.8 %). Uric acid (UA) stone was found in 16.0 % commonly affected peoples aged 60-70 years. Mixed stones, notably CaOx mixed with calcium phosphate (CaP), were more prevalent than pure stones. The food frequency questionnaire data showed that 59.7 % of stone patients consumed less than two liters of water per day. Low intakes of fruits and vegetables were notably present. In contrast, high consumption of rice was observed in over 65 % of stone patients. Conclusion: CaOx mixed with CaP was the most prevalent stone type. UA stone was more likely to occur in the elderly. Kidney stone patients were found to consume less-than-adequate amounts of water, food high in carbohydrates, along with low consumtion of fruits and vegetables. These dietary habits might be risk factors in stone development among the Thai population.
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A plain abdominal X-ray film (simple abdomen or KUB) is often used to display several types of urinary stones in vivo, or at least for a differentiation between calcium-containing 'radio-opaque' and calcium-noncontaining 'non-opaque' stones. We evaluated whether a KUB film could offer the information on composition of urinary calculi or not. The radiodensity of stone itself, the ratio of radio-opacity between the stones and the 2nd lumbar vertebra or lower renal pole parenchyme were measured in each 20 patients with renal stones above 1cm in diameter and variable compositions. However, such a definite distinction could not be resulted in our study. Therefore, we think that it is not possible to achieve a predictability of stone composition by measuring of its radiodensity on KUB film.
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Humanos , Abdomen , Columna Vertebral , Cálculos Urinarios , Película para Rayos XRESUMEN
There was no definitive reported cases of urinary calculi. This study is to estate the value of urinary calcium, magnesium, uric acid and magnesium/calcium ratio in cases of urinary calculi. The amount of calcium, uric acid and magnesium in 24 hour urinary excretion was measured by OCPC, Uricase and titan yellow method in 56 cases of upper urinary calculi compared with 35 control group.The results were summerized as follows.l. The mean values of 24 hour urinary excretion of calcium were 193+/-26mg/day in stone formers and 15l+/-25mg/day in control group. The 24 hour urinary excretion of calcium in the stone formers were significantly higher than those of the control group. 2. The mean values of 24 hour urinary excretion of uric acid were 498+/-40mg/day in the stone formers and 371+/-6mg/day in the control group. The 24 hour urinary excretion of uric acid in the stone formers were significantly higher than those of the control group. 3. Urinary magnesium values have not been shown any significant differences between the group with urinary calculi and those of control group. 4. The mean values of 24 hour urine of magnesium to calcium ratio was 1.01+/-0.95 in stone formers and l.42+/-1.31 in the control group. The magnesium to calcium ratio in the stone formers were significantly lower than those of the control group. These results suggest that increased urinary calcium and uric acid level may play some role in the genesis of urinary stone but urinary magnesium value was not different in the two groups. We think that a decrease in the urinary magnesium to calcium ratio was the results of increased excretion of calcium rather than lowered excretion of the magnesium for the stone formers.
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Calcio , Magnesio , Saturno , Urato Oxidasa , Ácido Úrico , Cálculos Urinarios , UrolitiasisRESUMEN
This study was performed for clarifying whether chemical compositions of urinary calculi may be associated with serum and urinary biochemical parameters in 50 patients with urinary calculi. The following results were obtained. 1. The results of chemical analysis of 50 urinary calculi revealed calcium oxalate in 62%, calcium phosphate in 12%, calcium oxalate and phosphate in 12%, MAP (magnesium ammonium phosphate) in 6% and others including uric acid in 8%. The major component of urinary calculi was calcium oxalate. 2. Among the serum biochemical parameters, only the mean value of phosphorus was significantly lower in calcium stone group than in non calcium stone group. 3. Among the 24 hour urinary biochemical parameters, all (calcium, phosphorus, uric acid and magnesium) were higher in calcium stone group than in non calcium stone group, but these differences were not statistically significant. 4. Hypercalciuria (>200mg/day) was observed in 38% of lithiasis patients. The incidence of hypercalciuria was greater in calcium stone group (42%) than in non calcium stone group (14%). 5. Hyperuricosuria (>800mg/day in male, >750mg/day in female) was observed in 22% of lithiasis patients. The incidence of hyperuricosuria was greatest in calcium oxalate group (26%) if that of "others" group including uric acid stone (50%) was excluded. 6. The incidence of alkaline urinary pH(>7.0) in lithiasis patients was 44% and urinary pH in calcium phosphate and MAP stone group was more alkaline. 7. The chemical compositions of 10 staghorn stones showed calcium oxalate in 4 cases, MAP in 3 cases, calcium phosphate in 2 cases and other in 1 case.
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Humanos , Masculino , Compuestos de Amonio , Calcio , Oxalato de Calcio , Concentración de Iones de Hidrógeno , Hipercalciuria , Incidencia , Litiasis , Fósforo , Ácido Úrico , Cálculos UrinariosRESUMEN
Urinary calculous disease is unusual in children. During the last 7.5 years period, author has experienced and treated 18 children suffering from urinary calculus from January, l978 to July, l985 at the Department of Urology, Chonbuk National University Hospital. The results are summarized as follows; 1. The incidence of the pediatric urolithiasis (18 cases) was 2.7% of 666 urolithiasis patients andO.6 % of total 2930 in-patients. 2. The age of the patients ranged from 12 months to 15 years old, with the highest incidence in 6-10 in age (60%) and male to female ratio 3.5: 1. 3. The locational distributions of urinary calculi were 15.8% in the kidney, 57.9% in the ureter 5.3 %, in the bladder, 21% in the urethra and 26.3% in lower urinary tract calculi. 4. The etiologies of urolithiasis were 77.7% in idiopathic, 5.5% in congenital and 16.8% in recurrent infection. 5. The clinical symptoms of urinary calculi were 25.8% in painful urination, 22.5% in flank pain, 6.5% in hematuria, 9.7% in frequency and 9.7% abdominal pain ete. 6. The size of stone was below 1.0cm in length 7 cases (70%), above 1.0cm in length 3 cases (30%). 7 The weight of urinary calculi was below of 0.4gm 6 cases (60%) and above of 1.0 gm 3 cases (30%). 8. Treatment consisted of Nephrolithotomy in l patient (5.3%), Pyelolithotomy in 6 patients (3l.6%), Ureterolithotomy in 2 patients (10.5%). Vesicolithotomy in 5 patients (=6.3%), and Spontaneorts passage in 5 patients (26.3%). 9. The results of chemical analysis and Infrared sphectroscopy of 10 urinary calculi are almost identical anti single calculi were 40%, mixed calculi were 60 %, calcium oxalate in 30% (3 cases), calcium oxalate and calcium phosphate in 30% (3 cases), calcium oxalate and calcium carbonate in 20%, (2 cases) calcium oxalate and uric acid in 10% (1 case), uric acid in 10% (1 case). The major component of urinary calculi was calcium phosphate oxalate.