Hypocitraturia in metabolically active calcium nephrolithiasis

Hypocitraturia is presumed to contribute to calcium stone formation. In this study, 52 patients with active calcium urolithiasis have been subjected to infrared spectrophotometric urolith analysis an collection of a 24-hour urinary sample for measurement of citrate, pH, calcium phosphorus, magnesium uric acid and oxalate. A venous blood sample was also taken for the measurement of calcium, potassium, uric acid, sodium phosphorus, carbon dioxide and creatinine levels. 93.3% of these patients had definite hypocitraturia, either as an isolated anomaly in 11.5% of patients or in association with hyperoxaluria and hyperuricosuria. When hypocitraturia was diagnosed more than half of the patients suffered from the severe form. Hypocitraturia in Egyptian metabolically active stone formers exceeds any known universal levels

Radiological morphology of calcium oxalate stones and their fragility in relation to their mono and dihydrate content

Eighty patients were treated for calcium oxalate urolithiasis with a diameter between 10 and 22 mm were subjected to a radiomorphological study of the surgically or endourologically extracted stones. X-ray densitometry of the stones and infrared spectroscopic urolith analysis were also performed. Sixty patients were treated with ESWL monotherapy. The success rate of stone fragmentation was determined by the total energy required in joules to fragment the stones. A definite radiological pattern was illustrated for the monohydrate, dihydrate and the mixed stones. Also, calcium oxalate monohydrate, stones acquired the highest optical density and required the highest energy for complete fragmentation. There was also an insignificant difference in the optical density regarding the different diameters of the oxalate stones. Therefore, calcium oxalate monohydrate stones are characterized by particular hardness and might not be recommended for ESWL monotherapy even in the 10-20 mm diameter zone