[The significance of citrate, uromucoid and GAG for diagnosis of renal tubular acidosis in patients with urinary calculi]. / Die Bedeutung von Zitrat, Uromukoid und GAG für die Diagnostik der renalen tubulären Azidose bei Harnsteinpatienten.

Renal tubular acidosis (type I) is characterized by alterations that lead to disturbed acidification in the tubule. As a result of these alterations, the excretion of uromucoid (formed in the distal tubule), citrate and glycosaminoglycan (GAG) is considerably reduced. There have been numerous investigations on changes in urine pH, citrate and calcium, but few, if any studies on the excretion of uromucoid and GAG. Apart from calcium, phosphate, pH and urease, the present study investigated the excretion of uromucoid, citrate and GAG in a collective of 41 stone patients with renal tubular acidosis (type I). We found that uromucoid excretion was reduced on 90.5%, GAG in 72.2% and citrate in 96% of cases. The reduction of uromucoid excretion in particular is characteristic of RTA I, and it has the function of a marker.

[Methodologic comparison of the analysis of urinary calculi. Roentgen diffractometry, polarization microscopy and microscopic-microchemical component analysis]. / Methodischer Vergleich von Harnsteinanalysen. Röntgendiffraktometrie, Polarisationsmikroskopie und mikroskopisch-mikrochemische Komponentenanalyse.

Not only instrumental, apparative or operative stone extraction is necessary for patients with urolithiasis (particularly those with recurrent urolithiasis); preventive treatment is also called for, and for this exact analysis of the composition of the stones is essential. The procedures currently accepted as standard for stone analysis are: X-ray diffraction, infrared spectroscopy, polarisation microscopy and the complicated chemico-quantitative analyses performed in some institutes. Recently a new, so-called microscopic-microchemical, analysis of stone components has been presented (the Harzalith). To test the value of this procedure as compared to e.g. X-ray diffraction or polarization microscopy, a comparative study was carried out in our department. Thirty different urolith compositions (calculi with one and with more components) were analysed qualitatively and quantitatively by three methods. No qualitative difference was found between X-ray diffraction and polarization microscopy; however, there was a difference from the Harzalith method, and with increasing number of components there was hardly any correspondence with the other methods. Only 10% of the calculi with three or four components could be analysed correctly. Often, too many components were determined by the new method. The test material was analysed by three laboratory assistants working independently of each other.