Urinary stone composition analysis of 3684 patients in the eastern Shandong region of China

Objective There has not been a study that analyzed the composition of urinary stones from patients in the eastern Shandong region of China. Thus, we explored the composition of urinary stones in the eastern Shandong region of China and discuss the clinical significance of the findings. Methods A total of 3684 urinary calculi from the eastern Shandong region were collected in our study. Compositions of the stones were analyzed using an Automatic Infrared Spectrum Analysis System (type LIIR-20). The results were verified through manual analysis of the spectrograms, which was accompanied by polarizing microscopy and chemical analysis if necessary. Results Among the 3684 specimens, there were 1767 single-component stones and 1917 mixed-component stones. According to the main components of the stones, the stones were divided into the following types: calcium oxalate monohydrate stones (1779, 48.3%), anhydrous uric acid stones (1105, 30.0%), carbonate apatite stones (590, 16.0%), ammonium magnesium phosphate hexahydrate stones (143, 3.9%), calcium oxalate dihydrate stones (36, 1.0%), and cystine stones (31, 0.8%). Conclusions There was a relatively high rate of uric acid stones in patients from the eastern Shandong region of China.

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Urinary stone composition analysis of 3684 patients in the eastern Shandong region of China

10.21203/rs.2.12457/v1 ◽

2019 ◽

Author(s):

Xuebao Zhang ◽

Jiajia Ma ◽

Ning Wang ◽

Chunhua Lin

Keyword(s):

Uric Acid ◽

Infrared Spectrum ◽

Calcium Oxalate ◽

Spectrum Analysis ◽

Urinary Stones ◽

Composition Analysis ◽

Carbonate Apatite ◽

Uric Acid Stones ◽

Analysis System ◽

Spectrum Analysis System

Abstract Objective To explore the composition of urinary stones in the eastern Shandong region of China and discuss its clinical significance. Methods A total of 3684 specimens of urinary calculi from the eastern Shandong region were collected in our study. Compositions of stones were analyzed by Automatic Infrared Spectrum Analysis System (type LIIR-20). The results were verified through manual analysis of the spectrogram which is accompanied by polarizing microscopy and chemical analysis if necessary. Results Among the 3684 specimens, there were 1767 single-component stones and 1917 mixed-component stones. According to the difference of the main components of the stones, the stones can be divided into the following types: calcium oxalate monohydrate stones (1779, 48.29%), anhydrous uric acid stones (1105, 29.99%), carbonate apatite stones (590, 16.02%), ammonium magnesium phosphate hexahydrate stones (143, 3.88%), calcium oxalate dehydrate stones (36, 0.98%), and cystine stones (31, 0.84%). Conclusion There are relatively many uric acid stones in the eastern Shandong region of China. The automatic infrared spectrum analysis system for calculus has the advantages of accuracy and convenience.

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Kidney Stone Composition in Various Country Around the World

10.21203/rs.3.rs-286555/v1 ◽

2021 ◽

Author(s):

Adam Halinski ◽

Elenko Popov ◽

Kamran Hassan Bhattikam ◽

Luca Boeri ◽

Jonathan Cloutier ◽

...

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Urinary Stones ◽

Stone Composition ◽

Calcium Stones ◽

Uric Acid Stones ◽

The World ◽

Cystine Stones ◽

Struvite Stones

Abstract To compare urinary stone composition patterns in different populations around the world in relation to the structure of their population, dietary habits, and climate. 1204 adult patients with urolithiasis and stone analysis was included . International websites were searched to obtain data. We observed 710(59%) patients with calcium oxalate, 31(1%) calcium phosphate, 161(13%) mixed calcium oxalate/calcium phosphate, 15(1%) carbapatite, 110(9%) uric acid, 7(<1%) urate, 100(9%) mixed uric acid/ calcium oxalate, 56(5%) struvite and 14(1%) cystine stones. Calcium stones were the most common in all countries (up to 91%) with the highest rates in Canada and China. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones except Egypt and India. The rate of uric acid stones, being higher in Egypt, India, Pakistan, Iraq, Poland, and Bulgaria. Struvite stones occurred in less than 5% except India (23%) and Pakistan (16%). Cystine stones occurred in 1%. The frequency of different types of urinary stones varies from country to country. Calcium stones are prevalent in all countries. Uric acid stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase it. Struvite stones are decreasing in most countries.

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Urinary stone composition analysis and clinical characterization of 1520 patients in central China

Scientific Reports ◽

10.1038/s41598-021-85723-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Daling Zhang ◽

Songchao Li ◽

Zhengguo Zhang ◽

Ningyang Li ◽

Xiang Yuan ◽

...

Keyword(s):

Calcium Oxalate ◽

Urinary Stone ◽

Geographic Region ◽

Central China ◽

Urinary Stones ◽

Composition Analysis ◽

Stone Composition ◽

Calcium Oxalate Stones ◽

Significant Difference ◽

Lower Urinary

AbstractA 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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Stone composition of renal stone formers from different global regions

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2021.3.307 ◽

2021 ◽

Vol 93 (3) ◽

pp. 307-312

Author(s):

Adam Hali´nski ◽

Kamran Hassan Bhatti ◽

Luca Boeri ◽

Jonathan Cloutier ◽

Kaloyan Davidoff ◽

...

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Urinary Stones ◽

Ureteral Stones ◽

Stone Analysis ◽

Stone Composition ◽

Stone Formers ◽

Cystine Stones ◽

Struvite Stones

Objective: To study urinary stone composition patterns in different populations around the world. Materials and methods: Data were collected by reviewing charts of 1204 adult patients of 10 countries with renal or ureteral stones (> 18 years) in whom a stone analysis was done and available. Any method of stone analysis was accepted, but the methodology had to be registered. Results: In total, we observed 710 (59%) patients with calcium oxalate, 31 (1%) with calcium phosphate, 161 (13%) with mixed calcium oxalate/calcium phosphate, 15 (1%) with carbapatite, 110 (9%) with uric acid, 7 (< 1%) with urate (ammonium or sodium), 100 (9%) with mixed with uric acid/ calcium oxalate, 56 (5%) with struvite and 14 (1%) with cystine stones. Calciumcontaining stones were the most common in all countries ranging from 43 to 91%. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones in most countries except Egypt and India. The rate of uric acid containing stones ranged from 4 to 34%, being higher in Egypt, India, Pakistan, Iraq, Poland and Bulgaria. Struvite stones occurred in less than 5% in all countries except India (23%) and Pakistan (16%). Cystine stones occurred in 1% of cases. Conclusions: The frequency of different types of urinary stones varies from country to country. Calcium-containing stones are prevalent in all countries. The frequency of uric acid containing stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase in the frequency of uric acid containing stones in association with high obesity rates. Struvite stones are decreasing in most countries due to improved health conditions.

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Efficacy of Hounsfield Unit of CT in Prediction of the Chemical Composition of Urinary Stones

QJM ◽

10.1093/qjmed/hcab110.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Salah Mahmoud Ahmed Shehata ◽

Mohamed Rafik El-Halaby ◽

Ahmed Mohamed Saafan

Keyword(s):

Uric Acid ◽

Chemical Composition ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Chemical Structure ◽

Urinary Calculi ◽

Hounsfield Unit ◽

Urinary Stones ◽

The Mean ◽

Struvite Stones

Abstract Objectives to make a reliable correlation between the chemical composition of the urinary calculi and its Hounsfield unit on CT scan, upon which we can depend on it for prediction of the type of the urinary calculi. The prediction of the chemical structure of the stone would help us to reach a more efficient therapeutic and prophylactic plan. Methods A retrospective study was performed by interpretation of the preoperative CT scans for patients who were presented by urinary stones. Identification of the chemical structure of the calculi was implemented using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). The laboratory report revealed multiple types of stones either of pure or mixed composition. Afterwards, a comparison was done between Hounsfield units of the stones and the chemical structure. Results The chemical structure of the urinary stones revealed four pure types of stones (Uric acid, Calcium Oxalate, Struvite and Cystine) and two types of mixed stones (mixed calcium oxalate+ Uric, and mixed calcium oxalate+ calcium phosphate). Uric acid stone had a mean Hounsfield Unit (HU) density of428 ± 81, which was quite less than the other stones, followed by struvite stones with density ranging about 714 ± 38. Mixed calcium oxalate stones could be differentiated from other types of stones like uric acid, pure calcium oxalate and struvite stones by the Hounsfield unit of Computed Tomography (the mean Hounsfield Unit was 886 ± 139 and 1427 ± 152 for mixed calcium oxalate + uric stone and mixed calcium oxalate + calcium phosphate stones respectively). Moreover, pure calcium oxalate stones were easily differentiated from all other stones using the mean Hounsfield density as it was 1158 ± 83. It was challenging only when it was compared to cystine stones, as they were quiet similar to HU value (997 ± 14). The variation of Hounsfield values among the previously mentioned stones, was statistically significant (p < 0.001). Conclusion The study proved that the Hounsfield Unit of CT scanning is a convenient measure to predict the chemical structure of urinary calculi.

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Urolithiasis in male patients: A pilot study on the ethnic differences and clinical profile

Nepal Journal of Epidemiology ◽

10.3126/nje.v4i4.11359 ◽

2014 ◽

Vol 4 (4) ◽

pp. 393-98

Author(s):

Jayadevan Sreedharan ◽

LJ John ◽

HAM Aly Freeg ◽

J Muttappallymyalil

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Dietary Factors ◽

Clinical Profile ◽

Urinary Stones ◽

Ureteral Stones ◽

Stone Size ◽

Uric Acid Stones ◽

Male Patients

Background Ethnicity play a role in the occurrence of urinary stones, probably related to climatic, environmental and dietary factors in ethnic groups. The association between ethnicity, age, clinical profile, stone size with type of ureteric stones among males with urolithiasis was studied. Materials and Methods Male patients (>18 years) with lower ureteral stones size <10mm attending outpatient department of Urology, at a private hospital, Ajman over a period of one year were included. Ethics approval was obtained from Institutional Ethics Committee. Data was retrieved from the case records which included socio-demographic variables (age, ethnicity), clinical profile (ureteric colic, duration of pain, other complaints), and laboratory investigations (type of stone, stone size). Descriptive and inferential statistics were performed with SPSS-20 and p values <0.05 considered significant. Results 185 male patients were included. Mean age was 41.5 (7.3) years, range (22-71) years. Out of the total, 81 (43.8%) patients were Asians, 81(43.8%) Arabs and 23 (12.4%) were of other ethnicity. Most patients (95.1%) presented with ureteric pain. 49 (26.5%) had family history of stone disease where calcium oxalate monohydrate and uric acid stones were common, with majority being first degree relation. Data on stone type was available for 90 patients; of which, 21 were calcium oxalate monohydrate, 33-calcium oxalate dehydrate, 24-uric acid and remaining 12 other form of stones. Average age for different types of stone was 38.3, 41.6, 39.4 and 42.8 years for calcium oxalate monohydrate, calcium oxalate dehydrate, uric acid and other types respectively. Conclusion Uric acid stones were more prevalent among Asians and calcium oxalate-dehydrate stones among Arabs. Future studies can be conducted among multiethnic population focusing on dietary pattern and stone analysis.DOI: http://dx.doi.org/10.3126/nje.v4i4.11359 Nepal Journal of Epidemiology 2014; 4(4):393-98

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Spectrum of pediatric urinary stone composition in North Western India: analysis at tertiary care center

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194974 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4102

Author(s):

Rama Kishan Saran ◽

Pawan Katti ◽

Kiran Mirdha ◽

Sanya Saran ◽

Rajendra Prasad Takhar

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Pediatric Patients ◽

Dietary Habits ◽

Urinary Stone ◽

Urinary Stones ◽

Stone Composition ◽

Epidemiological Characteristics ◽

North Western

Background: Pediatric urolithiasis results in significant morbidity in later life. Incidence as well as site and chemical composition of calculi varies according to the changes in socio-economic conditions over time and the subsequent changes in dietary habits leading to a marked variation in the spectrum of urinary stone composition. To evaluate the spectrum of urinary stone composition in pediatric population from North-western India.Methods: This was a prospective observational study conducted between October 2013 and February 2019 which included pediatric patients with urolithiasis. Demographic and epidemiological characteristics including age, sex, geography, religion, socio-economic status, dietary habits were recorded. The location and sizes of stones were documented. The data was collected, analyzed and presented using summary statistics.Results: A total of 163 patients with urolithiasis were enrolled, of which 86 (53%) aged between 6 and 10 years, 49 (30%) aged between 11 and 14 years and 28 (17%) were aged between 0 and 5 years. The majority of patients were male (n=134; 82.21%). The most common location of the stone was urinary bladder (n=106; 65.03%) followed by kidney (n=33; 20.25%), urethra (n=16; 9.82%) and ureter (n=8; 4.91%). The upper tract (kidney and ureter) to the lower tract (bladder and urethra) stone ratio was 1:4. Stones with mixed composition were more than pure stones (73.62% versus 26.38%). The most common composition was the mixed stone of calcium oxalate, calcium phosphate and uric acid (n=36; 22.09%) followed by mixed stone of calcium oxalate monohydrate and dihydrate with uric acid (n=29; 17.79%), calcium oxalate and uric acid (n=25, 15.34%), calcium oxalate and calcium phosphate (n=20; 12.27%). Calcium oxalate was present in 80% of the stones, followed by uric acid in 7%, struvite in 6%, cystine in 3% and calcium phosphate in 2%.Conclusions: These results suggest that the prevalence of mixed stones with calcium oxalate as the predominant chemical component in the urinary stones of pediatric patients studied.

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Time Changes in the Spectrum of Urinary Stone Composition: A Role for Climate Variations?

10.21203/rs.3.rs-41398/v2 ◽

2020 ◽

Author(s):

Alberto Trinchieri ◽

Alessandro Maletta ◽

Giovanni Simonelli ◽

Luca Boeri ◽

Elisa De Lorenzis ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Northern Italy ◽

Urinary Stones ◽

Temperate Climate ◽

Stone Composition ◽

Statistical Institute ◽

Time Changes

Abstract Introduction: An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003. Materials and Methods: Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute. Results: The average age of the 2001-2003 group (45.8+/-15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/-14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1:0.58) in 2001-2003 MI and 527 / 292 (1:0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001-03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14° C to 15.4° C during the two observation periods. Conclusions: No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

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Effect of Climate on Time Changes in the Spectrum of Urinary Stone Composition

10.21203/rs.3.rs-41398/v1 ◽

2020 ◽

Author(s):

Alberto Trinchieri ◽

Alessandro Maletta ◽

Giovanni Simonelli ◽

Luca Boeri ◽

Elisa De Lorenzis ◽

...

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Northern Italy ◽

Urinary Stones ◽

Temperate Climate ◽

Stone Composition ◽

Average Temperature ◽

Time Changes

Abstract Background: An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003.Methods: Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute.Results: The average age of the 2001-2003 group (45.8+/-15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/-14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1:0.58) in 2001-2003 and 527 / 292 (1:0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001-03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14° C to 15.4° C during the two observation periods.Conclusions: No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

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Chemical and morphological analysis of kidney stones: a double-blind comparative study

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502010000500011 ◽

2010 ◽

Vol 25 (5) ◽

pp. 444-448 ◽

Cited By ~ 13

Author(s):

Silvia Fernandes Ribeiro da Silva ◽

Djamile Cordeiro de Matos ◽

Sônia Leite da Silva ◽

Elizabeth De Francesco Daher ◽

Henry de Holanda Campos ◽

...

Keyword(s):

Chemical Analysis ◽

Calcium Oxalate ◽

Kidney Stones ◽

Morphological Analysis ◽

Calcium Oxalate Monohydrate ◽

Composition Analysis ◽

Minor Components ◽

Double Blind ◽

Stone Composition ◽

Calcium Oxalate Dihydrate

PURPOSE: To compare chemical to morphological kidney stone composition analysis based on a sample of 50 stones retrieved from patients at a nephrology service. METHODS: The chemical analysis was performed with a Bioclin® kit, while a 10-mm magnifying glass (10x; Prolabo, Paris, France) was employed in the morphological analysis. Findings obtained with the two methods were compared and classified as concordant (100% agreement), partly concordant (concordant for major components, discordant for minor components) or discordant (discordant for major components). RESULTS: In the chemical analysis, the most commonly observed major component was calcium (70%), followed by oxalate (66%), ammonium (56%), urate (28%) and carbonate (24%). In the morphological analysis, the most commonly observed major components were calcium phosphate and magnesium (32% each), followed by calcium oxalate monohydrate (24%), uric acid and urates (20% each), calcium oxalate dihydrate (18%) and cystine (6%). Infectious kidney stones were identified in 34% and 24% of cases by morphological and chemical analysis, respectively. Thirty-eight percent of the samples were classified as concordant, 52% were partly concordant and 10% were discordant. CONCLUSION: We suggest kidney stones be routinely submitted to both types of analysis for a better understanding of the mechanisms involved in lithogenesis.

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