Clinical-Chemical Study of Urinary Stones in Saudi Arabia — I. Uric Acid Stones

Author(s):  
R. E. Abdel-Halim ◽  
A. O. Baghlaf ◽  
A.-B. B. Farag
2014 ◽  
Vol 4 (4) ◽  
pp. 393-98
Author(s):  
Jayadevan Sreedharan ◽  
LJ John ◽  
HAM Aly Freeg ◽  
J Muttappallymyalil

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


2021 ◽  
Author(s):  
Adam Halinski ◽  
Elenko Popov ◽  
Kamran Hassan Bhattikam ◽  
Luca Boeri ◽  
Jonathan Cloutier ◽  
...  

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.


2010 ◽  
Vol 3 (3) ◽  
pp. 318-319
Author(s):  
M. Tanemoto ◽  
Y. Takeuchi ◽  
E. Mishima ◽  
T. Suzuki ◽  
T. Abe ◽  
...  

Author(s):  
Johan Jendeberg ◽  
Per Thunberg ◽  
Marcin Popiolek ◽  
Mats Lidén

Abstract Objectives To prospectively validate three quantitative single-energy CT (SE-CT) methods for classifying uric acid (UA) and non-uric acid (non-UA) stones. Methods Between September 2018 and September 2019, 116 study participants were prospectively included in the study if they had at least one 3–20-mm urinary stone on an initial urinary tract SE-CT scan. An additional dual-energy CT (DE-CT) scan was performed, limited to the stone of interest. Additionally, to include a sufficient number of UA stones, eight participants with confirmed UA stone on DE-CT were retrospectively included. The SE-CT stone features used in the prediction models were (1) maximum attenuation (maxHU) and (2) the peak point Laplacian (ppLapl) calculated at the position in the stone with maxHU. Two prediction models were previously published methods (ppLapl-maxHU and maxHU) and the third was derived from the previous results based on the k-nearest neighbors (kNN) algorithm (kNN-ppLapl-maxHU). The three methods were evaluated on this new independent stone dataset. The reference standard was the CT vendor’s DE-CT application for kidney stones. Results Altogether 124 participants (59 ± 14 years, 91 men) with 106 non-UA and 37 UA stones were evaluated. For classification of UA and non-UA stones, the sensitivity, specificity, and accuracy were 100% (37/37), 97% (103/106), and 98% (140/143), respectively, for kNN-ppLapl-maxHU; 95% (35/37), 98% (104/106), and 97% (139/143) for ppLapl-maxHU; and 92% (34/37), 94% (100/106), and 94% (134/143) for maxHU. Conclusion A quantitative SE-CT method (kNN-ppLapl-maxHU) can classify UA stones with accuracy comparable to DE-CT. Key Points • Single-energy CT is the first-line diagnostic tool for suspected renal colic. • A single-energy CT method based on the internal urinary stone attenuation distribution can classify urinary stones into uric acid and non-uric acid stones with high accuracy. • This immensely increases the availability of in vivo stone analysis.


2019 ◽  
Author(s):  
Xuebao Zhang ◽  
Jiajia Ma ◽  
Ning Wang ◽  
Chunhua Lin

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.


2021 ◽  
pp. 20210084
Author(s):  
Elisabeth Appel ◽  
Christoph Thomas ◽  
Andrea Steuwe ◽  
Benedikt M Schaarschmidt ◽  
Olga R Brook ◽  
...  

Objective: To assess accuracy of dual-energy computed tomography (DECT) to differentiate uric acid from calcium urinary stones in dual-energy split filter vs sequential-spiral vs dual-source acquisition. Methods: Thirty-four urinary stones (volume 89.0 ± 77.4 mm³; 17 calcium stones, 17 uric acid stones) were scanned in a water-filled phantom using a split-filter equipped CT scanner (SOMATOM Definition Edge, Siemens Healthineers, Forchheim, Germany) in split-filter mode at 120kVp and sequential-spiral mode at 80 and 140kVp. Additional DE scans were acquired at 80 and 140kVp (tin filter) with a dual-source CT scanner (SOMATOM Definition FLASH, Siemens Healthineers). Scans were performed with a CTDIvol of 7.3mGy in all protocols. Urinary stone categorization was based on dual energy ratio (DER) using an automated 3D segmentation. As reference standard, infrared spectroscopy was used to determine urinary stone composition. Results: All three DECT techniques significantly differentiated between uric acid and calcium stones by attenuation values and DERs (p < 0.001 for all). Split-filter DECT provided higher DERs for uric acid stones, when compared with dual-source and sequential-spiral DECT, and lower DERs for calcified stones when compared with dual-source DECT (p < 0.001 for both), leading to a decreased accuracy for material differentiation. Conclusion: Split-filter DECT, sequential-spiral DECT and dual-source DECT all allow for the acquisition of DER to classify urinary stones. Advances in knowledge: Split-filter DECT enables the differentiation between uric acid and calcium stones despite decreased spectral separation when compared with dual-source and dual-spiral DECT.


2018 ◽  
Vol 94 (1114) ◽  
pp. 458-462 ◽  
Author(s):  
Qi Ma ◽  
Li Fang ◽  
Rui Su ◽  
Liang Ma ◽  
Guohai Xie ◽  
...  

Uric acid stones account for 10%–15% of all urinary stones. Changes in dietary habits, environment or both can result in the increase of uric acid stones. The formation of uric acid stones is related to hyperuricosuria, low urinary volume and persistently low urinary pH. Diabetes and obesity also significantly increase the risk of stone formation. Dual-energy CT provides a convenient and reliable method for diagnosis. Stone composition analysis and 24-hour urine metabolic evaluations should be considered for further evaluation. Most small uric acid stones (diameter <2 cm) can be treated by pharmacotherapy or extracorporeal shock wave lithotripsy. However, ureteroscopy and other minimally invasive procedures should be reserved for larger stones (diameter ≥2 cm), or patients with concomitant urinary tract obstruction and/or infections. Additionally, adjustment of potential pathophysiologic defects by pharmacotherapy and dietary modification is strongly recommended for the prevention of uric stone recurrence.


2019 ◽  
Vol 48 (3) ◽  
pp. 030006051988726
Author(s):  
Xuebao Zhang ◽  
Jiajia Ma ◽  
Ning Wang ◽  
Chunhua Lin

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.


2019 ◽  
Vol 8 (10) ◽  
pp. 1536 ◽  
Author(s):  
Chan Jung Liu ◽  
Jin Shang Wu ◽  
Ho Shang Huang

Uric acid urolithiasis constitutes approximately 7–10% of all urinary stones. Previous studies have revealed that patients with gout do not equally have uric acid stones. Instead, the risk of gout in patients with uric acid stones remains controversial. This study aimed to investigate whether there is different associated risk of gout for diabetes mellitus (DM) and non-diabetes patients with uric acid urolithiasis. Therefore, we examined all baseline chemistries to determine any risk factors or protective factors related to developing gout in patients with uric acid stones. Ninety-nine patients from a single medical center, who had a uric acid component in their stone specimen were enrolled and their medical records were reviewed retrospectively between January 2010 and December 2016. All patients were divided into gout and non-gout groups. Gout was confirmed in 24 patients in this study (24.2%). The proportion of DM was significantly higher in the non-gout group (34.7%) than in the gout group (4.3%, p < 0.05). Renal function was decreased and serum triglyceride was higher in patients with gout. Uric acid urolithiasis patients with DM had a lower risk for gout (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). In 89 patients with predominant uric acid stones (>50% uric acid composition), the risk for gout was still lower in patients with diabetes than non-diabetes (adjusted odds ratio: 0.08; 95% confidence interval (CI) = 0.01–0.61, p = 0.015). These findings suggest that decreased risk of gout is found in uric acid urolithiasis patients with diabetes. Our results imply that patients with uric acid stones should have complete diabetes evaluation before the administration of uric acid controlling medication.


2012 ◽  
Vol 59 (3) ◽  
pp. 93-96
Author(s):  
Tomislav Pejcic ◽  
Biljana Markovic ◽  
Ljubomir Djurasic ◽  
Helena Maksimovic ◽  
Cedomir Topuzovic ◽  
...  

INTRODUCTION: The dissolution of urinary stones could be performed in the patients with urinary obstruction caused by phosphate, or uric acid stones, through the percutaneous nephrostomy (PCN). CASE REPORT: A 27-year-old woman with complete obstruction of the solitary left kidney due to uric acid stones is presented. The woman was admitted in emergency unit due to anuria. Five days after PCN, irrigation with 1.6% sodium bicarbonate solution was initiated. Due to complete ureteral obstruction, the "Y" extension with the valve was connected to PCN and to the urinary bag, which enabled the patient to perform intermittent self-irrigation. After 12 days of irrigation, all the stones dissolute and ceased. CONCLUSION: In the era of ESWL, PCNL and ureterorenoscopy, PCN-dissolution of urinary stones is rare procedure. However, this minimally invasive procedure could be successfully performed in selected cases.


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