Should Idiopathic Calcium-Phosphate Stones be Separated from Calcium-Oxalate Stones?

1. Diurnal variations in urine calcium oxalate and calcium phosphate activity products were observed in normal men and patients with recurrent calcium oxalate or mixed oxalate—phosphate renal stones. 2. Maximum and minimum calcium oxalate products were higher in the patients than in the controls, the difference being most marked in the patients with calcium oxalate stones. 3. Maximum and minimum calcium phosphate products expressed as octocalcium phosphate [(Ca8H2(PO4)6], brushite or hydroxyapatite, were significantly higher than normal in the patients with mixed stones but not in the patients with calcium oxalate stones. 4. The raised calcium oxalate products in the patients were due mainly to increased concentrations of Ca2+ ions; these, in turn, were due mainly to an increased rate of excretion of calcium. Raised calcium phosphate products were due mainly to hypercalciuria, combined with abnormally high urine pH values. 5. Patients with recurrent calcium stones appear to fall into two types: (1) patients with calcium oxalate stones associated with hypercalciuria, a normal or raised urine oxalate and a normal urine pH; (2) patients with mixed oxalate—phosphate stones associated with hypercalciuria, a normal or raised urine oxalate and a raised urine pH. 6. The implications of these findings in regard to treatment are discussed.

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Is precipitation of calcium phosphate an important factor for the development of calcium oxalate stones in the urinary tract

Frontiers in Bioscience ◽

10.2741/1053 ◽

2003 ◽

Vol 8 (6) ◽

pp. s326-332 ◽

Cited By ~ 4

Author(s):

Hans-Göran Tiselius

Keyword(s):

Urinary Tract ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Calcium Oxalate Stones

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Composition of Urinary Stones in Children: Clinical and Metabolic Determinants in a French Tertiary Care Center

10.21203/rs.3.rs-225887/v1 ◽

2021 ◽

Author(s):

Camille Rauturier ◽

Christelle Machon ◽

Delphine Demède ◽

Laurence Dubourg ◽

Justine Bacchetta ◽

...

Keyword(s):

Calcium Phosphate ◽

Calcium Oxalate ◽

Pediatric Patients ◽

Care Center ◽

Tertiary Care ◽

Urinary Stones ◽

Fourier Transformed Infrared Spectroscopy ◽

Calcium Oxalate Stones ◽

Main Component ◽

Epidemiological Trends

Abstract The aim was to describe the composition of stones of pediatric patients, to illustrate current epidemiological trends in pediatric urolithiasis.Clinical and metabolic data from all pediatric patients with at least one stone that was analyzed by Fourier Transformed Infrared Spectroscopy (FTIR) in the Hospices Civils de Lyon s Civils de Lyon between 2013 and 2017 were retrospectively collected. A total of 111 patients (sex ratio 1.4:1) were included; their median [IQR] age was 7.5 [3.1-10.5] years. The main component of stones was calcium oxalate [weddellite for 34 (31%) stones, whewellite 23 (21%)], calcium phosphate [carbapatite 32 (29%), brushite 6 (5%), amorphous calcium phosphate 3 (3%)], struvite 5 (5%), cystine 4 (4%), uric acid 2 (2%), and ammonium acid urate 2 (2%). A total of 20 (18%) stones were pure and 24 (22%) were infectious. Carbapatite stones were the most frequent in patients < 2 years and calcium oxalate stones in patients > 2 years old. Metabolic abnormalities (most frequently hypercalciuria) were found in 50% of tested patients and in 54% of patients with infectious stones. Congenital anomalies of the kidney and/or urinary tract (CAKUT) or neurogenic bladder was present in 9/24 (38%) patients with infectious stones and 12/16 (76%) patients with bladder stones. Conclusion: This study confirms that calcium oxalate stones are the most frequent among pediatric patients, which could reflect the nutritional habits of predisposed patients. In contrast, infectious stones are less frequent and occur mostly in association with anatomic or metabolic favoring factors.

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Comparison of Patients with Idiopathic Calcium Phosphate and Calcium Oxalate Stones

Medicine ◽

10.1097/00005792-199111000-00001 ◽

1991 ◽

Vol 70 (6) ◽

pp. 345-359 ◽

Cited By ~ 34

Author(s):

M. Henry Gault ◽

Linda L. Chafe ◽

Janet M. Morgan ◽

Patrick S. Parfrey ◽

John D. Harnett ◽

...

Keyword(s):

Calcium Phosphate ◽

Calcium Oxalate ◽

Calcium Oxalate Stones

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Helper T‐cell signaling and inflammatory pathway lead to formation of calcium phosphate but not calcium oxalate stones on Randall's plaques

International Journal of Urology ◽

10.1111/iju.13950 ◽

2019 ◽

Vol 26 (6) ◽

pp. 670-677 ◽

Cited By ~ 1

Author(s):

Kazumi Taguchi ◽

Shuzo Hamamoto ◽

Atsushi Okada ◽

Teruaki Sugino ◽

Rei Unno ◽

...

Keyword(s):

T Cell ◽

Calcium Phosphate ◽

Cell Signaling ◽

Calcium Oxalate ◽

T Cell Signaling ◽

Helper T Cell ◽

Inflammatory Pathway ◽

Calcium Oxalate Stones ◽

Randall’S Plaques

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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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