Can stone composition be predicted by plain X-ray and/or non-contrast CT? A study validated by X-ray diffraction analysis

Abstract Background The stone composition has a great influence on the outcome of its treatment. There are several tests to predict the composition of stones preoperatively and stone analysis postoperatively. Herein, we want to evaluate if the stone composition could be predicted from plain X-ray KUB (PKUB) and/or non-contrast CT (NCCT) validated by in vitro X-ray powder diffraction analysis (XRD). Methods Between April 2014 and March 2016, 100 cases with urinary tract stones were included in the study. The radio-opacity of the stones in PKUB, stone density by NCCT, and after stone extraction, XRD were performed. Statistical analysis for the results was performed using Chi-square and Fisher exact tests for categorical variables and Mann–Whitney U and Kruskal–Wallis H for the nonparametric variables. The receiver operating characteristic curve was constructed to determine the best cutoff value. Results This study included 74 males and 26 females with a median age of 32 years (range 2–70). Regarding the radio-opacity by PKUB, there were 30 stones dense opaque, 44 opaque, 21 faint opaque, and 5 radiolucent. XRD revealed 97 mixed and 3 pure stones. The calcium oxalate monohydrate (COM) stone composition could be predicted in dense opaque stone by PKUB in 75.9% and urate composition in the radiolucent stone by 40%. The cutoff value of HU density by NCCT to the dense opaque stones in the PKUB was > 1020 and for radiolucent stones was < 590. Conclusion Stone radio-opacity by PKUB and its attenuation value by NCCT could successfully predict its calcium oxalate monohydrate, struvite, and urate composition. However, the chemical stone analysis is still required as most stones are mixed.

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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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PROFIL ANALISIS BATU SALURAN KEMIH DI LABORATORIUM PATOLOGI KLINIK

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v12i3.870 ◽

2018 ◽

Vol 12 (3) ◽

pp. 114 ◽

Cited By ~ 2

Author(s):

G. Ratu ◽

A. Badji

Keyword(s):

Uric Acid ◽

Calcium Oxalate ◽

Medical Records ◽

Age Groups ◽

Stone Analysis ◽

Stone Composition ◽

Cross Sectional ◽

Problematic Issue ◽

Urethral Stone ◽

Age And Sex

Urethral stones, or urolithiasis, is a pathologic and condition which is still a frequent problematic issue in the clinic, especially for itsrecurrence. This condition appears mostly in productive-age groups leading to affect their productivity. By stone analysis, the type andthe composition of concretes could be identified, so that the handling of patients could be arranged and its recurrence could be prevented.The study was carried to find out the distribution of urethral stone composition according to age and sex groups. A cross-sectional studyby means of medical records of 199 patients with urethral stone admitted to Dr. Wahidin Sudirohusodo Hospital was carried out duringMay 2002 to May 2004. Analysis was conducted microscopically and macroscopically by colorimetric and titrimetry. Urethral stoneswere found more in men 79.9% (159 of 199) than in women 20.1% (40 of 199). The peak prevalence of age between 31 to 45 yearswere 71.35%, the eldest being 86 years while the youngest was 2 years. The mostly found composition of calcium-oxalate was 87.4%,brushitt was 45.2%, and uric acid was 32.2%. The prevalence of urethral stones was still high, mostly found in 31 to 45 years of agegroup, affecting more men than women, and calcium oxalate showed the highest frequency.

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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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The analysis of Upper tract Urinary Stone Composition in HIV-positive Patients: a single center experience

10.21203/rs.3.rs-29836/v1 ◽

2020 ◽

Author(s):

Wu Menghua ◽

Zheng Xin ◽

Fan Bohan ◽

Zhang Yu ◽

Zhao Jimao

Keyword(s):

Calcium Oxalate ◽

Highly Active Antiretroviral Therapy ◽

Calcium Oxalate Monohydrate ◽

Urinary Stone ◽

Hiv Positive ◽

Chi Square ◽

Stone Composition ◽

Positive Group ◽

Single Center Experience ◽

Significant Difference

Abstract Background: To appraise the most common stone composition, serum and urinary biochemical features in HIV-positive patients with urolithiasis.Methods: We retrospectively searched the records of HIV-positive patients in our stone registry. A retrospective study was generated from our registry. Collecting statistics about fundamental indexes and analyzing them is our basic procedure. Medications were considered. Groups were compared using the Student t and chi-square/Fisher exact tests with significance considered at p<0.05.Results: In total of 101 patients were included age, gender, Body Mass Index(BMI), serum calcium, serum uric acid(UA), stone position, and operative method were statistically described. The serum UA of HIV-positive group was higher than that of the negative group (P = 0.028). Patients with HIV-infected had a higher incidence of calcium oxalate dehydrate (CaODH) (p<0.001). The evaluation of overall stone composition showed that the number of CaODH was higher in HIV-positive group (21.4% vs 8.5%, p < 0.001). There was no significant difference in single calcium oxalate monohydrate(CaOMH) (p = 0.146), and UA (p = 0.7) between the two groups.Conclusions: In our study the highest stone proportion in HIV patients is calcium oxalate (CaO). HIV positive patients should pay attention to the diet, especially the food containing more calcium. In HIV-positive patients, the level of serum UA should be controlled accordingly. In the development of highly active antiretroviral therapy (HARRT), for low-risk patients, it may not be necessary to consider too much the factors of protease inhibitors (PIs) and other drugs forming urinary calculus.

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Urinary stone composition: Gender and age variations, and evolution in the last 7 years.

Acta Urológica Portuguesa ◽

10.24915/aup.34.3-4.17 ◽

2017 ◽

Vol 34 (3-4) ◽

pp. 7-12

Author(s):

Pedro Valente ◽

Hélder Castro ◽

Inês Pereira ◽

Fernando Vila ◽

Paulo Araújo ◽

...

Keyword(s):

Uric Acid ◽

Calcium Phosphate ◽

Calcium Oxalate ◽

Urinary Stone ◽

Stone Analysis ◽

Stone Composition ◽

Magnesium Ammonium Phosphate ◽

Age Variations ◽

Gender And Age ◽

Ammonium Urate

Objectives: To evaluate urinary stone composition in our institution, its gender and age, including variations and the evolution in the last 7 years. Material and Methods: The authors reviewed all urinary stone analysis performed since January 2009 to September 2015 in our hospital – Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. Patients were stratified by gender, age and stone composition analyzing the evolution of stone composition in different years. The stone analysis method was infrared spectroscopy. Results: From 302 valid stone analysis reports, 55,3% were female and 44,7% were male patients. Mean patient age was 51±14 years old. A total of 7 different mineral components were identified. 51,6% (n=156) of all the stones had Calcium Oxalate, 41% (n=124) had Calcium Phosphate (33% of Apatite form), 37,7% (n=114) had Uric Acid, 22,1% (n=67) had Ammonium Urate, 9,6% (n=29) had Magnesium Ammonium Phosphate, 6,3% (n=19) had Sodium Urate, and 1,3% (n=4) had Cystine in its composition. Only 30,4% of stones had a single chemical compound. Of these 56% were pure stones of Calcium Oxalate, and 31% were pure stone of Uric Acid. The most frequent mixed stone was Calcium Oxalate + Calcium Phosphate (Apatite) followed by Uric Acid + Ammonium Urate comprehending 45% and 27% of all mixed stones respectively. Related to the ethology we divided stones into 3 groups, pure non-infection, pure infection, and mixed with component of infection, and the prevalence was 37,7%, 4,3% and 57,9% respectively. The distribution between genders was similar and the highest difference was in the Ammonium Urate compound with 28% prevalence in male and 17% in women. (p=0,379) Patients after 50 years old had more prevalence of Uric Acid component accounting for 49% of their stones.(p<0,001) . Along the 7 years of study we identified a significant reduction in the prevalence of mixed stones with component of infection, gradually decreasing from 89,6% in 2009 to 27% in 2015. Conclusions: Calcium Oxalate calculus were the most prevalent, but this difference was not as important as in other studies worldwide. This study highlights the importance of the development of National and European database to report all regional stone composition variations.

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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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Time changes in the spectrum of urinary stone composition: a role for climate variations?

BMC Nephrology ◽

10.1186/s12882-020-02193-x ◽

2020 ◽

Vol 21 (1) ◽

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 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 to 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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Diversity of calcium oxalate crystals in Cactaceae

Canadian Journal of Botany ◽

10.1139/b07-046 ◽

2007 ◽

Vol 85 (5) ◽

pp. 501-517 ◽

Cited By ~ 21

Author(s):

Walter P. Hartl ◽

Helmut Klapper ◽

Bruno Barbier ◽

Hans Jürgen Ensikat ◽

Richard Dronskowski ◽

...

Keyword(s):

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Calcium Oxalate Crystals ◽

Polarizing Microscopy ◽

Calcium Oxalate Dihydrate ◽

Crystal Forms ◽

X Ray ◽

Oxalate Crystals ◽

Crystal Sand ◽

Scanning Electron

The occurrence of various types of calcium oxalate crystals was studied in 251 species and subspecies of Cactaceae to determine whether they are useful characters for Cactaceae systematics. Crystal hydration states were identified by X-ray powder diffraction and polarizing microscopy as monoclinic calcium oxalate monohydrate (COM) and tetragonal calcium oxalate dihydrate (COD). Ninety-eight percent of taxa studied contained either COM or COD crystals, or both. Different morphologies of crystals were further defined by light microscopy and scanning electron microscopy as druses, raphides, styloids (prisms), and crystal sand. In particular, the preponderance of one of the hydration states (COM or COD) was characteristic for certain Cactus subfamilies. Data showed that in Pereskioideae, Maihuenioideae, and Opuntioideae COM is predominant, while in Cactoideae COD prevails. In the remainder of Cactoideae, the crystals were quite variable. In tribe Hylocereeae, many species form both COM and COD as well. In the genera Hylocereus , Epiphyllum , Selenicereus , and Weberocereus , COM forms were almost exclusively represented by raphides together with different crystal forms in their epidermal cells. In the remainder of the Cactoideae, crystals did not follow any observable patterns. Development of crystallographic standards for identifying crystal forms microscopically is proposed for future crystal studies.

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An Sem and X-Ray Evaluation of Crystals in the Leaves of Rosa

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100053449 ◽

1982 ◽

Vol 40 ◽

pp. 150-151

Author(s):

H. J. Arnott ◽

M. L. Kelly ◽

M. A. Webb

Keyword(s):

Calcium Oxalate ◽

Calcium Oxalate Monohydrate ◽

Rosa Multiflora ◽

X Ray Diffraction ◽

Broad Distribution ◽

X Ray ◽

Isolation Techniques ◽

The Common ◽

Level Of Understanding ◽

And Function

The common occurrence of calcium oxalate in plant tissues belies our level of understanding of these objects; broad distribution has not yet brought a comprehensive understanding of their development and function (see reviews 1 and 2). Using isolation techniques developed previously, we have examined the crystals present in the small and medium leaflets of Rosa multiflora Thumb. With powder x-ray diffraction we have identified the crystals as whewellite (calcium oxalate monohydrate). All of the major peaks present in the ASTM standard are also found in our diffractograms, however the intensity of the peaks varies from the standards. Examination of cleared leaves shows the crystals are broadly distributed through the leaflet lamina but tend to be more concentrated along veins (Fig. 1).

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