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Immunochemical studies of serum, urine and calculus proteins in urolithiasis.

Total serum protein levels in 70 patients with urolithiasis were not significantly different from those in 20 control subjects, although certain variations were detected in individual protein patterns. In contrast, total urinary protein was significantly higher in patients with urolithiasis. 4-6 different components, i.e., albumin, alpha 1-acidic glycoprotein, alpha 1-antitrypsin, Gc-globulin, fibrinogen and immunoglobulin G, were found in the matrices of calculi and in urine, suggesting that proteinuria may play a role in the formation of stones in patients with urolithiasis.

Blood Proteins↗

[A clinical study of urolithiasis in Shizuoka City Hospital--stone analysis and 24-hour urine calcium and uric acid levels].

Stone analysis was performed for 216 urinary calculi which were obtained from 205 patients in our hospital from January, 1980 to June, 1984. The results revealed 161 calcium stones, 21 uric acid stones, 19 struvite stones, 2 cystine stones and 13 others. Sixty one of the 205 patients (male 44, female 17) and 19 controls (male 11, female 8) were investigated for 24-hour urine calcium and uric acid. Forty seven of the patients had calcium stones, 7 of the patients had uric acid stones and 7 of the patients had struvite stones. The mean 24-hour urine calcium level was 146.8 +/- 76.5 mg/day for the male controls and 139.1 +/- 69.9 mg/day for the female controls. The mean 24-hour urine uric acid level was 528.1 +/- 132.6 mg/day for the male controls and 362.0 +/- 135.2 mg/day for the female controls. The mean 24-hour urine calcium level for the male calcium-stone group was 214.6 +/- 96.8 mg/day, and it was significantly higher than that for the male controls (p less than 0.05). The 24-hour urine analysis revealed abnormalities in 17 urolithiasis patients (27.9%) including hypercalciuria in 11 patients (18.0%) and hyperuricosuria in 9 patients (14.1%).

Adolescent↗

X-ray powder diffraction and microscopic analysis of crystalluria in dogs with ethylene glycol poisoning.

Most of the urinary crystals in 2 dogs intoxicated with ethylene glycol had prismatic (rod-like, hippurate-like), and to a less extent, hemp seed or spindle shapes. Using X-ray powder diffraction and optical analysis, these crystals were identified as calcium oxalate monohydrate. A few crystals of calcium oxalate dihydrate (envelope shape) were also observed in the urine sediment. Their presence was confirmed by the appearance of weak X-ray peaks having interplanar spacings ranging from 0.617 to 0.620 nm, which are thought to correspond to the 200 X-ray reflection of calcium oxalate dihydrate. Thus, the 6-sided hippurate-like crystals in the urine of ethylene glycol-poisoned dogs are actually calcium oxalate monohydrate.

Animals↗

[Formation of the staghorn calculi].

To study the process of formation of staghorn calculi, 58 patients with staghorn calculi were evaluated clinically and the removed stones were studied architecturally. Of 35 patients with infection stones composed of struvite and/or apatite in the nuclei as well as peripheral layers, 18 had identified predisposing factors related to infection. Of 13 patients with infection stones containing calcium oxalate in the nuclei, 7 had predisposing factors of infection but only 2 had metabolic disorders. The patients with infection stones who had no predisposing factors may have transient or subclinical abnormalities. Initial stone formation of oxalate may also be one of the predisposing factors of infection. Most of the patients with staghorn calculi composed of uric acid, oxalate and cystine, had metabolic disorders related to these substances. Large numbers of bacteria and large amounts of organic matrix were found extensively within infection stones and were thought to be important components as well as crystals. Metabolic stones contained little matrix. In this case crystal aggregation is thought to play the most important role in stone formation.

Adolescent↗

Urinary beta 2-microglobulin excretion and renal lithiasis.

We assessed beta 2-microglobulin excretion in 42 active calcium oxalate stone-formers, 16 active struvite stone-formers, 4 active uric acid stone-formers, 14 inactive stone-formers and 21 non-stone-forming controls. The average excretion value was within normal limits for all groups and no significant differences existed. These observations coupled with previous findings of increased low molecular weight urinary proteins in active calcium oxalate stone-formers suggest the existence of specific alterations in tubular function in this specific group.

Beta-Globulins↗

[Practical experiences with antegrade local chemolysis of struvite/apatite, uric acid and cystine calculi in the kidney].

In 18 patients (20 kidneys) with struvite/apatite-, uric acid- and cystine stones antegrade local chemolysis was performed via percutaneous or operative nephrostomy. Complete stone dissolution was achieved in 11 kidneys, while in six kidneys partial dissolution of stones was performed. In these six cases added instrumental manipulations shortened the time of therapy. In three cases chemolysis was unsuccessful. Average irrigation time was 21 days per renal unit. Only minor complications like dysuria and skin rashes were seen. Due to long time of irrigation we recommend chemolitholysis mainly as an additional form of therapy in case of residual stones after operative or percutaneous nephrolithotomy.

Acetylcysteine↗

[Treatment of infection stones. I. Dissolution of experimental infection stones in rats].

The in vivo solubility of struvite stones experimentally induced in rats was investigated. The struvite stones implanted into bladders of normal rats were reduced in weight; and, they were dissolved by oral administration of ammonium chloride. Cefmetazone cured pyelonephritis and dissolved the bladder stones when it was administered to rats with urinary tract infection caused by Proteus mirabilis. Normalization of urine by antibiotics and acidifying agents may dissolve struvite stones, and help treat infection stones.

Ammonium Chloride↗

[Coralliform calculi and recurrent urinary infection: a case of newberyite calculi (MgHPO4.3H2O)].

In some 20% of cases urolithiasis is directly linked to chronic urinary tract infection by urea-splitting bacteria and essentially Proteus mirabilis. The stones are generally composed of struvite and carbonate apatite, which usually occur as the staghorn calculi feared because of their obstructive and infectious consequences which cause important renal damage. A case is described of newberyite calculus in a woman with chronic urinary infection. Newberyite is thought to be a breakdown product of struvite in particular physico-chemical conditions, and is a very rare constituent of urolithiasis. X-ray diffraction and infrared spectroscopy were used to identify the constituent. Clinical and technical investigations are briefly described, and the literature is reviewed.

Female↗