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[Clinical value of crystalluria study].

M Daudon1, P Jungers, B Lacour

  • 1Laboratoire de Biochimie A, Groupe hospitalier Necker-enfants malades, Paris. michel.daudon@nck.ap-hop-paris.fr

Annales De Biologie Clinique
|August 7, 2004
PubMed
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Crystalluria analysis, or urine crystal examination, helps detect and monitor kidney diseases. Analyzing crystal type, size, and frequency in urine samples is crucial for identifying risks of kidney stones and other renal conditions.

Area of Science:

  • Nephrology
  • Urology
  • Clinical Chemistry

Background:

  • Crystalluria, the presence of crystals in urine, indicates urine supersaturation.
  • It is observed in both normal and pathological states, offering clinical insights into renal diseases.
  • Understanding crystalluria aids in diagnosing and managing kidney disorders.

Purpose of the Study:

  • To detail the methods and interpretation criteria for crystalluria examination.
  • To highlight the clinical significance of various crystalluria characteristics in diagnosing renal conditions.
  • To establish crystalluria as a reliable marker for kidney stone recurrence risk.

Main Methods:

  • Urine samples (preferably first morning void) examined via polarized microscopy in a Malassez cell.

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  • Samples stored at 37°C or room temperature, analyzed within two hours of voiding.
  • Interpretation based on crystal chemical nature, crystalline phase, morphology, size, abundance, aggregation, and frequency.

    • Main Results:

    • Abnormal crystals (e.g., struvite, cystine) and common crystal phases (oxalates, phosphates, urates) are identified.
    • Calcium oxalate crystal characteristics (whewellite, weddellite) correlate with oxalate and calcium levels, indicating hyperoxaluria and hypercalciuria.
    • High crystal abundance and size suggest significant hypercalciuria and hyperoxaluria, especially when combined.

    Conclusions:

    • Crystalluria examination is essential for detecting and monitoring conditions leading to kidney stones and impaired kidney function.
    • Serial analysis of crystalluria, particularly first morning void samples, is a reliable marker for predicting kidney stone recurrence.
    • Global crystal volume assessment aids in monitoring primary hyperoxaluria and cystinuria.