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Published on: June 23, 2015
Comparison of urinary tract infection in calcium oxalate and calcium phosphate stone formers
M H Gault1, M D Paul, L Longerich
1General Hospital, Memorial University of Newfoundland, St. John's, Canada.
Abstract:
To compare the frequency of urine infection in calcium oxalate and calcium phosphate stone formers, we reviewed charts from patients whose last renal stone submitted for analysis was predominantly composed of calcium phosphate in 118 and of calcium oxalate in 223. Positive cultures were commoner, but not significantly, in the phosphate than the oxalate stone formers, both in men (17 vs. 7.6%) and women (22 vs. 15%). Bacteria frequently producing urease were found in only 4% of the phosphate group. Urine leucocytes were slightly more frequent in the oxalate group for men and significantly so for women. The results do not support the concept that calcium phosphate stones are mainly due to infection with urease-producing or other bacteria.
Insights
Urinary tract infections are not significantly more common in calcium phosphate stone formers than in calcium oxalate stone formers. This study suggests infection is not the primary cause of calcium phosphate stones.
Area of Science:
- Nephrology
- Urology
- Microbiology
Background:
- Urinary tract infections (UTIs) are a potential factor in kidney stone formation.
- Calcium phosphate and calcium oxalate stones are common types of renal calculi.
- The role of infection in the etiology of calcium phosphate stones requires further elucidation.
Purpose of the Study:
- To compare the incidence of UTIs in patients forming calcium phosphate versus calcium oxalate stones.
- To investigate the prevalence of urease-producing bacteria in calcium phosphate stone formers.
- To assess the association between urine leucocytes and stone type.
Main Methods:
- Retrospective chart review of patients with renal stones analyzed for composition.
- Categorization into calcium phosphate (n=118) and calcium oxalate (n=223) stone formers.
- Comparison of positive urine cultures and urine leucocyte counts between the two groups.
Main Results:
- Positive urine cultures were slightly more frequent in calcium phosphate stone formers (17% men, 22% women) compared to calcium oxalate stone formers (7.6% men, 15% women), but this difference was not statistically significant.
- Urease-producing bacteria were identified in only 4% of the calcium phosphate stone group.
- Urine leucocytes were more frequent in the calcium oxalate group, particularly in women.
Conclusions:
- The findings do not support the hypothesis that calcium phosphate stones are primarily caused by infections with urease-producing bacteria.
- Urinary tract infections do not appear to be a significantly greater risk factor for calcium phosphate stone formation compared to calcium oxalate stones.
Related Concept Videos
Urinary Tract Calculi I: Introduction
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
Urinary Tract Calculi III: Medical Management
Urinary Tract Calculi IV: Nutrition Therapy and Prevention
Urinary Tract Calculi V: Nursing Management
Urinary Tract Calculi VI: Surgical Management

