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Crystal agglomeration is a major element in calcium oxalate urinary stone formation
D J Kok1, S E Papapoulos, O L Bijvoet
1Department of Endocrinology, University Hospital Leiden, The Netherlands.
Kidney International
|January 1, 1990
Summary
Urine from healthy individuals inhibits calcium oxalate crystal growth and clumping, unlike urine from stone formers. This impaired crystal inhibition in stone formers is linked to lower citrate levels and can be improved with alkali treatment.
Area of Science:
- Nephrology
- Biochemistry
- Crystallography
Background:
- Calcium oxalate monohydrate (COM) crystals are a primary component of kidney stones.
- Understanding factors influencing COM crystallization kinetics is crucial for preventing stone formation.
Purpose of the Study:
- To investigate the impact of urine from healthy subjects and kidney stone formers on COM crystallization kinetics.
- To identify specific kinetic processes affected and their relationship with urinary composition and stone disease.
Main Methods:
- Seeded crystal growth method to independently measure solubility, growth, and agglomeration of COM crystals.
- Analysis of urine from 36 healthy individuals and 86 calcium oxalate renal stone formers.
Main Results:
- Urine from healthy subjects enhanced COM solubility and inhibited crystal growth and agglomeration.
- Urine from stone formers showed reduced inhibition of crystal growth and agglomeration, particularly agglomeration.
- Impaired agglomeration inhibition correlated with stone frequency and was linked to lower urinary citrate levels.
Conclusions:
- Kidney stone formers exhibit a diminished ability to inhibit COM crystal agglomeration, linked to hypocitraturia.
- Alkali treatment can increase urinary citrate and restore the urine's ability to inhibit crystal agglomeration in hypocitraturic stone formers.