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Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis
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Kidney stones in primary hyperoxaluria: new lessons learnt.

Dorrit E Jacob1, Bernd Grohe, Michaela Geßner

  • 1Department of Geosciences, Johannes Gutenberg University Mainz, Mainz, Germany. dorrit.jacob@mq.edu.au

Plos One
|August 14, 2013
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Primary Hyperoxaluria (PH) stone composition varies by PH type and treatment. PH I patients on treatment form compact calcium-oxalate monohydrate stones, unlike untreated PH I and PH III patients whose stones contain more calcium-oxalate dihydrate.

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Area of Science:

  • Nephrology
  • Urology
  • Biochemistry

Background:

  • Primary Hyperoxaluria (PH) is a metabolic disorder leading to kidney stone formation.
  • Understanding stone composition in different PH types and treatment statuses is crucial for management.
  • Previous studies suggested PH stones are primarily calcium-oxalate monohydrate (COM).

Purpose of the Study:

  • To investigate differences in kidney stone composition in Primary Hyperoxaluria (PH) types I and III.
  • To analyze the impact of medical therapy (treatment-naïve vs. preventive medication) on stone composition.
  • To compare stone morphology and composition between PH I and PH III patients.

Main Methods:

  • Analysis of twelve kidney stones from ten PH I patients and six stones from four PH III patients.
  • Examination of stone composition and morphology in relation to PH type and patient treatment status.
  • Comparison of stones from treatment-naïve patients versus those on preventive medication (citrate, magnesium, alkali citrate).

Main Results:

  • PH stones exhibit more diverse compositions than previously reported.
  • PH I patients on treatment predominantly form compact COM (whewellite) stones.
  • Untreated PH I and PH III patients' stones (and treated PH III) show aggregated calcium-oxalate dihydrate (COD, weddellite) crystals.
  • No significant treatment effects were observed in PH III stones.

Conclusions:

  • Stone composition in PH is more varied than previously thought and can be influenced by treatment.
  • Treatment with crystallization inhibitors may alter stone morphology and composition in PH I.
  • Detailed stone diagnostics are important for therapeutic relevance in calcium oxalate urolithiasis.
  • Further studies are needed to confirm these findings in larger cohorts.