Summary
(1) The highest degree of urinary supersaturation with respect to calcium oxalate monohydrate (COM) and brushite at which secondary nucleation and growth of small amounts of COM and hydroxyapatite (HAP) are inhibited was determined by new and simple methods. There were 39 subjects who produced 24 h-urine collections 11 idiopathic stone formers (ISF), 12 patients suffereing from primary hyperparathyroidism (HPT) and 16 healthy controls (HC). These subjects had a moderate calcium and low oxalate intake. The results obtained were compared with the state of urinary saturation and with urine chemistry. The measurements of crystallization conditions with respect to COM were repeated in 26 subjects (11 ISF, 5 HPT, 10 HC) after a dietary oxalate load. (2) In 24 h-urines of HC diluted to 2.4 1/24 h the degree of supersaturation necessary to induce crystallization of COM and HAP was 2–5 times higher than the state of urinary saturation measured under the same test conditions. (3) ISF showed a decreased pyrophosphate concentration and a decreased inhibitory activity to HAP crystallization in their 24 h-urine. (4) The urinary inhibitory activity towards crystallization of HAP showed a positive correlation to urinary pyrophosphate concentration. (5) In the 24 h-urine of HPT hypercalciuria and increased saturation with respect to brushite which reached values to induce HAP crystallization were found. (6) After a dietary oxalate load urinary supersaturation with respect to COM reached values to induce COM crystallization in ISF and HPT but not in HC.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- COM:
-
Calcium oxalate monohydrate
- CP:
-
Concentration product
- CPR:
-
Concentration product ratio
- HAP:
-
Hydroxy apatite
- HC:
-
Healthy controls
- HPT:
-
Patients suffereing from primary hyperparathyroidism
- ISF:
-
Idiopathic stone formers
References
Baumann JM, Wacker M (1979) Experiences with the measurement of inhibitory activity of urine and crystallization inhibitors by different techniques. Urol Res 7:183–188
Baumann JM, Wacker M (1980) The direct measurement of inhibitory capacity to crystal growth of calcium oxalate in undiluted urine and in other inhibitor containing solutions. Uro. Res 8:171–175
Baumann JM, Bisaz S, Felix R, Ganz U, Russell RGG (1977) The role of inhibitors and other factors in the pathogenesis of recurrent calcium-containing stones. Clin Sci 31:365–374
Bisaz S, Russell RGG, Fleisch H (1968) Isolation of inorganic pyrophosphate from bovine and human teeth. Arch Oral Biol 13:683–696
Bisaz S, Felix R, Neuman WF, Fleisch H (1978) Quantitative determination of inhibitors of calcium phosphate precipitation in whole urine. Min Electrol Metab 1:74–83
Breslau NA, Pak CYC (1980) Urinary saturation, heterogenous nucleation, and crystallization inhibitors in nephrolithiasis. In: Brenner BM, Stein JH (eds) Nephrolithiasis, contemporary issues in nephrology, vol 5. Churchill Livingstone New York Edinburgh London, pp 13–36
Drawert F, Paul H, Hagen W (1981) Enzymatische Bestimmung von Oxalsäure und Ameisensäure im Bier. Brauwissenschaft 3:57–61
Finlayson B (1978) Physicochemical aspects of urolithiasis. Kidney Int 13:344–360
Finlayson B, Reid F (1978) The expectation of free and fixed particles in urinary stone disease. Invest Urol 15:442–448
Fleisch H (1978) Inhibitors and promoters of stone formation. Kidney Int 13:361–371
Heinonen JK, Honkasalo SH, Kukko EI (1981) A method for the concentration and for the colorimetric determination of nanomoles of inorganic pyrophosphate. Anal Biochem 117: 293–300
Kageyama N (1971) Direct colorimetric determination of uric acid in serum and urine with uricase-catalyse system. Clin Chim Acta 31:421–426
Koutskoukos PG, Sheehan ME, Nancollas GH (1981) Epitaxial considerations in urinary stone formation. II. The oxalatephosphate system. Invest Urol 18:358–363
Meyer JL, Smith LH (1975) Growth of calcium oxalate crystals. II. Inhibition by natural urinary crystal growth inhibitors. Invest Urol 13:36–39
Nancollas GH (1976) The kinetics of crystal growth and renal stoneformation. In: Fleisch H, Robertson WG, Smith LH, Vahlensieck W (eds) Urolithiasis research. Plenum Press, New York London, pp 5–23
Neuman WF, Neuman MW (1958) Solubilities. In: Bay EB, Coggeshall LT, De Bruyn PPH, Dragstedt LR, Park T, Taliferro WH (eds) The chemical dynamics of bone mineral. The University of Chicago Press, Chicago 37, pp 23–38
Pak CYC, Hayashi Y, Finlayson B, Chu S (1977) Estimation of the state of saturation of brushite and calcium oxalate in urine: A comparison of three methods. J Lab Clin Med 89:891–901
Prien EL (1975) The riddle of Randall's plaques. J Urol 114: 500–507
Robertson WG, Peacock M, Nordin BEC (1968) Activity products in stone-forming and non-stone-forming urine. Clin Sci 34:579–594
Robertson WG, Peacock M, Nordin BE (1971) Calcium oxalate crystalluria and urine saturation in recurrent renal stone-formers. Clin Sci 40:365–374
Robertson WG, Peacock M (1972) Calcium oxalate crystalluria and inhibitors of crystallization in recurrent renal stone-formers. Clin Sci 43:499–506
Robertson WG, Knowles F, Peacock M (1976) Urinary acid mucopoly saccharide inhibitors of calcium oxalate crystallization. In: Fleisch H, Robertson WG, Smith LH, Vahlensieck W, (eds) Urolithiasis research. Plenum Press, New York London, pp 331–334
Russell RGG, Hodgkinson A (1966) The urinary excretion of inorganic pyrophosphate by normal subjects and patients with renal calculus. Clin Sci 31:51–62
Smith LH, Jenkins AD, Wilson JWL, Werness-Rochester PG (1984) Is hydroxyapatite important in calcium urolithiasis? Fortschr Urol Nephrol 22:193–197
Wikström B, Danielson BG, Ljunghall S, McGuire M, Russell RGG (1983) Urinary pyrophosphate excretion in renal stone formers with normal and impaired renal acidification. World J Urol 1:150–154
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Baumann, J.M., Lauber, K., Lustenberger, F.X. et al. Crystallization conditions in urine of patients with idiopathic recurrent calcium nephrolithiasis and with hyperparathyroidism. Urol. Res. 13, 169–174 (1985). https://doi.org/10.1007/BF00261818
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00261818