CRYSTAL AGGLOMERATION IS A MAJOR ELEMENT IN CALCIUM-OXALATE URINARY STONE FORMATION

被引:133
作者
KOK, DJ [1 ]
PAPAPOULOS, SE [1 ]
BIJVOET, OLM [1 ]
机构
[1] STATE UNIV LEIDEN HOSP,DEPT ENDOCRINOL,CLIN INVEST UNIT,BLDG 1,C4-R,RIJNSBURGERWEG 10,2333 AA LEIDEN,NETHERLANDS
关键词
D O I
10.1038/ki.1990.7
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The effects of urines from 36 healthy subjects and 86 calcium oxalate renal stone formers on calcium oxalate monohydrate crystallization kinetics were studied using a seeded crystal growth method in which the solubility, the growth and the agglomeration of the crystals are measured as three separate and system-independent parameters. The urines of healthy subjects were found to increase the solubility and to strongly inhibit the growth and the agglomeration of calcium oxalate monohydrate crystals. The urines of stone formers had a similar effect on the solubility, but a significant lower ability to inhibit the crystal growth and the crystal agglomeration. Of these two kinetic processes the inhibition of crystal agglomeration was more clearly affected, with 55% of the stone formers having abnormally low values, while the changes in crystal growth inhibition occurred within the normal range. The defect in crystal agglomeration inhibition was related to stone frequency, and urines from patients with very high stone frequency rates had also the most severely impaired ability to inhibit the agglomeration of the calcium oxalate monohydrate crystals. The inhibitory effect of urines on crystal agglomeration was found to be related to its citrate content (r = 0.68, P < 0.001). All patients with hypocitraturia, except two, had also abnormally low values for crystal agglomeration inhibition. In a group of 15 hypocitraturic stone formers, alkali treatment for a mean period of 18 months resulted in a parallel increase in urinary citrate excretion and in the ability of urines to inhibit crystal agglomeration (r = 0.77, P < 0.001). These results show that defective inhibition of the kinetic process of crystal agglomeration constitutes a major physicochemical mechanism of calcium oxalate renal stone formation, which appears to be modulated by urinary citrate concentrations.
引用
收藏
页码:51 / 56
页数:6
相关论文
共 18 条
[1]  
BIJVOET OLM, 1983, J CRYST GROWTH, V64, P116
[2]  
BLOMEN LJM, 1981, FORTSCHR UROL NEPHRO, V17, P159
[3]  
BLOMEN LJM, 1982, BEITR F SCHILLER U, P67
[4]   GROWTH-KINETICS OF CALCIUM-OXALATE MONOHYDRATE .2. THE VARIATION OF SEED CONCENTRATION [J].
BLOMEN, LJMJ ;
WILL, EJ ;
BIJVOET, OLM ;
VANDERLINDEN, H .
JOURNAL OF CRYSTAL GROWTH, 1983, 64 (02) :306-315
[5]  
Burns JR, 1984, URINARY STONE, P253
[6]  
FINLAYSON B, 1977, FOGARTY INT CTR P, V37, P7
[7]   SIZE DISTRIBUTION CHARACTERISTICS OF MINERAL PHASE IN RENAL STONES [J].
ISMAIL, SI ;
TAWASHI, R .
JOURNAL OF PHARMACEUTICAL SCIENCES, 1980, 69 (07) :829-831
[8]   ARCHITECTURE OF CALCIUM-OXALATE MONOHYDRATE URINARY CALCULI [J].
IWATA, H ;
NISHIO, S ;
WAKATSUKI, A ;
OCHI, K ;
TAKEUCHI, M .
JOURNAL OF UROLOGY, 1985, 133 (02) :334-338
[9]  
KOK DJ, 1986, LANCET, V1, P1056
[10]   MODULATION OF CALCIUM-OXALATE MONOHYDRATE CRYSTALLIZATION KINETICS INVITRO [J].
KOK, DJ ;
PAPAPOULOS, SE ;
BLOMEN, LJMJ ;
BIJVOET, OLM .
KIDNEY INTERNATIONAL, 1988, 34 (03) :346-350