Spectrum of stone composition: structural analysis of 1050 upper urinary tract calculi from northern India

Ansari, Mohd S. ; Gupta, Narmada P. ; Hemal, Ashok K. ; Dogra, Premnath N. ; Seth, Amlesh ; Aron, Monish ; Singh, Tej P. (2005) Spectrum of stone composition: structural analysis of 1050 upper urinary tract calculi from northern India International Journal of Urology, 12 (1). pp. 12-16. ISSN 0919-8172

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Official URL: http://onlinelibrary.wiley.com/doi/10.1111/j.1442-...

Related URL: http://dx.doi.org/10.1111/j.1442-2042.2004.00990.x


Abstract Background: The purpose of the present paper was to study the spectrum of stone composition of upper urinary tract calculi by X-ray diffraction crystallography technique, in patients managed at All India Institute of Medical Sciences. Methods: Between 30 April 1998 and 31 March 2003, a total of 1050 urinary calculi (900 renal, 150 ureteric) were analyzed. The stone fragments were collected after extracorporeal shock-wave lithotripsy, or retrieval by endoscopic (percutaneous nephrolithotomy, ureterorenoscopy), laparoscopic and various open surgical procedures. The structural analysis of the stones was done using X-ray diffraction crystallography. Results: Four types of primary and three secondary X-ray diffraction patterns were obtained. The primary patterns were as follows. Pattern A, well organized crystalline structure; pattern B, moderately organized crystalline structure; pattern C, poorly organized crystalline structure; pattern D, very poorly organized crystalline structure. The three secondary patterns mainly highlighted the mixed variety of stones. These patterns were further analyzed and compared with standard X-ray diffraction (powder) photographs. Of the 1050 stones analyzed, 977 (93.04%) were calcium oxalate stones, out of which 80% were calcium oxalate monohydrate (COM) and 20% were calcium oxalate dihydrate (COD). Fifteen were struvite (1.42%) and 19 were apatite (1.80%). Ten were uric acid stones (0.95%) and the remaining 29 (2.76%) were mixed stones (COM + COD and calcium oxalate + uric acid, calcium oxalate + calcium phosphate, and calcium phosphate + magnesium ammonium phosphate). A total of 89.98% of staghorn stones were made of oxalates (COM/+COD) and only 4.02% were struvite. Conclusion: Urinary stone disease in the Indian population is different from that in Western countries, with a larger percentage of patients having calcium oxalate stones, predominantly COM. Also, the majority of staghorn stones (89.98%) were made of oxalates.

Item Type:Article
Source:Copyright of this article belongs to John Wiley and Sons.
Keywords:Northern India; Stone Composition; Structural Analysis; Urinary Calculi
ID Code:49098
Deposited On:18 Jul 2011 13:49
Last Modified:18 Jul 2011 13:49

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