Analysis of Urinary Calculi by X-Ray Diffraction Method

Kim, Chul Sung; Kim, Choon Gon

Abstract

The analysis of urinary calculi is an essential step in the examination and initial treatment of the patient with urolithiasis. Among the various methods of stone analysis, we have used x-ray diffraction method for analyzing urinary calculi. The advantage of x-ray diffraction is its almost absolute identification of crystalline materials and mixtures of crystalline materials. The disadvantage of x-ray diffraction include initial high cost of equipment and inability to identify amorphous materials and constituents present in only minor or trace amounts. We have analyzed 127 urinary calculi by x-ray diffraction method, which were obtained from the patients who were admitted to the Department of Urology, Chosun University Hospital during the period of 5 years from Jan. l98l to Dec. l985. The following results were obtained: 1. In this studies, 8 crystalline components of urinary calculi were demonstrated: Calcium oxalate monohydrate, Calcium oxalate dehydrate, Calcium oxalate trihydrate, Hydroxyl-apatite, Magnesium ammonium phosphate hexahydrate, Calcium hydrogen phosphate dihydrate, Uric acid and Cystine. 2. Calculi of single component, comprising 73 (57.6%) of the total, was more common than those of mixed component, 54 (42.4%) of the total. Calcium oxalate monohydrate was the most common pure calculi, composing 46 (36.2 %) of all pure calculi and mixed calcium oxalate monohydratecalcium oxalate dihydrate calculi was the most common mixed calculi, constituting 20 (15.7%) of all mixed Calculi. 3. Classifying author`s results as Jensen`s classification, pure calcium oxalate and calcium oxalate apatite mixtures composed 87.3% of total, magnesium ammonium phosphate-apatite mixtures constituted 4.O%, uric acid comprised 6.5%. 4. Among the all urinary components analyzed in this studies, calcium oxalate monohydrate was the most common constituent, composing 78% of the total and calcium oxalate dihydrate was the second common constituent, comprising 37.6%, calcium oxalate was the most common component, composing 9l.3% of the total. 5. In the components associated with calcium oxalate monohydrate, calcium oxalate dihydrate was the most common associated component, in calcium oxalate dihydrate calcium oxalate monohydrate, in hydroxyl-apatite calcium oxalate monohydrate, in uric acid calcium oxalate monohydrate 6. According to the distribution of urinary component in each urinary organ, calcium oxalate (esp. calcium oxalate monohydrate exceeded 50%) was the most common component in entire urinary tract, which comprised 59.1% of all renal calculi, 69.4% of all ureteral calculi, 33.3% of all bladder calculi and 100% of all urethral calculi. 7. Of 44 renal calculi, 30 were composed of staghorn calculi, in which calcium oxalate was the most common component, constituting 56.6% of 30 staghorn calculi.