Clinical studyPredictive value of kidney stone composition in the detection of metabolic abnormalities☆
Section snippets
Patient data
Kidney stones were obtained from 1392 patients who underwent complete ambulatory evaluation 5, 7. This diagnostic protocol allows differentiation of different causes of kidney stones, based mainly on identification of abnormal urinary risk factors, believed to be either metabolic or environmental in origin (6). Patients collected the stones within 3 years of evaluation, mostly during the preceding year, at which time they had not been undergoing regular medical treatment for nephrolithiasis.
Association of medical diagnoses with stone composition
Calcium oxalate stones were the most common, followed by mixed calcium oxalate–calcium apatite, calcium apatite, uric acid, mixed uric acid–calcium oxalate, infection stones, brushite, cystine, and ammonium urate (Table 1).
Discussion
From our registry of patients with nephrolithiasis who underwent an ambulatory diagnostic evaluation, stone analyses and medical diagnoses were available in 1392 patients. Our results confirmed the generally recognized importance of stone composition of noncalcareous stones in detecting medical diagnosis 1, 2, including the association of uric acid stones with gouty diathesis (13) and chronic diarrheal syndromes (15), two conditions characterized by a low urinary pH, in which uric acid is
Acknowledgements
The authors wish to thank Roy Peterson and Vicki Lucido for duplicate data entry from patients’ research charts to the computer database in our “stone registry.”
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This work was supported by NIH grants P01-DK20543 and M01-RR00633, and by institutional funds.