Renal calculi chemical composition

Abstract

Introduction: Nephrolithiasis is a multifactorial pathology, placed first among urinary tract pathologies. Increased incidence of urolithiasis is determined by multiple factors such as lifestyle, diet, migration of population from rural areas cooler in warmer urban areas. The method of surgical treatment of urolithiasis previously applied, may also influence the risk of disease, more than how both patients with fragments outstanding calculi in the kidneys have a higher risk of recurrence. Although the incidence pathology is very high, some patients may produce only a single stone in their lifetime. It's important knowledge of regional peculiarities of the chemical composition of kidney stones, to select the correct therapeutic strategy. The impact of the disease can be reduced by administering a prophylactic treatment of patients with recurrent urolithiasis. For now, there is no information about the characteristics of the chemical composition of urinary calculi in the Republic of Moldova. Aim of the study: Calculi chemical composition research in patients with recurrent urolithiasis in the Republic of Moldova.

Material and methods: Prevalence descriptive study. 160 kidney calculi were analyzed using chemically modified method by Hodgkinson and infrared Spectroscopy with Fourier transformant.

Results: Phosphate stones have been identified in 33 (20.9%) cases: calcium phosphate - 15 (9.37%), struvites - 17 (10.62%), brushitis - 1 (0.62%) cases. Calcium oxalate calculi (n=61, 42.49%): whewellites - 39 (24.37%); weddelites - 22 (13.75%) were determined, being followed in frequency of uric acid-42(26.25%). In 24 (15%) cases calculi of mixed composition: whewellites + apatite carbonate - 6 (3.75%), whitlockites + protein - 6 (3.75%), whitlockites + weddelites 2 (1.25% ), whewellites + uric acid - 6 (3.75%) cases were detected. Other calculi types were rarely found (2,5%).

Conclusions: Kidney calculi from calcium oxalate, uric acid and calcium oxalate and uric acid mixed calculi are the most frequently found in Moldova. Relatively high incidence of infected calculi (27.4%) justifies the necessity of appropriate antibacterial therapy in the pre- and postoperative period. Addressing a healthy lifestyle and instructing patients using this information a substantially improve the results of primary and preventive measures to prevent recurrence of urolithiasis. The information obtained about chemical composition of kidney stones, identifying specific risk factors for Moldova would benefit and healthcare professionals in planning preventive measures to reduce the high incidence of this disease.