Excessive crystal agglomeration with low citrate excretion in recurrent stone-formers.
In 7 highly recurrent calcium oxalate stone-formers and 10 healthy subjects the effects of urine on three processes of calcium oxalate monohydrate crystallisation--solubility, crystal growth, and crystal agglomeration--were studied. The urine of the stone-formers showed low calcium oxalate solubility and normal crystal growth inhibition, but lacked the ability to inhibit crystal agglomeration. As the sole metabolic abnormality, all stone-formers showed hypocitraturia. Normalisation of urinary citrate concentration resulted both in vitro and in vivo in a significant rise in agglomeration inhibition. These results show that inhibition of agglomeration is a very important, probably citrate-regulated, process in calcium oxalate stone formation.
Kok
D J
DJ
Papapoulos
S E
SE
Bijvoet
O L
OL
D000328:Adult; D000468:Alkalies / Q000627:therapeutic use; D002129:Calcium Oxalate / Q000032:analysis; D002951:Citrates / Q000652:urine*; D003460:Crystallization; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007669:Kidney Calculi / Q000188:drug therapy / Q000378:metabolism* / Q000652:urine; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012995:Solubility
D000468:Alkalies; D002951:Citrates; D002129:Calcium Oxalate