title: Factors affecting crystal precipitation from urine in individuals with long-term urinary catheters colonized with urease-positive bacterial species.
abstract: Weekly urinalysis was conducted for 12 weeks on a group of 21 long-term catheter users with confirmed catheter encrustation and urinary tract colonization with urease-positive bacteria, in order to explore the cause of considerable variation in the severity of encrustation between sufferers. The rapidity of catheter blockage correlated significantly with the pH above which crystals precipitated from urine (the nucleation pH) but not the pH of the voided urine itself. Linear regression showed the nucleation pH to be significantly predicted by a combination of urinary calcium and magnesium concentrations, with calcium being the more influential variable. Reducing the rate of catheter encrustation could be achieved by lowering the urinary concentration of calcium and magnesium, which may only require catheter users to increase their fluid intake.
authors.affiliation: BioMed Centre, Bristol Urological Institute, Southmead Hospital, Bristol, BS10 5NB, UK. s.mathur@dial.pipex.com
authors.forename: Sunil
authors.initials: S
authors.lastname: Mathur
authors.forename: Marc T E
authors.initials: MT
authors.lastname: Suller
authors.forename: David J
authors.initials: DJ
authors.lastname: Stickler
authors.forename: Roger C L
authors.initials: RC
authors.lastname: Feneley
mesh_terms: D002118:Calcium / Q000652:urine; D011232:Chemical Precipitation; D003460:Crystallization; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016014:Linear Models; D008274:Magnesium / Q000652:urine; D011446:Prospective Studies; D011513:Proteus mirabilis / Q000201:enzymology / Q000302:isolation & purification*; D014510:Urease / Q000032:analysis*; D014546:Urinary Catheterization / Q000009:adverse effects*; D014556:Urine / Q000737:chemistry* / Q000382:microbiology
chemical_list: D014510:Urease; D008274:Magnesium; D002118:Calcium