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Divergence between stone composition and urine supersaturation: clinical and laboratory implications.
J Urol. 1999 Apr; 161(4):1077-81.JU

Abstract

PURPOSE

In general high urine supersaturation with respect to calcium oxalate, calcium phosphate or uric acid is associated with that phase in stones. We explore the exceptions when supersaturation is high and a corresponding solid phase is absent (type 1), and when the solid phase is present but supersaturation is absent or low (type 2).

MATERIALS AND METHODS

Urine supersaturation values for calcium oxalate, calcium phosphate and uric acid, and other accepted stone risk factors were measured in 538 patients at a research clinic and 178 at stone prevention sites in a network served by a single laboratory.

RESULTS

Of the patients 14% lacked high supersaturation for the main stone constituent (type 2 structural divergence) because of high urine volume and low calcium excretion, perhaps from changes in diet and fluid intake prompted by stones. Higher calcium excretion and low urine volume caused type 1 divergences, which posed no clinical concern.

CONCLUSIONS

Type 1 divergence appears to represent a condition of low urine volume which raises supersaturation in general. Almost all of these patients are calcium oxalate stone formers with the expected high supersaturation with calcium oxalate as well as high uric acid and calcium phosphate supersaturations without either phase in stones. Type 2 divergence appears to represent an increase in urine volume and decrease in urine calcium excretion between stone formation and urine testing.

Authors+Show Affiliations

Renal Section, University of Chicago, Illinois, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10081841

Citation

Lingeman, J, et al. "Divergence Between Stone Composition and Urine Supersaturation: Clinical and Laboratory Implications." The Journal of Urology, vol. 161, no. 4, 1999, pp. 1077-81.
Lingeman J, Kahnoski R, Mardis H, et al. Divergence between stone composition and urine supersaturation: clinical and laboratory implications. J Urol. 1999;161(4):1077-81.
Lingeman, J., Kahnoski, R., Mardis, H., Goldfarb, D. S., Grasso, M., Lacy, S., Scheinman, S. J., Asplin, J. R., Parks, J. H., & Coe, F. L. (1999). Divergence between stone composition and urine supersaturation: clinical and laboratory implications. The Journal of Urology, 161(4), 1077-81.
Lingeman J, et al. Divergence Between Stone Composition and Urine Supersaturation: Clinical and Laboratory Implications. J Urol. 1999;161(4):1077-81. PubMed PMID: 10081841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Divergence between stone composition and urine supersaturation: clinical and laboratory implications. AU - Lingeman,J, AU - Kahnoski,R, AU - Mardis,H, AU - Goldfarb,D S, AU - Grasso,M, AU - Lacy,S, AU - Scheinman,S J, AU - Asplin,J R, AU - Parks,J H, AU - Coe,F L, PY - 1999/3/19/pubmed PY - 1999/3/19/medline PY - 1999/3/19/entrez SP - 1077 EP - 81 JF - The Journal of urology JO - J. Urol. VL - 161 IS - 4 N2 - PURPOSE: In general high urine supersaturation with respect to calcium oxalate, calcium phosphate or uric acid is associated with that phase in stones. We explore the exceptions when supersaturation is high and a corresponding solid phase is absent (type 1), and when the solid phase is present but supersaturation is absent or low (type 2). MATERIALS AND METHODS: Urine supersaturation values for calcium oxalate, calcium phosphate and uric acid, and other accepted stone risk factors were measured in 538 patients at a research clinic and 178 at stone prevention sites in a network served by a single laboratory. RESULTS: Of the patients 14% lacked high supersaturation for the main stone constituent (type 2 structural divergence) because of high urine volume and low calcium excretion, perhaps from changes in diet and fluid intake prompted by stones. Higher calcium excretion and low urine volume caused type 1 divergences, which posed no clinical concern. CONCLUSIONS: Type 1 divergence appears to represent a condition of low urine volume which raises supersaturation in general. Almost all of these patients are calcium oxalate stone formers with the expected high supersaturation with calcium oxalate as well as high uric acid and calcium phosphate supersaturations without either phase in stones. Type 2 divergence appears to represent an increase in urine volume and decrease in urine calcium excretion between stone formation and urine testing. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/10081841/Divergence_between_stone_composition_and_urine_supersaturation:_clinical_and_laboratory_implications_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(01)61594-5 DB - PRIME DP - Unbound Medicine ER -