[Analytical evaluation of urinary calculi mineral composition].Ann Acad Med Stetin 1995; 41:259-71AA
Urolithiasis is the most frequent disease of urinary system. It affects about 3% of people of the productive age. One half of the hospitalized in Departments of Urology is made up of patients with urinary calculi. In some regions of the globe, urolithiasis is a very common pathological disorder. Upper Silesia being such a region in Poland. The objective of the paper is: 1) systematization of calculi according to their mineral composition with regard to eventual prophylaxis of urolithiasis, 2) comparison of mineral components of calculi in the aspect of pollutions for Upper Silesia and West Pomerania territories, and the effect of external factors on the constitution of the formed calculi, 3) making use of X-ray microanalysis in complex determinations of mineral compositions of stones, particularly the trace elements. For that purpose a total of 185 urinary calculi stemming from individuals of both sexes, aged 24 to 82 years were used. The content of calcium, magnesium, zinc and iron was determined by atom absorption method, that of aluminium, chloride, sulphur and copper by X-ray microanalysis method, fluoride by gas chromatographic method, phosphates and urates by colorimetric method. The content of cystine was defined by thermic decomposition and characteristic smell. The results were subjected to statistical analysis. With reference to the first task, the following chemical classification of stones has been suggested, namely; class I: ammonium stones being magnesium-ammonium phosphate, class II: stones with elevated calcium content, calcium oxalate, class III: stones with elevated magnesium content, class IV: calculi rich in calcium and magnesium, class V: calculi deficient in calcium and magnesium, class VI: organic uric stones, class VII: organic cystine stones. The second task consisted in comparing the mineral composition of stones from subjects inhabiting two remote from each other regions-industrialized Silesia and Pomerania (Tab. 10). The statistical analysis has revealed differences being statistically significant only with regard to calcium and magnesium in Silesia and Pomerania groups. Undoubtedly that is of importance when one takes into consideration that calcium and magnesium display high affinity to fluoride, the presence of which was detected in all the stones and which may influence the physicochemical properties of the urinary calculi, first of all their hardness and solubility. The third task consisted in evaluating the possibility of applying the X-ray microanalysis for searching the stone for further elements principally microelements. The performed study comprised 10 stones: Silesia region and Pomerania region, whose composition was compared pairwise. The pairs were selected in such a manner that they should have some features in common found out by previously described atom absorption methods. The established results concerning calcium, magnesium and phosphorus showed in general compatibility of results obtained by the two methods. However, by X-ray microanalysis method it was possible to detect further elements: sulphur, aluminium, chloride and copper. The following conclusions have been drawn, namely: 1) analytic examinations of mineral composition of urinary calculi are the base of their chemical composition with regard to eventual prophylaxis of urolithiasis, 2) a varied composition of urinary calculi from two different regions of Poland may be the reflection of actual state of natural environment pollution in those regions, 3) presence of fluoride in all the urinary calculi allows us to suppose that it is permanent element of urinary calculi.