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Ammonium acid urate crystal formation in adult North American stone-formers.
Am J Kidney Dis 1997; 30(2):237-42AJ

Abstract

Although ammonium acid urate (AAU) stones are endemic in Asia, pure AAU calculi have almost disappeared from industrialized countries and clinical pathophysiologic relevance of sporadic stones containing AAU crystals is currently unknown. We reviewed 1,396 crystallographic stone analyses performed in our institution over a 10-year period. Prevalence of stones containing AAU crystals and predominantly AAU stones were 3.1% and 0.2%, respectively. In more than two thirds of cases, AAU crystals represented less than 10% of stone crystal composition. No pure AAU stone was found. According to crystalline predominance, 42%, 35%, and 12% of these calculi were uric acid, infectious, and calcium oxalate stones, respectively. AAU crystals were detected as discrete intercrystalline or peripheral deposits in 74.4% of stones. In only one calculus was AAU crystals detected in the nucleus. The hospital charts of 37 patients who presented with 43 calculi containing AAU crystals were also reviewed. The mean age was 53.1 +/- 16.6 years. Fifty-seven percent of calculi were upper urinary tract stones and 43% were bladder stones. Upper urinary tract calculi were more frequently uric acid stones, followed by infectious and calcium oxalate stones. Lower urinary tract calculi were more frequently infectious stones, followed by uric acid stones. Upper urinary tract stones were passed spontaneously in 13 patients and removed surgically in nine patients. Nine of these subjects were idiopathic recurrent stone formers who had passed other calculi with no trace of AAU crystal. Fifty-seven percent of lower urinary tract stones were associated with documented bladder dysfunction. In conclusion, although AAU-containing urolithiases are occasionally seen in our population, predominantly or primarily AAU stones are exceptional. AAU crystal formation usually appears as a minor and secondary phenomenon of no primary pathophysiologic relevance in stone formation.

Authors+Show Affiliations

Service de Néphrologie, Hôpital Maisonneuve-Rosemont, Université de Montréal, Québec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9261035

Citation

Pichette, V, et al. "Ammonium Acid Urate Crystal Formation in Adult North American Stone-formers." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 30, no. 2, 1997, pp. 237-42.
Pichette V, Bonnardeaux A, Cardinal J, et al. Ammonium acid urate crystal formation in adult North American stone-formers. Am J Kidney Dis. 1997;30(2):237-42.
Pichette, V., Bonnardeaux, A., Cardinal, J., Houde, M., Nolin, L., Boucher, A., & Ouimet, D. (1997). Ammonium acid urate crystal formation in adult North American stone-formers. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 30(2), pp. 237-42.
Pichette V, et al. Ammonium Acid Urate Crystal Formation in Adult North American Stone-formers. Am J Kidney Dis. 1997;30(2):237-42. PubMed PMID: 9261035.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ammonium acid urate crystal formation in adult North American stone-formers. AU - Pichette,V, AU - Bonnardeaux,A, AU - Cardinal,J, AU - Houde,M, AU - Nolin,L, AU - Boucher,A, AU - Ouimet,D, PY - 1997/8/1/pubmed PY - 1997/8/1/medline PY - 1997/8/1/entrez SP - 237 EP - 42 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 30 IS - 2 N2 - Although ammonium acid urate (AAU) stones are endemic in Asia, pure AAU calculi have almost disappeared from industrialized countries and clinical pathophysiologic relevance of sporadic stones containing AAU crystals is currently unknown. We reviewed 1,396 crystallographic stone analyses performed in our institution over a 10-year period. Prevalence of stones containing AAU crystals and predominantly AAU stones were 3.1% and 0.2%, respectively. In more than two thirds of cases, AAU crystals represented less than 10% of stone crystal composition. No pure AAU stone was found. According to crystalline predominance, 42%, 35%, and 12% of these calculi were uric acid, infectious, and calcium oxalate stones, respectively. AAU crystals were detected as discrete intercrystalline or peripheral deposits in 74.4% of stones. In only one calculus was AAU crystals detected in the nucleus. The hospital charts of 37 patients who presented with 43 calculi containing AAU crystals were also reviewed. The mean age was 53.1 +/- 16.6 years. Fifty-seven percent of calculi were upper urinary tract stones and 43% were bladder stones. Upper urinary tract calculi were more frequently uric acid stones, followed by infectious and calcium oxalate stones. Lower urinary tract calculi were more frequently infectious stones, followed by uric acid stones. Upper urinary tract stones were passed spontaneously in 13 patients and removed surgically in nine patients. Nine of these subjects were idiopathic recurrent stone formers who had passed other calculi with no trace of AAU crystal. Fifty-seven percent of lower urinary tract stones were associated with documented bladder dysfunction. In conclusion, although AAU-containing urolithiases are occasionally seen in our population, predominantly or primarily AAU stones are exceptional. AAU crystal formation usually appears as a minor and secondary phenomenon of no primary pathophysiologic relevance in stone formation. SN - 0272-6386 UR - https://www.unboundmedicine.com/medline/citation/9261035/Ammonium_acid_urate_crystal_formation_in_adult_North_American_stone_formers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272638697001546 DB - PRIME DP - Unbound Medicine ER -