Urinary supersaturation as a diagnostic measure in urolithiasis

更新时间:2023-08-14

【摘要】AIM To demonstrate that urinary supersaturation per se is not a reliable diagnostic measure of the risk for stone formation.METHODS Available physical and chemical data for calcium oxalate monohydrate(COM) and calcium hydrogen phosphate dihydrate(brushite, BRU), and urinary supersaturations with respect to COM and BRU in healthy individuals and stone formers, were obtained from the literature. Classical theory of nucleation was used for calculations.RESULTS It was found that the rate of homogeneous nucleation(unaided by substrates) of COM and BRU is nil at all conceivable supersaturations of urine. Consequently spontaneous formation of crystals in urine requires the presence of nucleation substrates for(heteronuclei).CONCLUSION Urinary supersaturation with respect to lithiatic compounds is a necessary, but not a sufficient condition for nephrolithiasis. The absence of crystallization inhibitors and the presence of efficient nucleation promoters(heteronuclei) in urine are further necessary conditions of urolithiasis occurrence. Urinary supersaturation per se is not a reliable diagnostic measure of the risk of kidney stone formation.

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