A very simple analytical procedure with dimethylmethylene blue as photometric reagent was applied for the evaluation of glycosaminoglycan (GAG) urinary excretions and concentrations in both sexes, calcium oxalate stone formers, and a control group. The GAG concentrations varied significantly in stone formers (males and females) and in the control group; moreover, in some individual cases, a deficit of urinary GAGs was clearly detected. Apart from important inhibitory effects of GAGs on heterogenous calcium oxalate nucleation, the low urinary GAG content could be the cause of a pathological epithelium, favoring stone formation. The dimethylmethylene blue method is recommended as a quick screening procedure to determine a GAG deficit.
The possible effects of Zn and Cu in oxalocalcic urolithiasis were investigated. The formation of calcium oxalate crystals in the presence of Zn and Cu demonstrated that their morpholoy is clearly affected by these ions. Thus, when such ions were present in a number of higher concentrations, a notable increase in the primary aggregation was clearly detected. On the other hand, Zn and Cu urinary levels were determined in groups of stone-formers and healthy people. Zinc urinary concentration was significantly lower for lithiasic than for healthy people and the copper urinary concentration was lower for lithiasic than healthy males, but both female groups had a similar copper urinary concentration. The mentioned differences disappeared when serum levels were considered. These obtained results have been comparatively evaluated with those obtained by other authors. When considering all the commented aspects, it is concluded that no important direct action of zinc and copper on oxalocalcic calculi genesis takes place.
The part played by hyperoxaluria in the formation of calcium oxalate urinary calculi was studied in 153 patients who had each been diagnosed as having calcium oxalate urinary calculi on one or more occasions. Seventy-seven of the patients excreted normal amounts of calcium (less than 6.2 mmol/d), and 76 had hypercalciuria (excretion greater than or equal to 6.2 mmol/d); each group was divided into a further two groups depending on whether the oxalate concentration was above or below 0.16 mmol/l. Pure calcium oxalate stones were more common in patients whose calcium excretion was normal, and mixed calcium oxalate and phosphate stones were more common among hypercalciuric patients. Urinary concentrations/day of magnesium, citrate, and phosphorus were significantly lower in the two groups in which the oxalate concentrations were below 0.16 mmol/l than in a normal control group, and magnesium and phosphorus were significantly lower in the two groups in which oxalate concentrations were less than 0.16 mmol/l than in the two in which they were above that value. The concentration of citrate was also lower, but not significantly so. In addition, the pH of the urine in patients with mixed stones was significantly higher in all groups than when the stones were composed of pure calcium oxalate.
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