Some Aspects of the Adult Urinary Stone Problem in Great Britain and Northern Ireland

Abstract

Summary In a collection of 856 urinary calculi from Great Britain and Northern Ireland, the most abundant and frequently occurring crystalline constituents are the mono‐ and di‐hydrates of calcium oxalate and hydroxy‐ and carbonate‐apatite. On the basis of composition, most stones can be assigned to a few well‐defined groups. The most common composition type, accounting for 34% of the collection, is that composed of calcium oxalate+calcium phosphate. The oxalate can be either or both of the hydrates, often both are present, but the calcium phosphate is generally hydroxyapatite. Stones consisting of pure calcium oxalate make up 27% of the total, while those comprised of struvite+calcium phosphate contribute 17%. In the latter variety the calcium phosphate is almost invariably carbonate‐apatite. The other group considered consists of the pure calcium phosphate calculi which account for 7% of the collection. The incidence of stones in relation to their site in the urinary tract and the patient's age and sex has been investigated, together with the effect of the stone site, patient's age and sex on the distribution of calculi in the main composition groups and the effect of composition, site, age and sex on the stone weight. Most of these variables have a significant effect on one another. The incidence of stones is also related to daily occupation, professional workers being 10 times more likely to develop urolithiasis than labourers. We thank the Medical Research Council and Nuffield Foundation who financed most of this work and Mr D. Sturt who kindly agreed to the participation of the Computer Centre in this project. We are greatly indebted to Mr N. W. Please for advice and many helpful discussions on the statistics and for carrying out the analysis of variance. Finally, we are grateful to the many surgeons and physicians who provided the stones and the data.

Idiopathic Calcium Phosphate Nephrolithiasis

“…For instance. Sutor et al [15] found 6.9% of stones to be 'pure' calcium phosphate and this could account for the higher frequency that we found using the criterion of an 0:P ratio of < 1:1. Fig.…”

“…Sutor et al [15] found a relatively greater proportion of females among patients with mixed calcium oxalate and phosphate stones, compared with calcium oxalate stones, but only if the patients were 50 years or less. In one of the few studies in which quantification of the amounts of oxalate and phosphate has been related to sex, Otnes [17] found that 43% of 44 patients with stones containing 50% or more calcium phosphate (excluding those with MAP) were females; however, only 25% of 198 patients with stones containing more than 50% calcium oxalate, were females.…”

Bacteriological evaluation of bladder calculi: a study

“…11 The explanation for the presence of bacteria within the calculi may be due to insignificant intermittent bacteriemia, from where the bacteria are excreted in renal pelvis and may act as a nidus for deposition of crystals either by damaging the mucous coat or perhaps also by acting as a nidus for crystallization of salts. 12 Thus, a vicious cycle starts, the infection leading to stone formation and then the stone causing infection. 13 Most of the current literature on the subject focuses on pathogenesis of infectious urinary stones.…”

ClC-5 chloride channel and kidney stones: what is the link?

“…Most of the patients present recurrent kidney stones and metabolic disorders (5-7). Male patients predominate, but about 30% of patients are female (1)(2)(3).…”

“…Nephrolithiasis (or kidney stones) is one of the most common diseases in countries like the USA, United Kingdom, Japan, and Brazil (1)(2)(3)(4). Most of the patients present recurrent kidney stones and metabolic disorders (5-7).…”