高尿液結晶體積暗示鈣結石患者有高鈣尿症

盧艷金^1,3、林俊廷^1,3、曾一修^1,2

亞東紀念醫院 外科部 ¹創傷科，²泌尿科; ³醫學研究部

High urinary crystal volume suggests hypercalciuria in the calcium stone formers

Yen-Chin Lu^1,3, Jun-Ting Lin^1,3, Yi-Shiou Tseng^1,2

Divisions of Traumatology¹ and Urology², Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan

Department of Medical Research³, Far Eastern Memorial Hospital, New Taipei City, Taiwan

Purpose:

Crystalluria is an important clinical marker for the diagnosis of kidney stone formation. Morpho-constitutional analysis of urinary stones improves the etiological diagnosis of nephrolithiasis. The aim of our study was to investigate the association between urinary crystal morphology and biochemistry value in the calcium kidney stone formers.

Materials and Methods:

We enrolled 62 patients with kidney calcium stones in this study. The microscopic images were obtained from the 10μl of morning urine and also the biochemistry of 24 hours urine were measured. Global crystal volume (GCV) analysis was performed by using the number of crystal per cubic millimeter and average length (μm) of the whewellite and weddellite crystals.

Results:

Among the 62 patients, urinary crystal were not found in 48 patients (group A), but the other 14 patients (group B) presented crystals in the morning urine. The amount of 24 hours urinary calcium excretion was significantly higher in the group B than in the group A (180.33±22.96 vs. 107.60±11.77, mean±SEM, P = 0.0052). The urinary supersaturation index, AP(CaOx)Index had a lack of statistical significance between group A and group B (1.1263±0.38 vs. 0.6534±0.16, P = 0.1850).

Conclusions:

Our results found that more crystals in the morning urine from calcium stone formers suggest higher daily urinary calcium excretion. The therapeutic strategy for this kind of kidney stone patients may focus on the decrease of calcium in the urine.