陽性顯微鏡尿結晶代表潛在鈣代謝疾病

盧艷金^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

Positive microscopic urinary crystals indicate underlying calcium disorder

Yen-Chin Lu^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 analysis is a low-cost visual tool that is one of the reliable methods to predict stone formation. The crystalline composition provides valuable information in the stone process and indicates the possible underlying disease of stone formers. Our research aims to study the correlation between the microscopic crystal and urinary chemistry which may indicate underlying disease.

Materials and Methods: 10 μL morning urine analysis was performed on 138 stone formers. Urine samples were kept at room temperature and sent to the laboratory within 2 hours. The urine crystal types were examined at 200X magnification under microscopy for the all urine samples. Urinary crystal volume were calculated to represent the crystal concentration. Urine chemistry analysis were also performed.

Results: Crystals were not found in the 10 μL morning urine among 99 stone formers under microscopy. Both COM and COD crystals were found among other 39 stone formers. The stone formers with positive microscopic urinary crystal had higher urinary calcium concentration (11.06 ± 0.91 mg/dL) than those with negative crystal (8.03 ± 0.74 mg/dL). However, there were no significant difference in the urinary calcium daily excretion between groups with positive and negative crystals (136.23 ± 9.63 mg/day vs 168.39 ± 15.67 mg/day). Urinary calcium to creatinine ratios were higher in the positive crystal group (0.17303 ± 0.01 mg/day) than negative group (0.13309 ± 0.01 mg/day).

Conclusions: Our study found that stone formers with positive microscopic urinary crystals may had higher urinary calcium concentration, which indicated underlying disease about high calcium production. We can diagnose this kind of patients with calcium disorder and prevent their kidney stones recurrence after current therapy.