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Urolithiasis

, Volume 45, Issue 2, pp 151–157 | Cite as

Kinetics of calcium oxalate crystal formation in urine

  • Norbert LaubeEmail author
  • Florian Klein
  • Falk Bernsmann
Original Paper
  • 419 Downloads

Abstract

It is routinely observed that persons with increased urinary stone risk factors do not necessarily form uroliths. Furthermore, stone formers can present with urinalyses that do not reflect the clinical picture. We explain this discrepancy by differences in crystallization kinetics. In 1162 urines, crystallization of Ca-oxalate was induced according to the BONN-Risk-Index (BRI) method. The urine’s relative light transmissivity (RLT) was recorded from 100 % at start of titration to 95 % due to nuclei formation and crystal growth. From the RLT changes, a measure of the thermodynamic inhibition threshold of crystal formation (BRI) and of crystal growth kinetics is derived (“turbidity slope” after crystallization onset). On average, subjects presenting with a low inhibition threshold, i.e., high BRI, also present significantly higher crystal growth rates compared with subjects in lower BRI classes. Only subjects in the highest BRI class show a lower growth rate than expected, probably due to a depletion of supersaturation by massive initial nucleation. With increasing thermodynamic risk of crystal formation (i.e., increasing BRI) due to an imbalance between inhibitors and promoters of crystal formation, an increase in the imbalance between inhibitors and promoters of crystal growth (i.e., increasing growth rate) is observed. Both lead to an increased urolith formation risk. Healthy subjects with increased BRI are an exception to this trend: their urine is thermodynamically prone to form stones, but they show a kinetic inhibition preventing nuclei from significant growth.

Keywords

Urolithiasis supersaturation Thermodynamic inhibition Induced crystallization BONN Risk Index 

Abbreviations

BRI

BONN Risk Index

CaOx

Calcium oxalate

COM

Calcium oxalate monohydrate

COD

Calcium oxalate dehydrate

NH4Ox

Ammonium oxalate

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. None of the employers played any role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report or in the decision to submit the report for publication.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Deutsches Harnsteinzentrum, Urologisches Zentrum BonnBonnGermany
  2. 2.FH Aachen, Campus Jülich, FB Medizintechnik und Technomathematik52428 JülichGermany
  3. 3.NTTF Coatings GmbHRheinbreitbachGermany

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