Advertisement

Urolithiasis pp 427-436 | Cite as

Effect of Urinary Macromolecules on Calcium Oxalate Dihydrate Crystal Growth and Nucleation Rates

  • Alan D. Randolph
  • Zlatica I. Kraljevich
  • George Drach

Abstract

Two major theories of calcium oxalate urinary stone disease are the hyperexcretion-supersaturation theory and the inhibitor theory. Both are centrally related to the crystallization kinetics of calcium oxalate (CaOx). In the supersaturation theory oxalate stone is a result of persistent overconcentration of Ca2+ and/or Ox2- ions in the urine brought about by dietary and metabolic irregularities or inadequate fluid intake. CaOx precipitation (mono or dihydrate form) occurs when the CaOx ion product exceeds the formation product. The supersaturation theory maintains that persistent overconcentration causes excessive crystalluria growth, nucleation, and/or aggregation which raises the probability of a particle eventually lodging in the kidney to become the nidus for a stone. High supersaturations aggravate further growth of the stone by molecular growth, surface nucleation of dendrites and/or aggregation with additional crystalluria. Finlayson1 demonstrated convincingly using order-of-magnitude calculations that growth of 200μm particles (approximate dimensions of the ducts of Bellini) is virtually impossible solely by molecular accretion on single crystals; agglomeration/aggregation mechanisms are a likely part of the overall stone formation process. Nevertheless, the presence of small CaOx crystalluria sets up these mechanisms and therefore the hyperexcretion-supersaturation theory correctly focuses on the importance of crystallization kinetics.

Keywords

Nucleation Rate Stone Former Mother Liquor Crystallization Kinetic Calcium Oxalate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    B. Finlayson, in: “Calcium Metabolism in Renal Failure and Nephrolithiasis,” David S. David, ed., Wiley, New York (1977).Google Scholar
  2. 2.
    W. G. Robertson and M. Peacock, Clin. Sci. 43:499 (1972).PubMedGoogle Scholar
  3. 3.
    W. G. Robertson, M. Peacock, and B. E. C. Nordin, Clin. Chem. Acta. 43:31 (1973).CrossRefGoogle Scholar
  4. 4.
    D. J. Sutor, Br. J. Urol. 41:171 (1969).PubMedCrossRefGoogle Scholar
  5. 5.
    S. G. Welshman and M. G. McGeown, Br. J. Urol. 44:677 (1972).PubMedCrossRefGoogle Scholar
  6. 6.
    G. Robertson, M. Peacock, R. W. Marshall, D. H. Marshall, and B. E. C. Nordin, N. Eng. J. Med. 294:249 (1976).CrossRefGoogle Scholar
  7. 7.
    D. Randolph and M. A. Larson, in: “Theory of Particulate Processes,” Academic Press, New York (1971).Google Scholar
  8. 8.
    G. W. Drach, S. Thorson, and A. D. Randolph, J. Urol. 123:519 (1980).PubMedGoogle Scholar
  9. 9.
    Costello, M. Hatch, and E. Bourke, J. Lab. Clin. Med. 87: 903 (1976).PubMedGoogle Scholar
  10. 10.
    I. Resnick and W. H. Boyce, Invest. Urol. 16:270 (1979).PubMedGoogle Scholar
  11. 11.
    D. Miller, A. D. Randolph, and G. W. Drach, J. Urol. 117:342 (1977).PubMedGoogle Scholar
  12. 12.
    G. W. Drach, S. Sarig, A. D. Randolph, and S. Thorson, (in preparation).Google Scholar

Copyright information

© Springer Science+Business Media New York 1981

Authors and Affiliations

  • Alan D. Randolph
    • 1
  • Zlatica I. Kraljevich
    • 1
  • George Drach
    • 1
  1. 1.Section of UrologyThe University of ArizonaTucsonUSA

Personalised recommendations