Diagnostic possibilities of qualitative express analysis of mineralogical structure of urolites


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Abstract

Objective: the aim of the determination of the diagnostic information content of the qualitative analysis method - urinary calculus for use in medical practice in the study of the chemical structure of urolite. Materials, methods: Determination of the chemical composition of uroliths in the collection of urinary stones (n=2960), presented in «a Database of patients with urolithiasis who live in the territory of the Republic of Belarus» (2006-2019), made the developed method of qualitative analysisbased on the combined conduct of optical macroscopy of the sample, qualitative chemical reactions and chemical reactions of reprecipitation with subsequent microscopy of the crystals formed. Results: The developed method allowed identifying the following clinically most significant mineral components of urinary stones: vevellite (42.4%), weddellite (28.1%), Apatite (19.6%), carbonate Apatite (5.1%), struvite (13.2%), uric acid (17.6%), ammonium urate (0.4%), cystine (0.7%). The obtained data were consistent with the results of studying the elemental composition of urinary stones (n=24) by atomic emission spectrometry with inductively coupled plasma. The calcium level was highest in calcium stones (25.56% - Оа oxalate and 19.73% - Оа phosphate) with a minimum content (0.012%) in urate stones. The amount of magnesium prevailed in the group with magnesium-ammonium-phosphate stones (2.51%) at extremely low concentrations in urate samples (7.8 10-4%). The percentage of phosphorus was maximum (13.47%) in the group ofuroliths, represented by phosphate salts of calcium and magnesium (with values of 0.67% - calcium oxalate and 0.013% urate). Identification of trace elements Al, Ba, Cu, Fe, Zn, Sr revealed a fluctuation in their content in the range from 0.037 to 546.3 ppm. Conclusion. Considering the practical availability of implementation, low financial costs and sufficient information, the method of qualitative rapid analysis of urinary stone, based on a combined optical macroscopy of the sample, qualitative chemical reactions and chemical reactions of reindeposition with subsequent microscopy of the formed crystals, can be recommended for wide use in medical institutions of any regional level in the diagnosis of chemical types of uroliths in patients with ICD.

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About the authors

D. M. Nitkin

Belarusian Medical Academy of Post-Graduate Education

Email: nitkin@mail.ru
professor, rector Minks, Belarus

T. M Juraha

Belarusian Medical Academy of Post-Graduate Education

Email: 2652441@mail.ru
Senior fellow at the research laboratory Minks, Belarus

A. A Gres

Belarusian Medical Academy of Post-Graduate Education

M.D., Professor of urology and nephrology department Minks, Belarus

N. A Gres

Belarusian Medical Academy of Post-Graduate Education

Email: n_gres@mail.ru
Candidate of medical sciences, associate professor, leading scientific memberof scientific-research laboratory Minks, Belarus

O. M Solovey

Belarusian Medical Academy of Post-Graduate Education

Email: solo_som@mail.ru
Senior fellow at the research laboratory Minks, Belarus

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