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Asian Journal of Urology, 2024, 11(4): 596-603    doi: 10.1016/j.ajur.2024.04.003
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Correlation analysis between urinary crystals and upper urinary calculi
Xi Zhanga,Yang Zhengb,Yichun Wanga,Xiyi Weia,Shuai Wanga,Jie Zhengc,Jixiang Yaoc,Chen Xud,Zhijun Caod,Chao Qina*(),Lujiang Yie*(),Ninghong Songa*()
aDepartment of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
bNanjing Hospital of Traditional Chinese Medicine, Nanjing Hospital of Chinese Medicine, Nanjing, China
cDepartment of Urology, Wuhu Hospital Affiliated to East China Normal University, Wuhu, China
dDepartment of Urology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, China
eDepartment of Laboratory, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Abstract: 

Objective: This study aimed to analyze the correlation between urinary crystals and urinary calculi.

Methods: Clinical data, including urinary crystal types, were collected from 237 patients with urinary calculi. The detection rate of urine crystals and their correlation with stone composition were analyzed. The receiver operating characteristic curve analysis was used to determine the best cut-off value for predicting stone formation risk based on calcium oxalate crystals in urine.

Results: Calcium oxalate was the most common component in 237 patients. Among them, 201 (84.81%) patients had stones containing calcium oxalate. In these patients, calcium oxalate crystals were detected in 45.77% (92/201) of cases. In different groups of calcium oxalate stones, calcium oxalate crystals accounted for more than 90% of the total number of crystals detected in each group. The detection rate of calcium oxalate crystals was higher in first-time stone formers than in recurrent patients. The receiver operating characteristic curve analysis suggested a cut-off value of 110 crystals/μL for predicting stone formation, validated with 65 patients and 100 normal people.

Conclusion: Calcium oxalate crystals in urine can predict the composition of calcium oxalate stones and indicate a higher risk of stone formation when the number exceeds 110 crystals/μL. This non-invasive method may guide clinical treatment and prevention strategies.
Key words:  Calculus    Urine crystal    Calcium oxalate crystal    Predict model
收稿日期:  2023-04-19           接受日期:  2023-08-14      出版日期:  2024-10-20      发布日期:  2024-11-20      整期出版日期:  2024-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2024, 11(4): 596-603.
Xi Zhang, Yang Zheng, Yichun Wang, Xiyi Wei, Shuai Wang, Jie Zheng, Jixiang Yao, Chen Xu, Zhijun Cao, Chao Qin, Lujiang Yi, Ninghong Song. Correlation analysis between urinary crystals and upper urinary calculi. Asian Journal of Urology, 2024, 11(4): 596-603.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2024.04.003  或          http://www.ajurology.com/CN/Y2024/V11/I4/596
Stone composition Total Urinary crystal None urinary crystal Crystallization detection rate, % Match, % Mismatch,% COC detection rate, %
COC PC UC CC
Calcium oxalate calculus 97 42 3 1 0 51 47.42 91.30 8.70 43.30
Calcium oxalate mixed carbonate apatite 83 43 1 0 0 39 53.01 97.73 2.27 51.81
Calcium oxalate mixed uric acid calculus 20 7 0 2 0 11 45.00 100 0 35.00
Struvite mixed carbonate apatite 16 1 5 1 0 9 43.75 71.43 28.57 6.25
Uric acid calculus 15 1 1 4 0 9 40.00 66.67 33.33 6.67
Struvite calculus 2 0 0 0 0 2 0 0 0 0
Carbonate apatite mixed hydroxyapatite 1 1 0 0 0 0 100 0 100 100
Calcium oxalate mixed l-cystine calculus 1 0 0 0 1 0 100 100 0 0
Carbonate apatite mixed l-cystine calculus 1 0 0 0 0 1 0 0 0 0
l-cystine calculus 1 0 0 0 0 1 0 0 0 0
Total 237 95 10 8 1 123 48.10 91.23 8.77 40.08
  
  
Characteristics Calcium oxalate mixed carbonate apatite (n=43) Calcium oxalate mixed uric acid calculus (n=7) Calcium oxalate calculus (n=42) p-Value
Gender, n (%) 0.659
Male 30 (32.6) 6 (6.5) 29 (31.5)
Female 13 (14.1) 1 (1.1) 13 (14.1)
Age, year, n (%) 0.040
≤52 27 (29.3) 2 (2.2) 16 (17.4)
>52 16 (17.4) 5 (5.4) 26 (28.3)
Stone location, n (%) 0.023
Kidney and ureter 12 (13.0) 0 (0) 18 (19.6)
Ureter 13 (14.1) 2 (2.2) 3 (3.3)
Kidney 18 (19.6) 5 (5.4) 21 (22.8)
History, n (%) 0.040
First 30 (32.6) 2 (2.2) 32 (34.8)
Recrudescence 13 (14.1) 5 (5.4) 10 (10.9)
  
  
  
  
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