Artificial simulation of renal stone formation. Influence of some urinary components.

The effect of natural admixtures occurring in human urine (citrate, pyrophosphate and glycosaminoglycans) on the precipitation of stone-forming compounds was studied. Experiments were carried out under conditions closely simulating the early stages of renal stone formation. Among the studied admixtures, citrate was determined as the most effective substance preventing the phosphate particle formation. Indeed, in the presence of citrate, some calcium oxalate monohydrate crystals were found. Pyrophosphate induced the formation of calcium oxalate dihydrate crystals. Phosphate crystals appeared at pH 6 and never at pH 5. The easy formation of phosphate particles supports the hypothesis that these crystals represent a very important heterogeneous nucleus-initiating oxalocalcic calculus formation in the kidney. Reported results also indicated uric acid as a significant heterogeneous nucleus of calcium oxalate monohydrate crystals at urinary pH equal or lower than 5 and the important role of bacteria in increasing the organic detritus deposited on the solid surfaces.