FIGURE 1 - uploaded by Adnan Afaj
Content may be subject to copyright.
Source publication
For this study, 25 samples of urinary stones were chosen from different provinces in Iraq as representative sampling localities. These samples of urinary stones were collected to represent kidney, urate, and bladder stones. The main objectives of this study are to try to shed some light on the possibilities of tracking down the effective environmen...
Context in source publication
Context 1
... Calcium oxalate stone: The studied samples of these stones were kidney and bladder stones. The kidney stone sample had a spherical shape 1 cm in diameter and had many elongated nodes on its surface. It represented in Whewellite mineral (Fig. 1). The bladder stone was oval in shape with very clear concentric layers like an onion and was 6 cm in diameter. It was brownish in color (Fig. 2). 2. Phosphate stone: The studied samples were urate and bladder stones. The surface of these stones seemed to be heterogeneous, smooth, rough, or chalky. The urate stone, which represented in Dittmarite mineral, had more or less cardiac or staghorn shape with smooth surface, and was 3 cm long. Its color was white to brownish gray (Fig. 3). The other stones, which represented in Struvite and Hydroxy apatite minerals, were rounded in shape and 2 cm in diameter, very rough surface, and brownish in color (Fig. 4), or may be irregular in shape and also brownish in color (Fig. 5). 3. Urate stone: The studied samples of these stones were kidney stones and they have different sizes with irregular and smooth to rough surfaces. The colors were beige to brown. They represented in Uricite mineral (Fig. ...
Similar publications
To evaluate trends in urolith composition and urolithiasis in dogs during the past 21 years.
Retrospective case series.
25,499 uroliths and the dogs from which they were obtained.
Database of the Gerald V. Ling Urinary Stone Analysis Laboratory was searched from January 1985 through December 2006. All uroliths from dogs and the accompanying submiss...
Citations
... A common procedure is to grind extracted kidney stones and examine the resulting powder. This method was used in various publications [3][4][5][6][7][8][9][10]. ...
... Numerous factors, including genetics, geographical location, and socioeconomic status, significantly affect the incidence and composition of these stones in different world regions [11]. In the past, several researchers discovered a significant incidence of these stones in developing nations [11][12][13][14][15][16]. ...
... Numerous factors, including genetics, geographical location, and socioeconomic status, significantly affect the incidence and composition of these stones in different world regions [11]. In the past, several researchers discovered a significant incidence of these stones in developing nations [11][12][13][14][15][16]. A meta-analysis by Liu et al. [17] found a 'stone belt' in West, Southeast, and South Asia, with a prevalence ranging from 5% to 19.1%. ...
Renal calculi are a common clinical presentation. While ultrasound (US) is a widely used imaging modality for kidney stone diagnosis due to its accessibility and lower cost, its accuracy compared to computerized tomography (CT), the gold standard, remains understudied. This cross-sectional study evaluated the diagnostic accuracy of ultrasound for detecting and characterizing kidney stones compared to computed tomography (CT). Fifty-six patients with suspected kidney stones based on flank pain underwent abdominal ultrasound to assess stone presence, size, location, and the severity of any hydronephrosis (kidney swelling). These findings were then confirmed with a subsequent non-contrast CT scan. There was a fair agreement between US and CT (Kappa = 0.368) for detecting the stone location. The US could not detect 7 (12.5%) stones, being less sensitive in the middle and upper calyx compared to CT. There was a fair agreement between the US and CT (Kappa = 0.394) for detecting the severity of hydronephrosis. The US was less sensitive to moderate and severe hydronephrosis compared to CT. The abdominal ultrasound demonstrated excellent reliability for stone size measurement (intraclass correlation = 0.924), with CT measurements only slightly larger on average (mean difference 0.9 mm). Although abdominal ultrasound provides reliable stone size assessment, its capacity to accurately localize stones and assess hydronephrosis severity is limited.
... sizes, structures, and locations 10 . Kidney stones are classified into the following types, calcium oxalate (CaOx) is the most predominant type of all kidney stones around the world 11,12 , in Iraq; previous studies have reached the same results indicating that CaOx stones are the most common type 13 . It is followed by calcium phosphate, struvite, uric acid, and cysteine which are the least common 14,15 . ...
The alterations in glyoxylate reductase and hydroxy-pyruvate reductase concentrations in the sera and the genetic alterations associated with calcium oxalate kidney stones in Iraqi patients were not studied previously so this study aimed to focus on these points. This study included 80 subjects; they were 50 patients with calcium oxalate stones compared to 30 apparently healthy controls. Biochemical investigations for kidney functions (creatinine, urea, and uric acid), were performed on the sera of both groups. Also, complete blood count, random blood sugar, and blood group tests. Furthermore, urine had been collected for General Urine Examination to visualize oxalate crystals in the urine of the patient. Also, the GRHPR enzyme concentration was measured by ELISA for both groups. The DNA was isolated from whole blood and the target DNA was amplified by PCR then the pathogenic mutations at c.295C>T (rs119490108), c.165G>A (rs180177314) and c.904C>T (p. Arg302Cys) rs180177322 were investigated by direct sequencing of the product, and then the results were analyzed. This study found that the concentration of the enzyme in the controls (4.78 ± 1.06 mg/dl) was significantly higher than its concentration in the patients (0.411 ± 0.02mg/dl). The pathogenic mutations were not found in both studied groups, but other positions were found polymorphic; at exon 4 the rs2768659 (A>G), rs1294628807 (G>A) and rs2736664 (C>T), at exon 6: c.579A>G (p. Ala193=) rs309458 and c.494-68A>G rs309459 and at exon 9 c.*146A>G rs1057507. In conclusion, this study found that calcium oxalate stones were associated with decrease GRHPR enzyme concentration in the patients compared to the control group which may be caused by mutations or epigenetics masking of the gene expression.
... The most common of these is calcium oxalate (Alelign & Petros, 2018;Hesse, 2009). To date, kidney stones have been studied for their mineralogy (e.g., Bhatt & Paul, 2008;Mukherjee, 2014;Orlando et al., 2008), micromorphology (e.g., Abboud, 2008;Chandrajith et al., 2019;Didenko et al., 2014;Khan, 2021;Racek et al., 2019), geochemistry (e.g., Keshavarzi et al., 2015;Silva et al., 2010), epidemiology (distribution in human populations), physiopathology (processes) and etiology (causes) (e.g., Afaj & Sultan, 2005;Evan, 2010;Grases et al., 1998;Knoll, 2010;Romero et al., 2010;Sarıkaya et al., 2020). Analysis and examination of kidney stones are important in the diagnosis and initial treating of a patient with urolithiasis (Grases et al., 1998). ...
This study describes the primary characteristics of the selected kidney stones surgically removed from the patients at the Mersin University Hospital in the southern Turkey and interprets their formation via petrographic, geochemical, XRD, SEM–EDX, and ICP-MS/OES analyses. The analytical results revealed that the kidney stones are composed of the minerals whewellite, struvite, hydroxyapatite, and uric acid alone or in different combinations. The samples occur in staghorn, bean-shaped composite, and individual rounded particle shapes, which are controlled by the shape of the nucleus and the site of stone formation. The cross-section of the samples shows concentric growth layers due to variations in saturation, characterizing the metastable phase. Kidney stone formation includes two main stages: (i) nucleation and (ii) aggregation and/or growth. Nucleation was either Randall plaque of hydroxyapatite in tissue on the surface of the papilla or a coating of whewellite on the plaque, or crystallization as free particles in the urine. Subsequently, aggregation or growth occurs by precipitation of stone-forming materials around the plaque or coating carried into the urine, or around the nucleus formed in situ in the urine. Urinary supersaturation is the main driving force of crystallization processes; and is controlled by many factors including bacterially induced supersaturation.
... The results of the present study just enable a first and preliminary comparison (Table 3) between the frequency distribution of the mineralogical composition of uroliths from the Campanian region with other investigations across the world. However, it is a matter of fact that the analysis of 49 urinary stones cannot provide a reliable and exhaustive representation of urolithiasis in a complex and multifactorial territory such as the Campania region, especially when compared to a high variable number of samples such as those reported in the considered case studies (from 25 samples for Iraq [17] to 27,980 samples for France [83]). ...
... However, the higher percentages were found for northern Iran [87], China [88,89] and Democratic Republic of Congo [90][91][92]. Furthermore, Campania and Basilicata regions display the lowest percentage of phosphate stones (4-5%) along with Iran and Jordan, whereas it is significantly higher for other countries such as Iraq [17] and Japan [85]. Nevertheless, the frequency of purines in Campanian region is the highest ever observed (ca. ...
... 1.04) and Iraq (ca. 4.0) [16,17]. This range is quite consistent with the prevalence of urolithiasis in Italy [3], although local sex disparities can be observed [2][3][4]12]. ...
The present investigation exposes the main results raised from an active collaboration started in 2018 with the San Pio Hospital (Benevento, Southern Italy), aiming at a detailed mineralogical investigation of urinary stones of patients from the Campania region. Forty-nine uroliths (both bladder and kidney stones) have been surgically collected from patients admitted between 2018 and 2020 at the Department of Urology of the San Pio Hospital and characterized for clinical purposes and environmental biomonitoring from a mineralogical point of view. Possible causes and environmental implications were inferred according to the morpho-constitutional classification of the uroliths carried out by means of a conventional analytical approach. The mineralogical frequency distribution of uroliths from the Campanian region can be discussed as a function of dietary, socio-demographic, and environmental risk factors. Whewellite [CaC2O4·H2O] and weddellite [CaC2O4·(2+x)H2O], along with anhydrous calcium oxalate, represent the main mineralogical phases forming the biominerals examined here. Worth to note is that the percentage of oxalates in the Campanian region (ca. 51%) is quite comparable to those of other Mediterranean areas. Frequent uricite [C5H4N4O3] (ca. 33%), mainly observed in bladder stones of older male patients, could be related to an incorrect lifestyle and dietary habits. Occurrence of lower percentages of phosphate (i.e., brushite [CaHPO4·2(H2O)] and carbonated apatite [Ca10(PO4CO3)6(OH)8]) and mixed stones (such as, for example, a mixture of ammonium urate [NH4C5H3N4O3] and calcium oxalates) indicates specific etiopathogenetic mechanisms, suggesting proper therapeutical approaches.
... The current study found that the high occurrence of renal stones in patients aged from 50 to 57 years. Another study performed by Afaj and Sultan (2005), showed the highest percentage of the cases was in the 15-50 age group (6). This is may be due to difference in population and regions of the two studies. ...
This study was done to calculate the incidence of urinary stones in relation to age, gender and chemical composition of urinary stone. Moreover, the study was conducted in the period from the 1st of December 2020 to 1st of December 2021. Hundred patients were included in the study from both sexes, their ages ranged from 24 to 57year whom diagnosed with renal stone. All samples analyzed qualitatively by standard methods. The study showed that renal stones were more in males (80%) than females (20%) with male to female ratio of 4:1 with higher occurrence at the age of 50-57years. The commonest type was the calcium salts (oxalate and non-oxalate). Finally, the researcher concludes that the urinary stones are a common disease in west of Iraq with higher incidence in men than women. The commonest age of occurrence is 50-57 years and the commonest type is calcium oxalate.
... The fluoride in the intestine favours the absorption of oxalate and promotes excess of oxalate excretion and formation of calcium fluoride in urine [24]. Excretion of high concentration of magnesium in urine is also one of the causes for stone formation in kidney [25]. On other hand one of the studies conducted by Chandrajith et al., have not found any association between hardness of water and urolithiasis [26]. ...
Kidney stone disease is an oldest known and widespread medical condition characterised by its high prevalence in all over the world. Literature suggests that around 9–12% of population in industrialised countries have kidney stone disease in their lives with the 30–50% of reoccurrence rate. Because of high prevalence, recurrent and unpredictable nature of stone formation and its predominance mainly in adults contributes to the substantial impact on society, individual and health care system. In light of these trends, it’s imperative to use optimum preventive strategies to reduce the burden of kidney stone disease on individual and society. The aetiology of kidney stone disease is a multifactorial and it’s related to diet, environmental factors, genetics, metabolic syndromes and various life style factors. Its noteworthy that dietary and life style modification are the major contributors in the prevention of kidney stone reoccurrence. Dietary interventions aim to reduce the urinary abnormalities known to promote lithogenesis. Therefore, modification in the dietary factors is appealing way to patients and physicians in the treatment and prevention of stone recurrence as it is relatively inexpensive and safe. So, the present chapter is focusing on the role of dietary supplements in prevention of renal stones.
... Infrared spectroscopy is a simple and convenient method for analyzing the mineralogical composition of kidney stones [26][27][28]. Infrared spectra obtained by using an infrared spectrometer can identify the following crystalline compounds in collected kidney stones: , and ammonium acid urate (AAU, C 5 H 7 N 5 O 3 ). For example, symmetric and asymmetric absorption bands, which appeared at 3480, 3423, and 3055 cm −1 possibly due to asymmetric O-H stretching, characterize the calcium oxalate monohydrate kidney stone [29]. ...
The chemical composition of biominerals is essential to understand biomineral formation, and is regarded as an attractive subject in bio-mineralogical research on human kidney stones (urinary calculi). In order to obtain more geochemically interpreted data on biogenic minerals, mineralogical compositions, major and trace element contents of sixty-six kidney stone samples derived from stone removal surgeries were measured. Infrared spectroscopy results showed that calcium oxalate monohydrate (COM) and calcium oxalate dihydrate (COD) were two main mineral components of kidney stones. Geochemical results indicated that the major and trace element contents display in the order of Ca > Mg > Na > K > Zn >Fe > Pb > Ba > Cu > Ti > Mo > Cd > Cr. Except for Ca, Mg was regarded as the most abundant element. Zn exhibited higher concentrations relative to other trace elements, suggesting a potential substitution of calcium by metal ions with a similar charge and radius rather than by the metal in the formation of kidney stones. Pb showed much higher concentration than previous studies, indicating Pb enrichment in the environment. In order to discern multi-element relationships within kidney stones, the principal component analysis was applied. Three principal components (PCs, eigenvalues > 1) were extracted to explain 64.4% of the total variances. The first component exhibited positively correlated Na-Zn-Cr-Mo-Cd-Pb, while the second component represented more positively weighted Mg–K–Ba-Ti. Fe-Cu had a positive correlation in the third component. This study suggests that Ca has a preference of uptake by oxalates during human urinary stone crystallization, while other alkali metals and alkaline earth metals precipitate with phosphate.
... Bellizzi et al. (1998) have reported that increasing the hardness level of drinking water can increase the amount of urinary calcium by 50% if oxalate is not excreted. Mineralogical studies of the physicochemical properties of urinary stones in different parts of the world indicated that the incidence of urinary stones is affected by a set of biological and environmental parameters (Abboud, 2008b;Afaj & Sultan, 2005;Ancharov et al., 2005;Chandrajith et al, 2019;Qaader et al., 2006). In fact, other investigations cannot identify a specific parameter as the key cause of the disease (Kerr & Laing, 1992;Al-Eisa et al., 2002;Basiri & Shakhssalim, 2010a, 2010b. ...
... The urinary stones formation and the predominant chemical composition of stones depend on age and sex (Knoll, 2010). The prevalence rate reported by the age group continuously shows the pattern of increase and decrease with increase in the population age (Afaj & Sultan, 2005). The peak age of prevalence in Iran, Japan and the USA is similar, ranging from 40 to 49 years (Romero et al., 2010). ...
... Phosphate and cystine stones account for a small percentage of urinary stones. External morphology, color, texture, structure and size of crystals are important factors providing useful information about age, mineralogical composition and possible crystallization processes in biominerals (Afaj & Sultan, 2005;Zarasvandi et al., 2014). In addition, the study of thin sections under polarizing microscopic in geological and geochemical studies is important to understand how urinary stones are formed (Zarasvandi et al., 2014). ...
Owing to the importance of urinary stones as one of the biominerals in the human body, it is necessary to investigate their chemical composition and mineralogy. In this matter, a mineralogical study using X-ray diffraction and scanning electron microscopy indicated that urinary stones in Lorestan Province were divided into 5 groups of calcium oxalate, urate, cysteine, phosphate and mixed stones (Whewellite, uric acid, phosphate). In this regard, the microscopic studies revealed that Whewellite was the most important mineral phase among various phases. In the following, the major and rare elements of each group were determined by inductively coupled plasma mass spectrometry (ICP-MS) and X-ray fluorescence analysis. The obtained results demonstrated that Ca was found the most abundant element in urinary stones. In the analysis results of the major oxides, compared to other major oxides, CaO had the highest frequency in urinary stones. The reason was due to the role of calcium in most of the basic functions in cell metabolism. The average values of isotope 13C and 16O in the studied urinary stones were obtained − 33.71 and − 20.57, respectively. Overall, the values of 13C isotope in urinary stones were lower than those in the similar stones and human hard tissues in other countries.
... containing stones in Pakistan, Egypt, and Iraq (18)(19)(20)(21). In the present study, the prevalence of uric acid containing stones was also high in Southern India in accordance with previous reports. ...
Objective: To study urinary stone composition patterns in different populations around the world.
Materials and methods: Data were collected by reviewing charts of 1204 adult patients of 10 countries with renal or ureteral stones (> 18 years) in whom a stone analysis was done and available. Any method of stone analysis was accepted, but the methodology had to be registered.
Results: In total, we observed 710 (59%) patients with calcium oxalate, 31 (1%) with calcium phosphate, 161 (13%) with mixed calcium oxalate/calcium phosphate, 15 (1%) with carbapatite, 110 (9%) with uric acid, 7 (< 1%) with urate (ammonium or sodium), 100 (9%) with mixed with uric acid/ calcium oxalate, 56 (5%) with struvite and 14 (1%) with cystine stones. Calciumcontaining stones were the most common in all countries ranging from 43 to 91%. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones in most countries except Egypt and India. The rate of uric acid containing stones ranged from 4 to 34%, being higher in Egypt, India, Pakistan, Iraq, Poland and Bulgaria. Struvite stones occurred in less than 5% in all countries except India (23%) and Pakistan (16%). Cystine stones occurred in 1% of cases.
Conclusions: The frequency of different types of urinary stones varies from country to country. Calcium-containing stones are prevalent in all countries. The frequency of uric acid containing stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase in the frequency of uric acid containing stones in association with high obesity rates. Struvite stones are decreasing in most countries due to improved health conditions.
