Comparison Of Crytalluria In Patients Drinking Either Free Or Controlled Water Intake

B. Kacem¹, Z. Kaid-Omar¹, M. Daudon², A. Semmoud³, B. Lacour¹, D. Bougeard³ and A. Addou¹*

¹Laboratoire STEVA, Facult? des Sciences, University of Mostaganem (Algeria). ²Laboratoire de Biochimie A, H?pital Necker, Paris, (France). ³Laboratoire de Spectrochimie Infrarouge et Raman (LASIR), Universit? des Sciences et Technologies, Villeneuve d’Ascq (France)

ABSTRACT: In 223 stone formers, standardised daily water supply of 3 litres on average has enabled the reduction of crystalluria occurrence from 51.8% before to 23.3% following high water intake advice. After urine storage at +4°C for 48 hours, crystalluria occurred in 90.2% and 54.1% respectively. For comparison, spontaneous crystalluria was studied in 61 control subjects. It was present in 30% of the samples on direct examination and 60.7% after storage at +4°C. Interestingly, the occurrence of crystalluria in stone formers while on free water intake was varying from 46.6% to 60.6% of the urine samples according to the anatomic location of the stone. On standardised water supply conditions, crystalluria decreased in all patients, except patients with vesical lithiasis, but the number of the latter patients was in fact too low to draw tangible conclusions. Crystalluria of weddellite was the most frequent (69.5% of the cases), pure in 39.3% and associated to other crystals in 30.2%. Amorphous urates were present alone in 14.4% and associated in 26% of the crystallurias. Carbapatite was present always associated with other species in 13.5% of the cases in the same way as whewellite in 13.5% of the cases. Besides, the water intake has permitted the spontaneous evacuation of 34.1% of the stones in situ. The composition of the latter was mostly whewellite in 57.9% of the cases, carbapatite in 18.4%, and struvite in 6.6% of the cases. The expulsion kinetics study has shown that the maximum peak of stone evacuation is obtained after 30 to 45 days on diuresis treatment, 71.4% of the evacuations being observed within six weeks following the beginning of the treatment.

KEYWORDS: Crystalluria; urolithiasis; calcium oxalate; carbapatite; diuresis

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