Summary
Objective
Calcium oxalate stones are the most common type among stone-forming patients and in
some cases result from predisposed genetic conditions. In this work, we examined the
differences in structure and chemical composition between oxalate stones from patients
from three groups: 1) pediatric patients that were genetically predisposed (primary
hyperoxaluria) to form stones (PPH); 2) control pediatric patients that did not have
such genetic predisposition (PN-PH); 3) adult patients that formed oxalate stones
without the genetic predisposition (A-CaOx). A variety of instrumental analyses were
conducted to identify physicochemical properties of stones characteristic of predisposed
pediatric (PPH), pediatric hyperoxaluria (PN-PH), and adult (A-CaOx) patient populations.
Methods
Genetic variants of 16 stone-forming patients were determined using whole-exome gene
sequencing. Components of stones from PPH (n = 6), PN-PH (n = 5), and A-CaOx (n = 5)
groups were identified using Fourier transform infrared (FTIR) spectroscopy. Stone
morphology and density were evaluated using high resolution X-ray computed tomography
(micro-XCT). Stone microstructure and elemental composition were mapped with scanning
electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy, respectively.
Results
Calcium oxalate bipyramidal crystals were found on stones from all groups. Stones
from PPH patients with PH types I and II were composed of calcium oxalate monohydrate
(COM) with relatively uniform mineral density (1224 ± 277 mg/cc) and distinct smooth
surfaces. By contrast, micro-spherical calcium phosphate particles were found only
on PN-PH stones, which also showed a broader range of mineral densities (1266 ± 342
mg/cc). Stones from the PN-PH group also contained phosphorus (P), which was absent
in NP-PH stones. A-CaOx stones were of significantly lower mineral density (645 ± 237
mg/cc) than pediatric stones and were more heterogeneous in their elemental composition.
Conclusion
Graphical AbstractStructure and elemental composition of pediatric primary hyperoxaluria (PPH), pediatric
without primary hyperoxaluria (PN-PH), and adult calcium oxalate (A-CaOx) stones.
Keywords
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Article info
Publication history
Published online: November 20, 2020
Accepted:
November 13,
2020
Received in revised form:
November 9,
2020
Received:
June 26,
2020
Identification
Copyright
© 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
