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Vol. 88, No. 4, 2001
Issue release date: 2001
Nephron 2001;88:320–328

Study on Concretions Developed around Urinary Catheters and Mechanisms of Renal Calculi Development

Grases F. · Söhnel O. · Costa-Bauzá A. · Ramis M. · Wang Z.
aLaboratory of Renal Lithiasis Research, Faculty of Sciences, University Illes Balears, Palma de Mallorca, Spain; bUniversity of J.E. Purkyne, Ústí nad Labem, Czech Republic, and cDepartment of Physical Chemistry, University of Leoben, Austria

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Aims: To study the structure and composition of encrustation and concretions developed on urinary catheters to better understand their formation mechanism to be able to prevent them. Methods: The surface of catheters was studied by direct and scanning electron microscopy observation. In vitro formation of encrustations was performed in synthetic urine. Results: The surface of catheters was covered by a continuous layer of organic matter, on which a thin scale consisting of crystals of calcium oxalate monohydrate (COM), uric acid anhydrous or calcium phosphate developed. Encrustations observed on catheters generally exhibited the same composition as the previously developed renal calculi. In catheters collected from patients without previous episodes of renal calculi or with previous episodes of infected renal calculi in which infection was afterwards eradicated, on the first organic layer, in that case plate-like COM crystals forming a columnar layer were observed. In vitro experiments demonstrated that COM columnar structures were only formed when normocalciuric urine containing organic matter was used, and the presence of crystallization inhibitors, as phytate, notably delayed their formation. Conclusion: Calcium oxalate was the main crystalline phase developed on catheters inserted in patients, specially in the absence of urinary infection or urinary pH values <5.5 and high urinary uric acid levels. Thus, prophylaxis of encrustations may consist of preventive measures usually applied in cases of recurrent idiopathic calcium oxalate urolithiasis.

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  1. Kim KM: The stones. Scan Electrom Microsc 1982;4:1635–1660.
  2. Hesse A, Berg W, Bothor C: Scanning electron microscopic investigations on the morphology and phase conversions of uroliths. Int Urol Nephrol 1979;11:11–20.

    External Resources

  3. Iwata H, Iio S, Nishio S, Takeuchi M: Architecture of mixed calcium oxalate dihydrate and monohydrate stones. Scanning Microsc 1992;6:231–238.
  4. Khan SR: Calcium phosphate/calcium oxalate crystal association in urinary stones: Implications for heterogeneous nucleation of calcium oxalate. J Urol 1997;157:376–383.

    External Resources

  5. Daudon M, Bader CA, Jungers P: Urinary calculi: Review of classification methods and correlations with etiology. Scanning Microsc 1993;7:1081–1106.

    External Resources

  6. Cifuentes L, Miñón-Cifuentes J, Medina JA: New studies on papillary calculi. J Urol 1987;137:1024–1029.

    External Resources

  7. Grases F, March JG, Conte A, Costa-Bauzá A: New aspects on the composition, structure and origin of calcium oxalate monohydrate calculi. Eur Urol 1993;24:381–386.
  8. Leusmann DB: A classification of urinary calculi with respect to their composition and micromorphology. Scand J Urol Nephrol 1991;25:141–150.
  9. Grases F, Söhnel O, Villacampa AI, March JG: Phosphates precipitating from artificial urine and fine structure of phosphate renal calculi. Clin Chim Acta 1996;244:45–67.
  10. Fried FA, Vermeulen CW: Artificial uric acid concretions and observations on uric acid solubility and supersaturation. Invest Urol 1964;2:131–144.
  11. Meyer JL, Bergert JH, Smith LH: Epitaxial relationships in urolithiasis: The calcium oxalate monohydrate-hydroxyapatite system. Clin Sci Mol Med 1975;49:369–374.

    External Resources

  12. Khan SR, Hackett RL: Crystal-matrix relationships in experimentally induced urinary calcium oxalate monohydrate crystals, an ultrastructural study. Calcif Tissue Int 1987;41:157–163.
  13. Vermeulen CW, Lyon ES, Ellis JE, Borden TA: The renal papilla and calculogenesis. J Urol 1967;97:573–582.

    External Resources

  14. Azoury R, Garside J, Robertson WG: Calcium oxalate precipitation in flow system: An attempt to simulate the early stages of stone formation in the renal tubules. J Urol 1986;136:150–153.

    External Resources

  15. Bouropoulos N, Bouropoulos C, Klepetsanis PG, Melekos M, Barbalias G, Koutsoukos PG: A model system for the investigation of urinary stone formation. Br J Urol 1996;78:169–175.
  16. Grases F, Costa-Bauzá A, March JG, Söhnel O: Artificial simulation of renal stone formation. Influence of some urinary components. Nephron 1993;65:77–81.
  17. Grases F, García-Ferragut L, Costa-Bauzá A: Study of the early stages of renal stone formation: Experimental model using urothelium of pig urinary bladder. Urol Res 1996;24:305–311.
  18. Achilles W, Jöckel U, Schaper A, Burk M, Riedmiller H: In vitro formation of ‘urinary stones’: Generation of spherulites of calcium phosphate in gel and overgrowth with calcium oxalate using a new flow model of crystallization. Scanning Microsc 1995;9:577–586.
  19. Finlayson B, Khan SR, Hackett RL: Mechanisms of stone formation – An overview. Scanning Electron Microsc 1984;3:1419–1425.
  20. Mandel N: Mechanism of stone formation. Semin Nephrol 1996;16:364–374.
  21. Griffith DP, Osborne CA: Infection (urease) stones. Miner Electrolyte Metab 1987;13:278–285.
  22. Grases F, Costa-Bauzá A, García-Ferragut L: Biopathological crystallization: A general view about the mechanisms of renal stone formation. Adv Colloid Interface Sci 1998;74:169–194.
  23. Robert M, Boularan AM, El Sandid M, Grasset D: Double-J ureteric stent encrustations: Clinical study on crystal formation on polyurethane stents. Urol Int 1997;58:100–104.
  24. Choong SKS, Hallson P, Whitfield HN, Fry CH: The physicochemical basis of urinary catheter encrustation. Br J Urol 1999;83:770–885.
  25. Prien EL: Calcium oxalate renal stones. Annu Rev Med 1975;26:173–179.
  26. Grases F, Costa-Bauzá A, Conte A: Studies on structure of calcium oxalate monohydrate renal papillary calculi. Mechanism of formation. Scanning Microsc 1993;7:1067–1073.

    External Resources

  27. Khan SR: Mechanisms involved in calcium oxalate nephrolithiasis based on studies in an animal model. Ital J Miner Electrolyte Metab 1995;9:3–9.
  28. See WA, Williams RD: Utothelial injury and clotting cascade activation: Common denominators in particulate adherence to urothelial surfaces. J Urol 1992;147:541–548.
  29. Chandhoke PS, Fan J, May DJ, Yagisawa T: Role of the renal collecting system in initial kidney stone formation. J Endourol 1999;13:601–604.
  30. Grases F, Söhnel O, Millán A, Costa-Bauzá A: Calcium oxalate crystallization and renal calculi formation. Cur Top Crystal Growth Res 1994;1:367–389.

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