Kidney and gallstones represent a widely prevalent and costly health issue. The chemical composition of gallstones or kidney stones is essential to study the aetiopathogenesis of gallstone disease and to help identify the cause of the kidney stone and, where possible, to prevent the recurrence of more stones. Both health conditions are very common in this part of the country.
GALLSTONE ANALYSIS
The problem of gallstone is probably related to obesity, cardiovascular disorders, metabolic syndrome, and dietary habits. Studies on gallstone composition carried out in different parts of the world indicate a close link with dietary habits and ethnicity. Gallstone analysis is done to devise a method for systematic classification of gall bladder stones, analyse the clinical characteristics of each type of stone and provide a theoretical basis for the study of the formation mechanism of different types of gallbladder stones.
KIDNEY STONE ANALYSIS
The kidney stones can be formed in the kidneys and cause problems either because they grow large enough to obstruct urine flow or because they become dislodged or break off and begin to travel from the kidney through the ureter; they can cause temporary obstruction and stretch, irritate and/or damage the walls of the ureters. This movement can cause abrupt, extremely severe pain that may be intermittent or continuous.
Many stones will eventually pass out of the body in the urine, but some are too large or have too irregular a shape for the body to expel. With very large stones, which typically cannot pass from the kidney into the ureters, and for smaller stones that get into but do not pass through the ureters, some form of treatment is needed.
The stone may be surgically removed. With some stones, it is possible to use extracorporeal shock wave lithotripsy. This treatment pulverises the stone using targeted shock waves.
Stones can develop for several reasons, but the most common is because there is a high concentration of a particular chemical in the urine that precipitates and forms crystals.
This can happen when a person produces and excretes an excess amount of the chemical.
A kidney stone analysis is performed to determine the chemical composition of a stone when it is filtered out of the urine or removed surgically from the urinary tract. A laboratory will also typically document the physical characteristics of a stone – its size, shape, colour, weight and texture. The stone may also be fractured so that its layers can be observed. One or more tests will be performed to determine the stone’s composition.
WHEN ARE THEY DONE?
Gallstones are collected from patients after cholecystectomy at hospitals.
Kidney stone analysis is done when a person has passed kidney stone and it has been filtered out of the urine or when a stone has been removed from some part of the urinary tract through surgicalprocedure. Signs and symptoms associated with a kidney stone may lead a health practitioner to search for a stone either in the urine passed out or within the body using imaging tests.
WHAT DOES THE TEST RESULT MEAN?
Gallstones are not really stones. They are pieces of solid material that form in the gallbladder. The two most common types are cholesterol stones and pigment stones.
A kidney stone analysis identifies the chemical composition of the stone. Common types of kidney stones include:
– Calcium oxalate
– Calcium phosphate
– Uric acid
– Struvite (magnesium and ammoinium phosphate) – stones associated with bacterial infection
– Cystine – stones associated with an inherited excess of cystine excretion
– Drug-related – stones that are associated with drugs
A person with an underlying disease or condition may produce and/or excrete an excess of a specific chemical into the urine. Not drinking enough fluids and/or having urine with a high or low pH can contribute to a person’s risk of forming stones. Preventing kidney stones from developing again depends upon identifying and addressing the cause of the stone formation.
Some reasons why kidney stones are formed are:
– An inherited tendency to absorb more than the normal amount of calcium from the diet, causing high urine calcium.
– Dietary factors – consuming food or drink high in calcium or oxalate may result in increased amount of these substances in the urine.
– Factors affecting absorption of nutrients, such as inflammatory bowel disease or intestinal surgery – an imbalance in nutrient absorption may result in excess urinary calcium.
– A variety of metabolic disorders – these may lead to some degree of metabolic acidosis, resulting in an increased amount of calcium excreted in the urine.
– Uric acid stone may be formed when a person excretes excess uric acid due to conditions such as gout or disorders of uric acid metabolism.
CONCLUSION
Composition of kidney stone varies from patient to patient, based on the location where they are formed, food habits of individual and geographical location. As composition of urinary stones varies from place to place, qualitative analysis of crystals material present in kidney stones is essential to provide ideal treatment to patients with a history of recurrent stone formation.
Of all the techniques employed for the analysis of kidney or gall stones, the Fourier Transform Infrared Spectroscopy (FTIR) is considered to be the best. It provides an unambiguous information about the stone composition, both main substances and trace elements, all essential to guide therapy. A study of the chemical composition of kidney/gall stones is important for understanding the etiology as well and the therapy for stone disease is usually based on the analysis of calculi thus permitting proper management of the disease.
(The writer is Junior Consultant Pathologist, BABINA Diagnostics, Imphal)
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