Induced urinary crystal formation as an analytical strategy for the prediction and monitoring of urolithiasis and other metabolism-related disorders.
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In case of urolithiasis, induced crystal formation in native urine has led to the development of the Bonn-Risk-Index (BRI), a valuable tool to quantify an individual's risk of calcium oxalate urolithiasis.If the progression of a disease is associated with characteristic changes in the activities of urinary components, this leads to an altered urinary crystallisation capacity.Since crystal formation inherently takes into account the entire urinary composition, the influence of the disease on individual urinary parameters does not have to be known in order to monitor the consequent pathologic alterations.
Affiliation: Deutsches Harnsteinzentrum, Urologisches Zentrum Bonn Friedensplatz, Friedensplatz 16, Bonn 53111, Germany ; NTTF Coatings GmbH, Maarweg 32, Rheinbreitbach 53619, Germany.
ABSTRACT
Crystal formation reflects the entire composition of the surrounding solution. In case of urolithiasis, induced crystal formation in native urine has led to the development of the Bonn-Risk-Index (BRI), a valuable tool to quantify an individual's risk of calcium oxalate urolithiasis. If the progression of a disease is associated with characteristic changes in the activities of urinary components, this leads to an altered urinary crystallisation capacity. Therefore, the results of induced urinary crystal formation can be used to detect and monitor any disease linked to the altered urinary composition. Since crystal formation inherently takes into account the entire urinary composition, the influence of the disease on individual urinary parameters does not have to be known in order to monitor the consequent pathologic alterations. In this paper, we review the background of urinary crystal formation analysis and describe its established application in urolithiasis monitoring as well as potential further fields of clinical application. No MeSH data available. Related in: MedlinePlus |
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Figure 8: Examples of disease patterns affecting renal function or urinary composition. The resulting urine's crystal formation risk with respect to a particular salt can be specifically and significantly altered compared to that of a healthy subject. Mentions: A strategic shift from ‘disease care’ (i.e. repeated cost-intensive and side effect beset ‘stone removal only’) to ‘health care’ by individualised recurrence prevention could be achieved by providing adequate diagnostic tools. A point-of-care device like the BRI-on-Chip to measure urolithiasis risk by induced urinary crystal formation might be used for screening (for prophylaxis, e.g. children with a parent suffering from recurrent urolithiasis or chronic renal disease) and as a test for individual adjustment and effective control of metaphylaxis.Induced crystal growth in urine can be a powerful strategy not only in urolithiasis therapy but also for a wide spectrum of diseases affecting metabolism (Figure 8), either to identify chronically altered or changing renal clearance patterns associated with metabolic diseases, or for targeted evaluation of the overall influence of therapeutic measures, including dietary habits (i.e. treatment success). In the following paragraphs, some diseases known to affect renal handling and to augment crystal formation risk are presented, which might benefit from BRI-like analyses of induced urinary crystal formation. |
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Affiliation: Deutsches Harnsteinzentrum, Urologisches Zentrum Bonn Friedensplatz, Friedensplatz 16, Bonn 53111, Germany ; NTTF Coatings GmbH, Maarweg 32, Rheinbreitbach 53619, Germany.
No MeSH data available.