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J Endourol. 2016 May;30(5):609-14. doi: 10.1089/end.2015.0692.

Can the Presence of Crystalluria Predict Stone Formation in Patients with Cystinuria?

Author information

1
1 The Urology Centre, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
2
2 Department of Cytopathology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
3
3 Department of Surgery and Cancer, Imperial College London , London, United Kingdom .
4
4 Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .

Abstract

OBJECTIVES:

To determine the feasibility of crystalluria as a biomarker for stone disease in patients with cystinuria.

PATIENTS AND METHODS:

All patients attending a multidisciplinary cystinuria clinic provided early morning urine (EMU) and clinic urine (CU) samples for crystal measurement over a 2-year period (August 1, 2010, to July 31, 2012). Association between presence of crystals, presence of stone(s), and new stone growth (NSG) was determined using the chi-square test. Crystal numbers in EMU and CU were compared in patients with stones/NSG and no stones/stable disease using the Mann-Whitney U test.

RESULTS:

There was a statistically significant difference between the presence of crystalluria and presence of stones for CU (chi-square test = 5.86, df = 1, p = 0.02) but not EMU (chi-square test = 1.92, df = 1, p = 0.17) and between the presence of crystalluria and NSG for CU (chi-square test = 8.10, df = 1, p = 0.004) but not EMU (chi-square test = 1.32, df = 1, p = 0.25). Patients with stones and NSG have higher levels of crystalluria in CU than patients with no stones or stable disease (stones, median = 41, interquartile range [IQR] = 600 vs median = 0, IQR = 21, p = 0.01; NSG, median = 49, IQR = 525 vs median = 0, IQR = 40, p = 0.01).

CONCLUSION:

The presence of crystalluria in CU samples is associated with the presence of stones. Crystalluria is comparable to ultrasound and may serve as a useful adjunct to predict whether a patient with cystinuria has stones, which could guide the frequency of clinic review and imaging.

PMID:
26781171
DOI:
10.1089/end.2015.0692
[Indexed for MEDLINE]

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