Professional Documents
Culture Documents
Struvite stones
Composed of magnesium ammonium phosphate triple phosphate crystals Precipitate at alkaline pH created by urease producing bacteria such as Proteus or Klebsiella Urease Urea 2NH3 + CO2 NH3 + H20 NH4+ + OH-
Cystine stones
Cystine stones may also
form staghorn calculi Cystinuria is a rare autosomal recessive disease responsible to 1-2% of stone formers Caused by mutations in genes, SLC3A1 and SLC7A9, that are involved in amino acid transport Median age of onset of kidney stones is 12
Hexagonal crystals in urine sediment Treatment with fluids, alkali, cystine binding drugs penicillamine, tiopronin, and captopril
Surgical management
Open surgery Percutaneous nephrolithotomy (PNL) Shock wave lithotripsy (SWL)
Retrospective study
112 patients with staghorn calculus with mean follow up 7.7 years
Renal deterioration occurred in 28% Worse outcome associated with solitary kidney, recurrent stones, hypertension, urinary diversion, and neurogenic bladder
J Urol 1995 May;153(5):1403-7