Chemical composition and morphology of renal stones.

Two issues related to nephrolithiasis are explored: (1) does the chemical composition and morphology of renal calculi in South Poland overlap with the studies from other countries? and (2) are there possibilities to evaluate in vivo chemical composition of stones using computed tomography? The study was conducted on 108 renal stones. X-ray fluorescence, X-ray diffraction and Fourier transformed infrared spectroscopy were used to determine the chemical composition. The morphology of the stones was examined using micro computed tomography. The stone chemical composition in South Poland indicate that calcium oxalate monohydrate was overwhelmingly dominant (84%) followed by hydroxyapatite (8%) and struvite (6%). The occurrence of uric acid stones was very low (2%). The relative frequency of various stone types is similar in South Poland to other industrialized countries. The studied renal stones were characterized by a large variability in the concentrations of both major and trace elements. The maximum/minimum concentration ratio exceeds two orders of magnitude. Significant morphological differences have been observed between different types of stones. The stones were composed of oxalate polyhedrons stuck together or had the phosphate core overlaid with layers oxalate and organic mater. The use of CT to identify stone type seems to be limited.