Ionic and macromolecular modifiers of crystallization of calcium salts in urine

  • W. G. Robertson
  • D. S. Scurr
  • V. J. Sergeant
Conference paper
Part of the Fortschritte der Urologie und Nephrologie book series (2824, volume 23)


Urine is said to contain many substances which have the ability to modify the rate of crystallization of calcium salts, and numerous studies have been carried out to identify these modifiers and to establish their role in the formation of calcium-containing urinary stones (1–8). However, there are many apparently confusing and conflicting data on this subject. Part of the problem is due to the lack of a clear definition of what is meant by a modifier of crystallization; part is due to the unwarranted generalisation that what modifies the crystallization of one salt must modify that of another; part is due to the lack of definition of which particular crystallization processes are being influenced by a given modifier; and part is due to the great variety of test systems and conditions employed in the evaluation of the importance of a given modifier. Modifiers of crystallization are of two basic types; those which inhibit the rate of crystallization of a given salt and those which enhance or promote it.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fleisch H, Bisaz S (1964) The inhibitory effect of pyrophosphate on calcium oxalate precipitation and its relation to urolithiasis. Experientia 20: 276–277PubMedCrossRefGoogle Scholar
  2. 2.
    Robertson WG, Peacock M, Nordin BEC (1973) Inhibitors of the growth and aggregation of calcium oxalate crystals in vitro. Clin Chim Acta 43: 31–37PubMedCrossRefGoogle Scholar
  3. 3.
    Meyer J, Smith LH (1975) Growth of calcium oxalate crystals. II. Inhibition by natural urinary crystal growth inhibitors. Invest Urol 13: 36–39Google Scholar
  4. 4.
    Ito H, Coe FL (1977) Acidic peptide and polyribonucleotide crystal growth inhibitors in human urine. Am J Physiol 233: F455–F463PubMedGoogle Scholar
  5. 5.
    Sallis JD, Lumley MF (1979) On the possible role of glycosaminoglycans as natural inhibitors of calcium oxalate stones. Invest Urol 16: 296–299PubMedGoogle Scholar
  6. 6.
    Ryall RL, Harnett RM, Marshall VR (1981) The effect of urine, pyrophosphate, citrate, magnesium and glycosaminoglycans on the growth and aggregation of calcium oxalate crystals in vitro. Clin Chim Acta 112: 349–356PubMedCrossRefGoogle Scholar
  7. 7.
    Robertson WG, Scurr DS, Bridge CM (1981) Factors influencing the crystallization of calcium oxalate - critique. J Crystal Growth 53: 182–194CrossRefGoogle Scholar
  8. 8.
    Nakagawa Y, Abram V, Kezdy FJ, Kaiser ET, Coe FL (1983) Purification and characterization of the principal inhibitor of calcium oxalate monohydrate crystal growth in human urine. J Biol Chem 258: 12594–12600PubMedGoogle Scholar
  9. 9.
    Pak CYC, Galosy RA (1980) Propensity for spontaneous nucleation of calcium oxalate. Am J Med 69: 681–689PubMedCrossRefGoogle Scholar
  10. 10.
    Bisaz S, Felix R, Neumann WF, Fleisch H (1978) Quantitative determination of inhibitors of calcium phosphate precipitation in whole urine. Min Electr Metab 1: 74–83Google Scholar
  11. 11.
    Hallson PC, Rose GA (1978) A new urinary test for stone “activity”. Br J Urol 50: 442–458PubMedCrossRefGoogle Scholar
  12. 12.
    Fleisch H (1985) Round Table on the comparison of models for the study of inhibitory activity in urine. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and Related Clinical Research. Plenum New York, pp 903–910Google Scholar
  13. 13.
    Robertson WG, Latif AB, Scurr DS, Caswell AM, Drach GW, Randolph AD (1984) Inhibitors of calcium oxalate crystallization in urine from stone-formers and normals. In: Ryall R, Brockis JG, Marshall V, Finlayson B (eds) Urinary Stone. Churchill Livingstone, Melbourne pp 167–172Google Scholar
  14. 14.
    Scurr DS, Robertson WG (1985) Studies on the mode of action of polyanionic inhibitors of calcium oxalate crystallization in urine. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and Related Clinical Research. Plenum New York, pp 835–838Google Scholar
  15. 15.
    Sheehan ME, Nancollas GH (1980) Calcium oxalate crystal growth. A new constant composition method for modelling urinary stone formation. Invest Urol 17: 446–450Google Scholar
  16. 16.
    Randolph AD, Drach GW (1981) Some measurements of calcium oxalate nucleation and growth rates in urine-like liquors. J Crystal Growth 53: 195–201CrossRefGoogle Scholar
  17. 17.
    Mukai, T, Howard JE (1963) Some observations on the calcification of rachitic cartilage by urine. Bull Johns Hopk Hosp 112: 279–290Google Scholar
  18. 18.
    Meyer JL, McCall JT, Smith LH (1974) Inhibition of calcium phosphate crystallization by nucleoside phosphates. Calc Tiss Res 15: 289–293CrossRefGoogle Scholar
  19. 19.
    Meyer JL, Angino EE (1977) The role of trace metals in calcium urolithiasis. Invest Urol 14: 347–350PubMedGoogle Scholar
  20. 20.
    Meyer JL, Thomas WC (1982) Trace metal-citric acid complexes as inhibitors of calcification and crystal growth. II. Effects of Fe(III), Cr(III) and A1(III) complexes on calcium oxalate crystal growth. J Urol 128: 1376–1378PubMedGoogle Scholar
  21. 21.
    Howard JE, Becker G (1976) Phosphate-citrate interactions as a source of anticalcifying activity in simple synthetic urines. In: Finlayson B, Thomas WC (eds) Colloquium on Renal Lithiasis. University Presses of Florida, Gainesville, pp 119–126Google Scholar
  22. 22.
    Schrier EE, Rubin JL, Lee KE, Werness PG, Smith LH (1981) Characterization of the calcium oxalate crystal growth inhibitors in human urine. In: Smith LH, Robertson WG, Finlayson B (eds) Urolithiasis - Clinical and Basic Research. Plenum, New York, pp 579–588Google Scholar
  23. 23.
    Smith LH, Werness PG, Wilson DM (1979) Enteric hyperoxaluria: associated metabolic abnormalities that promote formation of renal calculi. In: Rose GA, Robertson WG, Watts RWE (eds) Oxalate in Human Biochemistry and Clinical Pathology. Wellcome Foundation, London, pp 224–230Google Scholar
  24. 24.
    Coe FL, Lawton RL, Goldstein RB, Tembe V (1975) Sodium urate accelerates precipitation of calcium oxalate in vitro. Proc Soc Exp Biol Med 149: 926–929PubMedGoogle Scholar
  25. 25.
    Robertson WG, Knowles CF, Peacock M (1976) Urinary acid mucopolysaccharide inhibitors of calcium oxalate crystallization. In: Fleisch H, Robertson WG, Smith LH, Vahlensieck W (eds) Urolithiasis Research. Plenum, New York, pp 331–334CrossRefGoogle Scholar
  26. 26.
    Pak CYC, Holt K, Zerwekh JE (1979) Attenuation by sodium urate of the inhibitory effect of glycosaminoglycans on calcium oxalate nucleation. Invest Urol 17: 138–140PubMedGoogle Scholar
  27. 27.
    Hallson PC, Rose GA (1979) Uromucoids and urinary stone-formation. Lancet 1: 1000–1002PubMedCrossRefGoogle Scholar
  28. 28.
    Sutor DJ, Percival JM, Piper KAJ (1979) Urinary inhibitors of calcium phosphate formation: the inhibitory activity of normal and artificial urine. Br J Urol 51: 1–5PubMedCrossRefGoogle Scholar
  29. 29.
    Rose GA, Sulaiman S (1984) Effects of macromolecules and of sodium dodecyl sulphate upon precipitation of calcium oxalate and calcium phosphate from whole urine. Urol Int 39: 68–72PubMedCrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG., Darmstadt 1980

Authors and Affiliations

  • W. G. Robertson
    • 1
  • D. S. Scurr
    • 1
  • V. J. Sergeant
    • 1
  1. 1.MRC Mineral Metabolism UnitThe General InfirmaryGB-LeedsUK

Personalised recommendations