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Concave urinary crystals: direct evidence of citrate dissolving calcium oxalate crystals in vivo

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Document pages: 8 pages

Abstract: Atomic force microscopy (AFM), scanning electron microscopy (SEM), X-ray powder diffraction (XRD) and zeta potential analyzer were used to study the changes of urinary crystal properties in patients with calcium oxalate stones after oral administration of potassium citrate (k3ci). AFM and SEM results showed that the surface of urinary crystals was concave, the edges and corners became blunt, the average size of urinary crystals decreased significantly, and the aggregation of urinary crystals decreased. These changes were attributed to a significant increase in excreted citrate concentrationss, which dissolved these crystals. Thus, the appearance of concave urinary crystals was a direct evidence of CaOx dissolution by citrate in vivo. The XRD results showed that the quantities and species of urinary crystals decreased after K3cit intake. The mechanism of inhibition of formation of CaOx stones by K3cit was possibly due to the complexation of Ca2+ with citrate, increase in urine pH, concentration of urinary inhibitor glycosaminoglycans (GAGs), and the absolute value of zeta potential after K3cit intake.

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