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Kinetics of calcium oxalate crystal formation in urine

机译：尿液中草酸钙晶体形成的动力学

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It is routinely observed that persons with increased urinary stone risk factors do not necessarily form uroliths. Furthermore, stone formers can present with urinalyses that do not reflect the clinical picture. We explain this discrepancy by differences in crystallization kinetics. In 1162 urines, crystallization of Ca-oxalate was induced according to the BONN-Risk-Index (BRI) method. The urine's relative light transmissivity (RLT) was recorded from 100 % at start of titration to 95 % due to nuclei formation and crystal growth. From the RLT changes, a measure of the thermodynamic inhibition threshold of crystal formation (BRI) and of crystal growth kinetics is derived ("turbidity slope" after crystallization onset). On average, subjects presenting with a low inhibition threshold, i.e., high BRI, also present significantly higher crystal growth rates compared with subjects in lower BRI classes. Only subjects in the highest BRI class show a lower growth rate than expected, probably due to a depletion of supersaturation by massive initial nucleation. With increasing thermodynamic risk of crystal formation (i.e., increasing BRI) due to an imbalance between inhibitors and promoters of crystal formation, an increase in the imbalance between inhibitors and promoters of crystal growth (i.e., increasing growth rate) is observed. Both lead to an increased urolith formation risk. Healthy subjects with increased BRI are an exception to this trend: their urine is thermodynamically prone to form stones, but they show a kinetic inhibition preventing nuclei from significant growth.
机译：常规观察到泌尿石危险因素增加的人不一定形成尿石。此外，石材成型剂可以呈现不反映临床图的尿尿布。我们通过结晶动力学的差异来解释这种差异。在1162中，根据Bonn-Risk-Index（BRI）方法诱导Ca-草酸盐的结晶。由于核形成和晶体生长，尿液的相对透光率（RLT）从100％记录在滴定时至95％。从RLT改变，衍生晶体形成（BRI）和晶体生长动力学的热力学抑制阈值的量度（结晶发作后“浊度斜坡”）。平均而言，呈现低抑制阈值的受试者，即高BRI，与下BRI类中的受试者相比，晶体生长速率显着更高。只有最高BRI级别的受试者显示出低于预期的增长率低，可能是由于大量初始成核的过度耗尽。由于晶体形成的抑制剂和启动子的不平衡增加了晶体形成的热力学风险（即，增加Bri），观察到抑制剂与晶体生长的抑制剂（即，增加生长速率）之间的不平衡的增加。两者都导致尿道形成风险增加。 Bri增加的健康受试者是这种趋势的例外：它们的尿液是热力学上的易于形成石头，但它们显示出核酸抑制核从显着的生长中抑制核。

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