CHEMICAL ANALYSIS OF STONES, SERUM IONS AND THEIR SIGNIFICANCE IN UROLITHIASIS OF TIKRIT POPULATION, IRAQ

Background: Area of high incidence of stone formation is recognized throughout the world, the etiological factors in this phenomenon are unknown. In general, stone formation is facilitated by factors that increase solutes concentration in the urine, alteration in pH, provides a nidus for precipitation, congenital abnormality, stasis, dehydration and altered Ca2+ metabolism and metabolic disorder by hyperparathyroidism, hyperuricemia and cystinuria oxalosis, hypercalcuria secondary o neoplasm or sarcoidosis vitamin D intoxication and abnormal renal function alter the urine composition such as renal tubular acidosis and foreign body. Methodology: A total of 135 patients with urolithiasis were studied including 91 males and 44 females. Patients aged between 15 to 70 years. and submitted for chemical analysis. 54 stones and some serum values like Serum Ca+2, serum uric acid, serum P+5 and serum Mg+2 among the patients were chemically analyzed. Results: The majority among those mixed stones were composed of a mixture of calcium oxalate and calcium phosphate and uric acid with frequency almost 24%. Other stones were a mixture of calcium oxalate and calcium phosphate which were the second most common type of stones (22.2%). Serum Ca+2, serum uric acid, serum P+5 and serum Mg+2 among the patients were estimated. The serum values abnormalities included an increase in means of serum uric acid, serum calcium and serum phosphorous and their values were 0.37, 2.5 and 1.22 mmol/l respectively. Conclusions: Calcium-based stones predominate in males, while infection-related stones (particularly ammonium magnesium phosphate) are more frequent in females. Calcium-based stones were primarily associated with elevated serum calcium, while infection-related stones (struvite) showed no significant biochemical elevation, supporting a non-metabolic etiology. The analysis demonstrates that urolithiasis is primarily associated with increased urinary pH and reduced serum magnesium levels, both of which create a favorable environment for crystal formation.