Physicochemical background for ambiguity of clinical recommendations in treating phosphate nephrolithiasis.

Efficiency of clinical recommendations for curing and prevention of phosphate nephrolithiasis founded on physicochemical investigations is unexpectedly low and apparently did not exceed 50%. We tried to consider possible physicochemical causes of this fact. For this purpose the influence of changes of urine pH and of calcium, phosphate and complexon concentrations on the probability of different precipitation phases of solid calcium phosphate has been reviewed.

Urine pH variation dynamics in healthy individuals and stone formers.

Urine pH density distribution curves have been obtained in groups of patients with concrements of various chemical compositions. Quantitative regularities for mixing chemical compounds in the concrements established by the infrared spectroscopic method have been shown to agree with urine pH distribution density (in time). Potential physicochemical mechanisms for the revealed generality are considered.