Background: Metabolic and physicochemical evaluation is recommended to manage the condition of patients with nephrolithiasis. The estimation of the saturation state (β values) is often included in the diagnostic work-up, and it is preferably performed through calculations. The free concentrations of constituent ions are estimated by considering the main ionic soluble complexes. It is contended that this approach is liable to an overestimation of β values because some complexes may be overlooked. A recent report found that β values could be significantly lowered upon the addition of new and so far neglected complexes, [Ca(PO4)Cit]4− and [Ca2H2(PO4)2]. The aim of this work was to assess whether these complexes can be relevant to explaining the chemistry of urine. Methods The Ca–phosphate–citrate aqueous system was investigated by potentiometric titrations. The stability constants of the parent binary complexes [Cacit]− and [CaPO4]−, and the coordination tendency of PO43− toward [Ca(cit)]− to form the ternary complex, were estimated. βCaOx and βCaHPO4 were then calculated on 5 natural urines by chemical models, including or not including the [CaPO4]- and [Ca(PO4)cit]4− species. Results: Species distribution diagrams show that the [Ca(PO4)cit]4− species was only noticeable at pH>8.5 and below 10% of the total calcium. β values estimated on natural urine were slightly lowered by the formation of [CaPO4]− species, whereas [Ca(PO4)cit]4− results were irrelevant. Conclusions: While [CaPO4]− species have an impact on saturation levels at higher pHs, the existence of ternary complex and of the dimer is rejected.

Critical Reappraisal of Methods for Measuring Urine Saturation with Calcium Salts

Silvia Berto;Pier Giuseppe Daniele
2021

Abstract

Background: Metabolic and physicochemical evaluation is recommended to manage the condition of patients with nephrolithiasis. The estimation of the saturation state (β values) is often included in the diagnostic work-up, and it is preferably performed through calculations. The free concentrations of constituent ions are estimated by considering the main ionic soluble complexes. It is contended that this approach is liable to an overestimation of β values because some complexes may be overlooked. A recent report found that β values could be significantly lowered upon the addition of new and so far neglected complexes, [Ca(PO4)Cit]4− and [Ca2H2(PO4)2]. The aim of this work was to assess whether these complexes can be relevant to explaining the chemistry of urine. Methods The Ca–phosphate–citrate aqueous system was investigated by potentiometric titrations. The stability constants of the parent binary complexes [Cacit]− and [CaPO4]−, and the coordination tendency of PO43− toward [Ca(cit)]− to form the ternary complex, were estimated. βCaOx and βCaHPO4 were then calculated on 5 natural urines by chemical models, including or not including the [CaPO4]- and [Ca(PO4)cit]4− species. Results: Species distribution diagrams show that the [Ca(PO4)cit]4− species was only noticeable at pH>8.5 and below 10% of the total calcium. β values estimated on natural urine were slightly lowered by the formation of [CaPO4]− species, whereas [Ca(PO4)cit]4− results were irrelevant. Conclusions: While [CaPO4]− species have an impact on saturation levels at higher pHs, the existence of ternary complex and of the dimer is rejected.
MOLECULES
26
3149
3157
https://doi.org/10.3390/ molecules26113149
nephrolithiasis, calcium oxalate, calcium phosphate, citrate, chemical speciation, oversaturation
Silvia Berto, Martino Marangella, Concetta De Stefano, Demetrio Milea, Pier Giuseppe Daniele
File in questo prodotto:
File Dimensione Formato  
2021_ Urine saturation_Molecules.pdf

accesso aperto

Descrizione: Articolo principale
Tipo di file: PDF EDITORIALE
Dimensione 9.61 MB
Formato Adobe PDF
9.61 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1789390
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact