Analysis of urinary calculi in adults from the Moroccan Medium Atlas by Fourier transform infrared spectrophotometry

Objective: To determine the stone composition in adult patients from the medium Atlas of Morocco.

Methods: A series of 183 calculi from adult patients (males: 123, females: 60) collected in medium Atlas of Morocco was analysed by Fourier Transform infrared spectroscopy. The stones were surgically removed (n = 168) or spontaneously passed (n = 15).

Results: Kidney stones are encountered in 70.5% of calculi. The stones were twice frequent in males than in females (M/F = 2.10). Whewellite was the main component in 51.4% of the stones and 49.7% of the stone core, weddellite in only 7.1% of stones and 6.4% of the nuclei. Uric acid was predominant in 18% of stones and also 19.7% of nuclei, and carbapatite in 12.6% of stones and nuclei. All in all, whewellite was present in 77.6% of calculi and weddellite in 25.1%, carbapatite in 68.3% and PACC in 23.5%, struvite in 15.3%, uric acid in 20.8% and ammonium hydrogen urate in 14.2% of cases. Struvite stones were more frequent in females and uric acid calculi in males, in particular in patients aged more than 60 years old.

Conclusions: As observed in most countries, calcium oxalate was the most frequent major component of the stones (58.5%). Uric acid stones were more frequent (18%) than reported in Western countries, thus suggesting that particular dietary habits are involved in stone formation. The relatively high occurrence of struvite stones (8%) could be a marker of an insufficient early detection and treatment of chronic urinary tract infection.