Introduction & After urinary tract infection and prostatic disorders , the urine stones are the third common genitourinary diseases. Demographic, environmental and genetic factors affect urine stone formation. The aim of our study is to survey epidemiologic factors in patients with urinary stones referring to educational hospitals of Hamadan during 2010-2013.
In this analytic-cross-sectional study, we studied 500 cases of urinary stones referring to educational hospitals of Hamadan. The data were collected from electronic patient records system of laboratory. The results were registered in a check list and analyzed by spss16 and descriptive statistical indicators.
The patients were between 0.5-84 years. The average age of them was 40.36 years. In our study of 500 cases, 348 cases were male (69.6%) and 152 cases were female (30.4%). The male to female ratio was 2.3 to 1. Urinary stones were more prevalent in 25- 45 year old men and 30-50 year old women. Among 500 patients, 466 cases had only one type of renal stones and 34 cases had 2 types. The calcium oxalate was the most common stone (386 cases, 72.5%). The other common stone types were uric acid (130 cases, 24.3 %), cystine (14 cases,2.6 %) ,calcium carbonate (3 cases,0.5 %) and calcium phosphate (1 case,0.1 %)
Urinary stones are twice as common in men as in women. Most patients are between 38-42 years old. The most common stone in both sexes and all ages was calcium oxalate.

Heavy water (high solute concentration water) has been proposed as important risk factor in areas that have reserves of heavy water. The aim of this study is to determine the main cause of stone forming in Shahrod area, which is of heavy water reserved. 100 patients with urinary stone in Shahrod city were studied. History and physical exam, stone component test, blood test of complete blood count, calcium, phosphate, urate and simple urine test accurately infection, ph, crystal, and cystine were examined in all patients. 24 hour urine test in order to determine risk factors of stone forming were performed in individuals with a history of stone their family, previous stone or multiple stone.Low water intake that defined as less than 2liters urination in 24hour observed in 81 patients (81%).Low level of citrate were found in 32 patients (32%).In 11 patients (11%)) other causes of stone forming like hypercaliuria were observed. Low water intake and low level of citrate in normal diet of Shahrod city people are the main cause of stone forming in people of this area.Heavy water and hypercalciuria had no significant role in stone forming in this area.

Calculi are deposited chemicals in compact form . The cause of calculus formation is not known ; however many physical factors which affect the metastable solubility or insolubility of crystalloids in complex biological fluids are involved in the phenomenon . The majority of kidney stones are composed of one or more of the following substances : calcium oxalate , calcium phosphate , uric acid , cystine ,or a mixture of these with magnesium ammonium phosphate. Most medical therapy for renal stone disease is now based on analysis of calculi ; and decisions about proper procedures for treatment require knowledge of stone composition. In this study 267 renal calcuili were analysed. The commonest types of calculus are calcium oxalate 95.9% and nonoxalated calcium 97% and uric acid calculi 53.2% or mixture of the two. Stone composition is an important guide for the physicians decisions concerning investigation and a rational choice of treatment .

Cystinuria is an inherited disorder affecting luminal transport of cystine and dibasic amino acids. Because of the poor solubility of cystine in urine, stone formation in the kidney occurs frequently. Cystinuria is associated with mutations in the SLC3A1 and SLC7A9 genes. Despite the population-specific distribution of mutations in the SLC7A9 genes, there are few genetic data reported for cystinuric patients from the Middle East.
Exon 4 of the SLC7A9 gene was sequenced in 21 patients with cystinuria, using the polymerase chain reaction and sequencing methods.
A new variation in exon 4 of the SLC7A9 gene was identified, which was insertion of 1 adenine nucleotide between 2 cytosine nucleotides in position c.272-273 insA.
It seems to be important since it causes frame shift and it may be an important cause to make disease.

Dual-energy computed tomography (DECT) scan is a non-invasive method for the in vivo identification of renal stone composition. However, DECT scanners have several demerits, including high cost, low accessibility, and high radiation dose to patients.

The present study aimed to investigate the efficacy of deep neural networks in the classification of renal stone types using single-energy CT imaging. The Taguchi method was used for the optimization of hyperparameters.

A total of 146 pure renal stone samples were first surgically collected from the patients. The stones were then inserted into a Rando phantom and scanned using a DECT scanner. An ultra-low-dose CT scan was acquired to determine the stone position prior to the DECT scan. The result of chemical analysis was used as the gold standard for determining the stone composition throughout the study. Several neural networks, including ResNet-50, ResNet-18, GoogLeNet, and VGG-19, were used to classify the stone images into three composition groups, including uric acid, calcium oxalate, and cystine. Moreover, the Taguchi method was employed to optimize the network hyperparameters. The signal-to-noise ratio (SNR) was also analyzed to determine the optimal arrangement.

In this study, CT scans of 53 uric acid, 55 calcium oxalate, and 38 cystine stones, with diameters of 1 - 3 mm, were acquired. The deep learning findings showed that the ResNet-18 network had the highest accuracy for 120-kVp and 135-kVp CT scanning, while ResNet-50 performed better in 80-kVp CT scanning. The ResNet-50 network showed the best performance of all networks in predicting stone types in 80-kVp scanning, as indicated by its high sensitivity, specificity, and precision.

The present results indicated that our deep learning approach could be used for the in vivo determination of renal stone types. Moreover, low-dose or ultra-low-dose single-energy CT scanning ismorewidely accessibleand safer in terms of radiation exposure.

  Nowadays, there are many physical and chemical methods available for urinary stone analysis. According to the latest guidelines, infrared spectroscopy (IR) or x-ray diffraction (XRD) are the two preferred methods in this issue. Therefore, we decided to do a practical comparison between the two above-mentioned techniques with a reference method in order to set up a proper analysis method in our clinical laboratories. A total of 60 kidney stones were obtained at Labbafinejad hospital through open surgery or percutaneous nephrolithotomy. Then stone analysis techniques included both a morphological examination by SEM (Scanning Electron Microscopy) and internal structure analysis by EDAX (Elemental distribution analysis X-ray), XRD, IR and wet chemical analysis. SEM together with EDAX (SEM-EDAX) was considered as reference methods. The results of XRD had the highest agreement with SEM-EDAX analysis (93%), while the total agreement of FTIR and wet chemical analysis was 81% and 71% respectively. The agreement of FTIR for calcium oxalate stones was acceptable (90%), but for uric acid and cystine stones was challenging (65% and 76% respectively). Our results revealed that XRD is more reliable than FTIR; but considering cost issues, FTIR is more suitable for routine clinical laboratory. Moreover, wet chemical analysis, which is routinely used in our laboratories is insufficient for stone analysis and it is mandatory to be replaced by techniques that are more accurate.

Metabolic disorders are common in patients with staghorn renal stones. Aim of this study was to evaluate and compare the metabolic disorders in patients with unilateral and bilateral staghorn stones. In this cross sectional study, 78 patients who underwent percutaneous nephrolithotomy (PCNL) for staghorn renal stones were included. The urine volume, the level of calcium, oxalate, uric acid, phos phate, sodium, citrate, creatinine, and cystine from 24 hour urine collection as well as the serum levels of calcium, phosphorus, magnesium, creatinine, blood urea nitrogen (BUN), parathyroid hormone (PTH) and uric acid were recorded and compared among the two groups with unilateral and bilateral renal stones. 56 patients (71.8%) had unilateral and 22 (28.2%) had bilateral renal stones. At least one abnormal meta bolic factor was found in 32 (57.1%) and 15 (68.2%) patients with unilateral and bilateral renal stones, respectively (P = .044). Cystine urine levels and serum levels of BUN were higher in cases with bilateral compared to unilateral renal stones (36.4% vs. 12.5%, P = .025 and 27.3% vs. 1.8%, P = .002, respectively). Metabolic factors are strongly correlated with the formation of staghorn renal stones specially bilat eral ones. In our study among different metabolic factors, cystine urine levels and serum levels of BUN were sig nificantly higher in patients with bilateral renal stones. Proper metabolic assessments are recommended in patients with staghorn urolithiasis.

Prevalence of urolithiasis in childhood is increasing. The wide geographic variation in the incidence of lithiasis in childhood is related to climatic, dietary, and socioeconomic factors. Many children with stone disease have a metabolic abnormality. In Southeast Asia, urinary calculi are endemic and are related to dietary factors. The main aim of this study was to determine the prevalence of renal stone, urine metabolic abnormality, control of blood pressure and demographic character in elementary school children of Qom. A cross sectional study was performed on 110 primary school children (56 girls and 54 boys) aged 7 to 11 years old. Demographic data such as age, height, weight were gathered, and systolic and diastolic blood pressure, Urine analysis and culture, urinary levels of calcium, creatinine, phosphorus, magnesium, sodium, potassium, uric acid, cystine, citrate, oxalate, protein and sonographic findings were evaluated. The mean (±SD) of age was 8.85±1.51 years. Only one child had renal stone (1%), but the prevalence of abnormal renal sonography was 7%. The most prevalent urine metabolic abnormalities were hypercalciuria (23%) and hypocitraturia (100%). 11.2% of children had positive urine culture that all were female. The prevalence of high blood pressure was 7.1% for girls and 11.1% for boys. The prevalence of renal stone in children in this study was 1%, which means the accurate judgment about the prevalence of renal stone in Qom city needs more comprehensive studies. Similar to other studies in Iran this study shows that the prevalence of hypercalciuria is significantly higher comparing to other countries, it may be associated with excessive intake of sodium.

Nephrolithiasis is quite common in children. It sometimes has a genetic basis and can lead to serious complications like urinary obstruction, multiple surgical interventions, or even renal insufficiency if left treated. Cystinic stones and cystinuria account for approximately 8% of the cases of nephrolithiasis in children. We studied seven pediatric patients, 1 to 3 years old (mean age: 20.5 months), with cystinic urinary stones receiving D-penicillamine plus other drugs to dissolve the stone. All of them tolerated the treatment very well and did not show any serious complication. All of our cases were managed with D-penicillamine that was initiated at a low dose and then increased progressively. We used low dose D-penicillamine, maximim15 mg/kg/day, which was beneficial without any specific side effects. D-penicillamine can be used safely in little children. Gradual induction and close observation with CBC, urine analysis, BUN, creatinine, and liver function tests may be required. D-penicillamine can prevent new stone formation and resolve the present cystinic calculi. Low dose D-penicillamine may be sufficient in treating cystinic calculi in children. We suggest more evaluations on the advantage of low dose D-penicillamine in cystinuria.

This retrospective study aimed to evaluate the metabolic and biochemical abnormalities in children with nephrocalcinosis to identify its important risk factors and better understand the disease pathophysiology. Data were collected from the medical records of 163 children diagnosed with nephrocalcinosis. Their clinical and laboratory characteristics at admission were recorded, and a 24-hour urinalysis was performed to measure parameters such as calcium, oxalate, citrate, uric acid, magnesium, and cystine. Family history of kidney stones and parental consanguinity were present in 58.8% and 58.2% of patients, respectively. The most common underlying conditions were hyperparathyroidism (24%), distal renal tubular acidosis (16.6%), and medullary sponge kidney (12.9%). The main abnormalities included hypocitraturia (65.2%), hypercalciuria (51.9%), hypomagnesuria (44.6%), hyperoxaluria (39.1%), hyperuricosuria (31.5%), vitamin D deficiency (30.06%), and metabolic acidosis (27%). Patients with kidney stones and failure to thrive had higher rates of hypercalciuria. Metabolic acidosis was more common in those with parental consanguinity and vitamin D deficiency. Renal failure at final follow-up was more evident in older patients, those with parental consanguinity, hypokalemia, acidosis, and hyperparathyroidism. End-stage renal disease was more frequent in patients with consanguineous parentage, hyperparathyroidism, hypokalemia, and acidosis. Parental consanguinity, family history of kidney stones, and urinary metabolic disorders are important risk factors for pediatric nephrocalcinosis. This highlights the need for genetic counseling, screening, and monitoring of biochemical abnormalities. Early diagnosis and timely treatment are crucial to maintain glomerular function and prevent kidney failure.