Urinary lithogenesis risk tests: Comparison of a commercial kit and a laboratory prototype test

Abstract

Objective. Renal stone formation is a multifactorial process depending in part on urine composition. Other parameters relate to structural or pathological features of the kidney. To date, routine laboratory estimation of urolithiasis risk has been based on determination of urinary composition. This process requires collection of at least two 24 h urine samples, which is tedious for patients. The most important feature of urinary lithogenic risk is the balance between various urinary parameters, although unknown factors may be involved. The objective of this study was to compare data obtained using a commercial kit with those of a laboratory prototype, using a multicentre approach, to validate the utility of these methods in routine clinical practice. Material and methods. A simple new commercial test (NefroPlus; Sarstedt AG & Co., Nümbrecht, Germany) evaluating the capacity of urine to crystallize calcium salts, and thus permitting detection of patients at risk for stone development, was compared with a prototype test previously described by this group. Urine of 64 volunteers produced during the night was used in these comparisons. The commercial test was also used to evaluate urine samples of 83 subjects in one of three hospitals. Results. Both methods were essentially in complete agreement (98%) with respect to test results. The multicentre data were: sensitivity 94.7%; specificity 76.9%; positive predictive value (lithogenic urine) 90.0%; negative predictive value (non-lithogenic urine) 87.0%; test efficacy 89.2%. Conclusion. The new commercial NefroPlus test offers fast and cheap evaluation of the overall risk of development of urinary calcium-containing calculi.

Key Words::

• urinary test
• urine analysis
• urolithiasis risk

Acknowledgements

This work was supported by Fundació Barceló (ref. 1458/2007) and project grant CTQ 2010-18271 from the Ministerio de Ciencia e Innovación del Gobierno de España. I.G. expresses her appreciation to the Conselleria d'Innovació i Energia del Govern de les Illes Balears (Spain) for the fellowship that supports her work.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.