Factors affecting crystallization, dispersion, and aggregation of calcium oxalate monohydrate in various urinary environments

The mechanisms for the formation of kidney stones are not well understood. One possible mechanism is the formation of aggregates in the nephron tubules of the kidneys. However, altering the urinary environment may be a method to help prevent the recurrence of the formation of kidney stones. The primary inorganic constituent found in kidney stones of North American patients is calcium oxalate monohydrate (COM). In this research, studies on the effect of mixing rate on COM precipitation showed that rapid mixing compared to slow mixing produced smaller particle sizes and a narrower particle size distribution due to the more uniform supersaturation level. The findings are consistent with the general contention that mixing directly influences nucleation rate while mixing rate has relatively little influence over rate of growth in precipitation processes.; Screening and central composite experimental designs are used to determine the effect of various factors on the aggregation and dispersion characteristics of previously grown calcium oxalate monohydrate (COM) crystals in artificial urinary environments of controlled variables. The variables examined are pH, calcium, oxalate, pyrophosphate, citrate, and protein concentrations in ultrapure water and artificial urine. Optical density measurements, zeta potential analysis, particle size analyzer, optical microscopy, AFM force measurements, protein adsorption, and ions and small molecule adsorption have been used to assess the state of aggregation and dispersion of the COM crystals and to elucidate the mechanisms involved in such a complex system. The data indicate that our model protein, mucin, acts as a dispersant. This is attributed to steric hindrance resulting from the adsorbed mucoprotein. Oxalate, however, promotes aggregation. Interesting interactions between protein and oxalate along with protein and citrate are observed. Such interactions (synergistic or antagonistic) are found to depend on the concentrations of these species. Surface responses for these interactions are presented and discussed in this dissertation. In summary, solution, surface, and interface chemistries interact in a complex manner in the physiological environment to either inhibit or promote aggregation. The data indicate the interactions between species play an important role in dispersion/aggregation of kidney stone constituents.