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Figure 2 | European Journal of Medical Research

Figure 2

From: Idiopathic Recurrent Calcium Urolithiasis (IRCU): variation of fasting urinary protein is a window to pathophysiology or simple consequence of renal stones in situ? A tripartite study in male patients providing insight into oxidative metabolism as possible driving force towards alteration of urine composition, calcium salt crystallization and stone formation*

Figure 2

Electron micrographs of selected precipitates as developed in postprandial urine (A-1 - C-1), the pertinent energy peaks of elements, and the calcium/phosphorus peak ratio (inserted as Ca/P; A-2 and B-2). Note that in A-1 - C-1 the scale is different, and that in B2 (coexistence of mature CaOx crystals and poorly crystallized CaPi) the peaks of potassium (KKα) and chloride (ClKα) are impressive (for further information see text). A-1: Massive accumulation of mostly spheroidal CaPi crystals and interspersed rhomboidal CaOx dihydrate crystals (arrowheads). Note that Ca/P is approx. 1.6, indicative of hydroxyapatite; the situation is typical for Ca excess at urine pH 6.0 of patients in whom the first appearing crystal was CaPi. B-1 and B-2: Co-precipitation of CaOx (left arrowhead) and poorly crystallized CaPi (right arrowheads); note that Ca/P is approx. 1.0; the situation is typical for Ca excess at urine pH 6.0 of patients in whom the first appearing crystal was CaOx. C-1 and C-2: Rhomboidal CaOx dihydrate (weddellite), typically formed upon induction of Ox excess at original urine pH (for more information see text and Table 3). Note the absence of a P peak. Reproduced from [18] with kind permission of Walter De Gruyter, Berlin, Germany.

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