Calculi, Urinary

CPT: 82360
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Test Details

Synonyms

  • Kidney Stone

Test Includes

Ammonium acid urate; calcium bilirubinate; calcium carbonate; calcium hydrogen phosphate; calcium oxalate dihydrate; calcium oxalate monohydrate; calcium phosphate; cellular material; cholesterol; core composition; cystine; dried blood; magnesium ammonium phosphate; newberyite; sodium uric acid; triamterene; uric acid; uric acid dihydrate; color; size; weight

Use

Evaluate stone composition, metabolic factors affecting stone formation; work up nephrolithiasis

Methodology

Optical microscopy

Reference Interval

Percentage of interior and exterior layers

Additional Information

In the United States, the incidence of urinary tract calculi is common, with one person in 1000 requiring hospital care and treatment. A typical urinary calculus is composed of crystalline substances precipitated in the body. To ensure proper treatment and prevention of recurrences of urinary calculi, it is critical that the crystalline constituents of the stone be identified. Mandel describes fifteen crystalline substances common in urinary calculi and subdivides them into six broad catagories.1

Calculi, Urinary

Chemical Name

Formula

Mineralogic Name

Calcium oxalate monohydrate

CaC2O4 • H2O

Whewelite

Calcium oxalate dihydrate

CaC2O4 • 2H2O (to 2 • 5H2O)

Weddellite

Magnesium hydrogen phosphate trihydrate

MgHPO4 • 3H2O

Newberyite

Magnesium ammonium phosphate hexahydrate

MgNH4PO4 • 6H2O

Struvite

Hydroxyapatite

Ca10(PO4)6 (OH)2

Hydroxyapatite

Carbonate-apatite

Ca10(PO4)6-x (OH)2-y (CO3)x+y

Carbonate-apatite

Calcium hydrogen phosphate dihydrate

CaHPO4 • 2H2O

Brushite

Uric acid

C5H4N4O3

Uric acid dihydrate

C5H4N4O3 • 2H2O

Ammonium acid urate

C5H3N4O3NH4

Sodium acid urate monohydrate

C5H3N4O3Na • H2O

Cystine

[-SCH2CHNH2COOH]2

Xanthine

C5H4N4O2

Specimen Requirements

Specimen

Calculi

Container

Clean container or capsule

Collection

Calculi must be submitted completely dry. Specimens should not be submitted in liquid (formalin, urine, blood, etc), in gauze, filters, taped, or on Q-tips. There will be delay in analyzing and reporting specimens not received completely dry.

Storage Instructions

Maintain specimen at room temperature.

Clinical Information

Footnotes

1. Mandel N. Urinary tract calculi. Lab Med. 1986; 17(8):449-458.

References

Prien EL, Frondel C. Studies in urolithiasis: I. The composition of urinary calculi. J Urol. 1947 Jun; 57(6):949-994. 20243909
Rodgers L, Spector M. Crystallographic analysis of urinary calculi. In: Rous SN, ed.Stone Disease: Diagnosis and Management. New York, NY: Grune & Stratton;1987.
Sierakowski R, Finlayson B, Landes RR, Finlayson CD, Sierakowski N. The frequency of urolithiasis in hospital discharge diagnoses in the United States. Invest Urol. 1978 May; 15(6):438-441. 649290

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
120790 Calculi, Urinary 120428 Color 9796-4
120790 Calculi, Urinary 120709 Size mm 9802-0
120790 Calculi, Urinary 120402 Weight mg 9804-6
120790 Calculi, Urinary 120440 Composition N/A
120790 Calculi, Urinary 120693 Ca oxalate dihydrate % 49500-2
120790 Calculi, Urinary 120694 Ca oxalate monohydr. % 38252-3
120790 Calculi, Urinary 120733 Calcium phosphate % 32137-2
120790 Calculi, Urinary 120695 Magnesium ammon phos % 32143-0
120790 Calculi, Urinary 120741 Uric acid % 32149-7
120790 Calculi, Urinary 120671 Uric acid dihydrate % 54436-1
120790 Calculi, Urinary 120642 Ammonium acid urate % 38191-3
120790 Calculi, Urinary 120634 Sodium acid urate % 54437-9
120790 Calculi, Urinary 120696 Ca hydrogen phos. % 40998-7
120790 Calculi, Urinary 120667 Cystine % 32138-0
120790 Calculi, Urinary 120659 Cholesterol % 54438-7
120790 Calculi, Urinary 120674 Calcium bilirubinate % 54439-5
120790 Calculi, Urinary 120698 Calcium carbonate % 32156-2
120790 Calculi, Urinary 120672 Triamterene % 43690-7
120790 Calculi, Urinary 120678 Newberyite % 54440-3
120790 Calculi, Urinary 120670 Dried Blood % 49499-7
120790 Calculi, Urinary 120673 Cellular Material % 56119-1
120790 Calculi, Urinary 120437 Nidus 42192-5
120790 Calculi, Urinary 120438 Shell N/A
120790 Calculi, Urinary 120439 Surface Crystals N/A
120790 Calculi, Urinary 120676 Comment 14638-1
120790 Calculi, Urinary 120677 Comment 14638-1
120790 Calculi, Urinary 130421 Please note: N/A
120790 Calculi, Urinary 519994 Comment: N/A
120790 Calculi, Urinary 120701 Disclaimer: N/A

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