Calculi, Urinary With Photograph

CPT: 82360
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Test Details

Synonyms

  • Kidney Stone

Test Includes

Ammonium acid urate; calcium carbonate; calcium hydrogen phosphate; calcium oxalate dihydrate; cellular material; core composition; dried blood; calcium oxalate monohydrate; calcium phosphate; cholesterol; cystine; magnesium ammonium phosphate; newberyite; sodium acid urate; 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; core material stated

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 15 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
120691 Calculi, Urinary, with Photo 120428 Color 9796-4
120691 Calculi, Urinary, with Photo 120709 Size mm 9802-0
120691 Calculi, Urinary, with Photo 120402 Weight mg 9804-6
120691 Calculi, Urinary, with Photo 120440 Composition N/A
120691 Calculi, Urinary, with Photo 120693 Ca oxalate dihydrate % 49500-2
120691 Calculi, Urinary, with Photo 120694 Ca oxalate monohydr. % 38252-3
120691 Calculi, Urinary, with Photo 120733 Calcium phosphate % 32137-2
120691 Calculi, Urinary, with Photo 120695 Magnesium ammon phos % 32143-0
120691 Calculi, Urinary, with Photo 120741 Uric acid % 32149-7
120691 Calculi, Urinary, with Photo 120671 Uric acid dihydrate % 54436-1
120691 Calculi, Urinary, with Photo 120642 Ammonium acid urate % 38191-3
120691 Calculi, Urinary, with Photo 120634 Sodium acid urate % 54437-9
120691 Calculi, Urinary, with Photo 120696 Ca hydrogen phos. % 40998-7
120691 Calculi, Urinary, with Photo 120667 Cystine % 32138-0
120691 Calculi, Urinary, with Photo 120659 Cholesterol % 54438-7
120691 Calculi, Urinary, with Photo 120674 Calcium bilirubinate % 54439-5
120691 Calculi, Urinary, with Photo 120698 Calcium carbonate % 32156-2
120691 Calculi, Urinary, with Photo 120672 Triamterene % 43690-7
120691 Calculi, Urinary, with Photo 120678 Newberyite % 54440-3
120691 Calculi, Urinary, with Photo 120670 Dried Blood % 49499-7
120691 Calculi, Urinary, with Photo 120673 Cellular Material % 56119-1
120691 Calculi, Urinary, with Photo 120437 Nidus 42192-5
120691 Calculi, Urinary, with Photo 120438 Shell N/A
120691 Calculi, Urinary, with Photo 120439 Surface Crystals N/A
120691 Calculi, Urinary, with Photo 120676 Comment 14638-1
120691 Calculi, Urinary, with Photo 120677 Comment 14638-1
120691 Calculi, Urinary, with Photo 120675 Photo N/A
120691 Calculi, Urinary, with Photo 519994 Comment: N/A
120691 Calculi, Urinary, with Photo 130422 Please note: N/A
120691 Calculi, Urinary, with Photo 120701 Disclaimer: N/A

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