Environ Geochem Health

DOI 10.1007/s10653-007-9103-3

ORIGINAL PAPER

Concentration effect of trace metals in Jordanian patients of

urinary calculi
Iyad Ahmed Abboud

Received: 21 September 2006 / Accepted: 23 March 2007

Springer Science+Business Media B.V. 2007

Abstract Due to the increase in the number of Zn = 0.7, Cu = 0.19, Mn = 0.029, P = 10.35, S = 1.88,
urinary calculi disease cases in Jordan, stone samples Sr = 0.306, Mo = 0.2, Cr = 0.146, Co = 0.05,
were collected from patients from various Jordanian Ni = 0.014)%. In conclusion, metals concentration in
hospitals (Princes Basma (PBH), King Abdullah Jordanian patient’s urinary calculi samples was
University (KAUH), Al-Basheer (ABH) and Al- higher than its equivalents of other patients’. It has
Mafraq (AMH)). This study concentrates on the been noted that there is no concentration of toxic
effect of trace metals in patients of urinary calculi. trace elements (like Li, V, Pb, Cd, and As). Some
Trace metals were detected in 110 urinary calculi heavy metals, however, were detected Mo, Cr, Co
samples using X-ray fluorescence (XRF) and atomic and Ni as traces. P and S ions are present in few
absorption spectroscopy (AAS) techniques. Of the calculi stones as traces.
calculi examined, 21 were pure calcium oxalate
(CaOax), 29 were mixed calcium oxalate/uric acid, Keywords Urinary calculi
Urinary stones

23 were mixed calcium oxalate/phosphate (apatite), Renal stones
Kidney stones
Calcium oxalate

25 were phosphate calculi (apatite/struvite), five were Medical geochemistry
Medical geology

mixed calcium oxalate monohydrate/struvite, four X-ray fluorescence
Atomic absorption spectroscopy
were urate calculi (mixed ammonium acid urate/
sodium acid urate) and three were pure cystine
calculi. The concentration measurement of Ca and Introduction
other trace metals levels has been found useful in
understanding the mechanism of stone formation and Some metals are naturally present in the human body
in evaluating pathological factors. It has been found and are essential to human health. Over 40 elements
that Ca is the main constituent of the urinary calculi, in the periodic table have biological functions on the
especially those stones composed of calcium oxalate human body and health if taken during eating,
and calcium phosphate. The concentration of most of drinking, or breathing. Many of these elements occur
the trace metals that were analyzed was (Ca = 48.18, at highly variable concentration ranging from very
Na = 1.56, K = 0.9, Mg = 3.08, Fe = 1.17, Al = 0.49, low to high. This variance depends on the analytical
method used (Fell 1984). They normally occur at low
concentrations and are known as trace metals. In high
I. A. Abboud (&)
doses, they are toxic to the human body or produce
Institute of Earth and Environmental Sciences, Al al-Bayt
University, Al-Mafraq, Jordan deficiencies in the case of other trace metals (Pouls
e-mail: Abboud_Iyad@Yahoo.com and Payne 2006). In recent years, the interest in the

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 Environ Geochem Health

role of trace elements analyses in all fields of many of which are considered to be either inhibitors
chemical, biochemical, geochemical, biological and or promoters of urinary stone formation. While the
environmental researches has been optimised. They study of effects on solubility and crystallization, the
are currently considered to be either harmless determination of the trace elements content of human
impurities or essential, depending on their concen- concentrations has attracted increasing attention
tration and the influence they have on physiological (Levinson et al. 1978).
phenomena (Feinendegen and Kasperek 1980; Wandt Several techniques have been used in the analysis
and Underhill 1988). Heavy metals are considered as of urinary stones and determination of elements: wet
traces with a density at least five times that of water chemical tests (Al-Kinani et al. 1984; Jhaumeer-L
(Pouls and Payne 2006). As such, they are stable and Subratty 1999), inductive coupled plasma
elements and cannot be metabolized by the human (ICP-AES) (Wandt and Underhill 1988), flame pho-
body and bio-accumulative passed up the food chain tometry, electron microprobe analysis, and neutron
to humans (Harte et al. 1991; Pouls and Payne 2006). activation analysis (Al-Kinani et al. 1984). The
They are taken into the human body via inhalation, following techniques were have been found to best
ingestion, and skin absorption, while liberated into serve the purpose of the present study: X-ray
the environment through the air, drinking water, food, fluorescence (XRF) spectroscopy and Atomic absorp-
or countless human-made chemicals and products tion spectroscopy (AAS).
(Pouls and Payne 2006).
The human body is like a machine. It consumes
energy from the breakdown of food products to carry Methodology
out function of life, and in so doing produces waste
products that must be removed. If the waste products One hundred and ten urinary stones of different types,
are not eliminated, the machine becomes clogged up including renal and gall bladder stones, were col-
and function ceases. The kidney, ureters, urinary lected from patients aging between 21 and 62 years
bladder and urethra make up the urinary system of the (73 males, 37 females). The stones were collected
body. Its function is to eliminate soluble waste following medical surgeries that the aforementioned
materials from metabolism of food and water con- patients undergone at the following hospitals: Princes
sumed (Fullerton 2003). Urinary stones may be Basma (PBH), King Abdullah University (KAUH),
regarded as an example of biomineralization that Al-Basheer (ABH), and Al-Mafraq (ABH) during the
involves the formation of inorganic minerals by living period extending from April/1st/2004 to April/30th/
organisms (Lieske et al. 1995). However, kidney stone 2006 (Table 1). Stone analysis was carried out at the
is a pathological manifestation of the phenomenon, laboratories of Al al-Bayt University, Al-Mafraq,
exhibiting features typical of uncontrolled biominer- Jordan using XRF and atomic absorption techniques.
alization (Karlsen et al. 1995). Accurate stone analysis All stones removed from patients were placed in
is therefore essential for the investigation and polyethylene dry bottles (bearing the name, sex, age,
management of the stone forming patient (Vergauwe weight, date and marital status of the patient) and
et al. 1994). Urinary stones may contain various transferred to Al al-Bayt University labs.
combinations of chemicals. The most common types All samples were washed several times with de-
of stones are comprised of calcium in combination ionized water until they became free from urine,
with either oxalate (Dajani et al. 1988; Mhelan 1992; blood debris and remnants of organic matter. Each
Yagisawa et al. 1999) or phosphate. Struvite (STR) sample was washed with distilled water and then was
stone is a less common type of stones that is formed by dried at 1008C overnight. After that, samples were
infection in the urinary tract. Uric acid stone is less crushed and ground in agate mortar. The resulting
common than STR stone. Cystine stone is rare. powder was homogenized chemically and then a
Hammarsten (1929)—in Wandt and Underhill pellet stups were made by exposing them to 200 Kn
1988—discovered the antagonistic influence of pressure before analyzing them using XRF (model
urolithiasis, which Co, Mg and Ni have upon calcium Philips Magix PW2424). Major and some trace
by increasing the solubility of calcium oxalate. Meyer elements were measured as oxide in weight percent-
and Angino (1977) added various ions to the list, age (wt%) (Tables 1, 2).

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Environ Geochem Health

Table 1 Percentage concentration of metal elements results of urinary calculi (wt%)

Element Concentration (%)

Group 1 Group 2 Group 3 Group 4 Group 5 Group 6 Group 7 All stones

(n = 21) (n = 29) (n = 23) (n = 25) (n = 5) (n = 4) (n = 3) (n = 110)

Na Mean 0.73 0.93 1.46 0.98 1.12 3.56 2.23 1.56

Range 0.043–0.92 0.56–1.02 0.63–2.31 0.095–1.68 0.68–2.01 1.26–7.35 0.95–4.65 0.043–7.35
K Mean 0.56 0.89 1.02 1.21 0.95 1.22 0.45 0.90
Range 0.002–1.02 0.13–1.56 0.32–1.25 0.51–1.51 0.052–1.32 0.86–1.57 0.21–1.08 0.002–1.57
Ca Mean 38.25 30.35 25.82 18.32 13.65 10.33 5.56 20.33
Range 25.23–45.5 16.56–36.6 17.91–36.5 15.71–20.6 12.6–18.53 9.35–11.5 4.8–8.12 6.80–38.25
Mg Mean 1.57 1.86 2.11 5.58 4.65 3.25 2.57 3.08
Range 0.009–2.65 0.26–1.95 0.35–2.33 1.56–6.95 1.23–5.21 0.95–4.23 0.85–3.02 0.009–6.95
Fe Mean 0.56 0.85 1.02 1.25 1.14 1.85 1.49 1.17
Range 0.11–0.95 0.09–1.23 0.32–1.42 0.11–3.85 0.79–2.28 0.65–2.01 0.87–1.95 0.09–3.85
Al Mean 0.21 0.35 0.45 0.62 0.58 0.71 0.53 0.49
Range 0.11–0.65 0.12–0.42 0.006–0.95 0.26–0.96 0.02–0.85 0.39–0.86 0.24–0.75 0.006–0.96
Zn Mean 0.02 0.15 1.09 1.18 0.28 0.92 1.23 0.70
Range 0.005–0.06 0.008–0.26 0.02–1.54 0.24–1.56 0.08–0.54 0.11–1.21 0.22–1.55 0.005–1.56
Cu Mean 0.05 0.07 0.26 0.35 0.22 0.15 0.22 0.19
Range 0.01–0.51 0.002–0.25 0.02–0.56 0.19–0.65 0.26–1.05 0.21–0.89 0.24–0.98 0.002–1.05
Mn Mean 0.019 0.035 0.023 0.052 0.009 0.008 0.058 0.029
Range 0.009–0.03 0.01–0.06 0.02–0.045 0.008–0.05 0.005–0.01 0.006–0.02 0.05–0.06 0.005–0.06
P Mean 2.35 3.45 15.45 24.63 19.34 5.34 1.86 10.35
Range 0.55–3.56 1.25–4.01 3.56–21.23 5.26–29.65 4.53–22.32 0.98–7.23 1.23–2.01 0.55–29.65
S Mean 0.96 0.42 2.03 1.65 2.12 2.45 3.50 1.88
Range 0.56–1.21 0.32–0.76 0.58–3.56 0.95–2.05 0.87–8.36 1.05–5.62 1.78–6.35 0.32–8.36
Sr Mean 0.56 0.43 0.41 0.32 0.25 0.09 0.08 0.306
Range 0.11–0.87 0.21–0.56 0.30–0.78 0.12–0.56 0.006–0.45 0.06–0.11 0.09–0.88 0.006–0.88
Mo Mean 0.008 0.04 0.05 0.01 0.054 0.65 0.58 0.20
Range 0.005–0.009 0.01–0.08 0.005–0.07 0.008–0.05 0.03–0.08 0.09–0.91 0.09–0.89 0.005–0.91
Cr Mean 0.01 0.015 0.06 0.15 0.25 0.26 0.28 0.146
Range 0.005–0.07 0.003–0.12 0.01–0.2 0.12–0.77 0.22–0.66 0.11–0.76 0.21–0.77 0.003–0.77
Co Mean 0.05 0.024 0.078 0.06 0.03 0.054 0.056 0.05
Range 0.02–0.08 0.012–0.05 0.001–0.08 0.01–0.075 0.011–0.06 0.02–0.065 0.022–0.08 0.001–0.08
Ni Mean 0.01 0.015 0.014 0.009 0.021 0.021 0.009 0.014
Range 0.008–0.03 0.009–0.026 0.009–0.02 0.008–0.01 0.01–0.029 0.01–0.022 0.008–0.01 0.008–0.03
Group 1: Calcium oxalate calculi (CaOax) minerals: calcium oxalate monohydrate (COM) & calcium oxalate dihydrate (COD)
Group 2: Mixed calcium oxalate/uric acid calculi minerals: COM & COD/uric acid (UA) & uric acid dihydrate (UAD)
Group 3: Mixed calcium oxalate/phosphate calculi minerals: COM & COD/apatite (APA) & struvite (STR)
Group 4: Phosphate calculi minerals: APA/STR
Group 5: Mixed calcium oxalate monohydrate/Phosphate (struvite) calculi minerals: COM/STR
Group 6: Mixed urate calculi minerals: mixed ammonium acid urate (AAU)/sodium acid urate (SAU)
Group 7: Cystine calculi minerals (CYS)
n: Number of stones

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 Table 2 Comparison of trace metal concentrations in urinary calculi from different studies (wt%)
Element Concentration (%)

123
Present study* Al-Fawaaz 2006a Jhaumeer-L & Subratty Al-Maliki 1998c Wandt et al. Joost & Tessadri Levinson et al. Ohta 1957g
(n = 110)** (n = 35) 1999b (n = 12) (n = 19) 1988d (n = 102) 1985e (n = 24) 1978f (n = 69) (n = 10)

Na Mean 1.56 4.038 0.37 – 4670 – 3574 4570

Range 0.043–7.35 1.27–9.12 0.061–0.715 – <129–50042 – – 1690–7650
K Mean 0.90 1.33 0.217 0.098 1737 0.025 15265 2890
Range 0.002–1.57 0.19–3.02 0.03–0.56 0.01–0.16 <180–6756 – – 520–8140
Ca Mean 20.33 60.88 16.13 16.71 15.81 – – 22.8
Range 6.8–38.25 24.7–88.8 0.16–32.81 0.07–30.2 <0.01–31.43 – – 5.2–45
Mg Mean 3.08 1.478 0.84 2.92 2.38 5.29 – 1.12
Range 0.009–6.95 0.39–2.83 0.0004–4.6 0.16–8.18 <0.01–9.75 – – 0.15–3.14
Fe Mean 1.17 1.094 0.67 1.094 27 45.38 33 215
Range 0.09–3.85 0.17–2.05 0.00095–5.23 0.03–4.62 <0.1–156 – – 118–340
Al Mean 0.49 4.19 – – 32 – 180 –
Range 0.006–0.96 1.15–11.5 – – <10–89 – – –
Zn Mean 0.70 0.34 0.132 0.432 270 28.44 420 555
Range 0.005–1.56 0.1–0.58 0.002–0.799 0.03–0.9 <0.1–1381 – – 239–913
Cu Mean 0.19 0.285 0.0013 0.155 1.4 11.64 2.5 14
Range 0.002–1.05 0.24–0.33 4.5 · 10 5–0.0059 0.04–0.82 <1–10 – – 4.8–27
Mn Mean 0.029 0.13 0.07 0.045 – 0.5 – –
Range 0.005–0.06 – – 0.01–0.79 – – – –
P Mean 10.35 3.644 22.49 – 6.61 – – 5.68
Range 0.55–29.65 1.05–7.38 1–67.6 – <0.01–16.79 – – 0.33–12
S Mean 1.88 2.366 – – 8564 – – –
Range 0.32–8.36 0.29–4.91 – – 134–271000 – – –
Sr Mean 0.306 0.11 – – 121 – 81 –
Range 0.006–0.88 0.06–0.16 – – <6–622 – – –
Mo Mean 0.20 8.66 – – 2.2 – 27 –
Range 0.005–0.91 1.7–17.47 – – <1.5–8.3 – – –
Cr Mean 0.146 – 0.0065 – – – – –
Range 0.003–0.77 – 0.0015–0.017 – – – – –
Co Mean 0.05 3.848 – 0.03 – – – –
Range 0.001–0.08 0.9–11.0 – – – – – –
Environ Geochem Health
Environ Geochem Health

Ohta 1957g

Present study**: (21) Calcium oxalate calculi (CaOax), (29) Mixed calcium oxalate/uric acid calculi, (23) Mixed calcium oxalate/phosphate (APT & STR) calculi, (25) Phosphate
The samples were studied after a standard diges-

(n = 10)
tion process. Thirty milligrams of the homogenized
powder stones were dissolved in 1 ml of concentrated

–
–
boiling nitric acid (98%, Analar, BDH chemicals
Ltd., Poole, England) at 250 8C for at least 1 h.
Levinson et al.
1978f (n = 69)

Digested aliquots were diluted to volume and stored

in polyethylene bottles for subsequent analysis by
Atomic Absorption Spectrophotometer (Perkin–El-
calculi (APA/STR), (5) Mixed calcium oxalate monohydrate/struvite calculi, (4) Urate calculi (mixed AAU/SAU), (3) Cystine calculi = 110 stones
mer, Model 703 & HGA-500). The quality and
–
–

quantity of the main alkaline (Na, K), alkaline earth

Joost & Tessadri

(Ca, Mg) and trace metal (Fe, Al, Zn, Cu, Mn, P, S,
1985e (n = 24)

Sr, Li, Mo, Cr, Co, Ni, V, Pb, Cd, As) elements were
found out. Zn, Cu, Mn, Co, Cr, Ni and V were being
indispensable with for life activity of an organism,
–
–

while Pb, Cd and As are toxic heavy metals for life

organism. In addition, Aluminum also inert, Lithium,
1988d (n = 102)

vanadium, lead, cadmium and arsenic concentrations

Wandt et al.

were found to be below detection limit in all studied

samples and these elements were not considered
further. Details of all procedure employed are
–
–

described elsewhere (Evenson and Warren 1975;

Al-Maliki 1998c

Foote and Delves 1982; Durak et al. 1988; Wandt and

Underhill 1988; Jhaumeer-L and Subratty 1999;
0.03–0.05

Batanjac 2000).
(n = 19)

0.03

Results
Jhaumeer-L & Subratty

The results of chemical analysis of 110 urinary

1999b (n = 12)

calculi were selected from different patients depend-

Ca, Mg and K elements in percent. Others in ppm (as received)

ing on the size and weight of the stone. Urinary

Ca, Mg and P elements in percent. Others in ppm (as received)

Ca, Mg and P elements in percent. Others in ppm (as received)

(as received)

calculi stones were classified into seven mineral

Mg and K elements in percent. Others in ppm (as received)

groups depending on the mineral composition using

–
–

X-ray diffraction. Each of the above-mentioned

groups includes more than one mineral (See below
Al-Fawaaz 2006a

3
in percent for all ions except phosphor as PO4

and caption under Table 1) depending on the different

formation factors of urinary stones in patients. Of the
0.43–1.34
(n = 35)

110 calculi stones analyzed in this study, 21 belonged

0.965

to the calcium oxalate calculi (CaOax) group (cal-

All elements in ppm (as received)
Concentration (%)

cium oxalate monohydrate (COM) and calcium

Present study*

oxalate dihydrate (COD) minerals). Twenty-nine

(n = 110)**

0.008–0.03

belong to the mixed calcium oxalate (COM and

in percent (as received)

COD minerals)/uric acid calculi group (uric acid

0.014

n*: Number of stones

(UA) and uric acid dihydrate (UAD) minerals).

Table 2 continued

Twenty belong to the mixed calcium oxalate (COM

and COD minerals)/phosphate calculi group (apatite
Range
Mean

(APA) and struvite (STR) phosphate minerals).

Element

Twenty-five belong to the phosphate calculi group

Ni

(APA and STR minerals). Five belong to the mixed

b

g
a

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 Environ Geochem Health

calcium oxalate monohydrate (COM) mineral/stru- (ranging between 0.002% and 1.05%, with an aver-
vite (STR) mineral calculi group. Four calculi age value of 0.19%) (Table 1). Green foods, flour,
containing urates group (ammonium acid urate milk products and meats are responsible for these
(AAU) and sodium acid urate (SAU) minerals) and concentrations. Manganese ion is present in eleven
3 cystine mineral stones group (CYS) were contained samples of different types of urinary calculi ranging
in the selection. between 0.005% and 0.06% with an average value of
The presence of different trace metals in the stones 0.029% (Table 1). The main source of Mn is beans,
was also been studied (Table 1). Table 1 shows the tea, and green foods (Mena et al. 1969). It has been
results of the trace metals and their mean and average noted that there is no concentrations of toxic trace
concentrations for all mineral groups of the calculi elements like Li, V, Pb, Cd, and As. Furthermore,
type, respectively. It was been found that these some heavy metals such as Mo, Cr, Co and Ni have
urinary calculi contain mostly calcium as cation, been traces (Table 1). P and S ions are present in few
ranged between 6.80% and 38.25% with an average calculi stones as traces (Table 1).
value of 20.33% (Table 1), and was considered as the In Table 2, elemental concentrations obtained in
main constituent of stones of all different types. It is the present study are compared with values obtained
obvious that Ca content is affected by the type of by others (Ohta 1957; Levinson et al. 1978; Joost and
food and drinks patients take, including diary and Tessadri 1987; Wandt et al. 1984; Al-Maliki 1998;
milk products, eggs, tea, and hard water (Robertson Al-Fawaaz 2006). It is noteworthy mentioning that
et al. 1980; Abboud 2006; Sobhi 2006). By compar- the sequence of the average trace metal concentration
ing the Ca content in urinary calculi with that within values for the calculi in this study is similar to that
water in Jordan, it has been noted that there is a found by other researchers (Table 2).
strong relationship between both. This indicates that
the main source of Ca comes from the water that
people drink (Abboud 2006). Percentage mass of Discussion
magnesium ion in the stones was been found to be <
3% (Table 1), (ranging from 0.009% to 6.95% with Studies confirm that heavy metals can directly
an average value of 3.08%). Presence of Magnesium influence behavior by impairing mental and
in urinary stones is usually an indicator of an increase neurological function, influencing neurotransmitter
in their concentration in human body (Deeming and production, utilization, and altering numerous met-
Webu 1977). Drinks, food, drugs and vitamins are abolic body processes. Systems in which toxic
also responsible for Mg content (Sobhi 2006). metal elements can induce impairment and dys-
Alkaline metals (Na, K) are present in low function include the blood and cardiovascular,
concentrations ranging from 0.043% to 7.35% and detoxification pathways (colon, liver, kidneys, skin),
0.002% to 1.57%, respectively, with an average value endocrine, energy production pathways, enzymatic,
of 1.56% and 0.90%, respectively (Table 1). The gastrointestinal, immune, nervous, reproductive, and
main contributor for magnesium, sodium and potas- urinary (Kellas and Dworkin 1996; Pouls and Payne
sium in the urinary calculi is their presence in 2006).
drinking water (Abboud 2006). Food is another The human body’s organ systems, like the endo-
source of these elements (Robertson et al. 1980; crine system, and immune system, are infected with
Sobhi 2006). environmental toxicity through chemical pollutants
Concentration of transition metal ions such as iron, and chemicals added to our food, water and air.
manganese, copper and zinc have been very low to be Fullerton (2003), has found heavy metals as one of
detected. The presence of Fe ions ranges between the most common chemical causes of pathology,
0.09% and3.85% with an average value of 1.17% especially aluminum and mercury (Pouls and Payne
(Table 1). Food and water are responsible for the 2006).
presence of Fe. Meats and beans are considered the There are many possibilities, offered by different
main source of Fe (Meranger and Smith 1972). Most technologies, to determine the chemical composition
samples of urinary calculi have no concentrations of of urinary calculi. As can be seen in Table 1, all trace
Cu. Seventeen samples have had low presence of Cu metal concentrations have been identified precisely

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Environ Geochem Health

by analysis with XRF and AAS. A high percentage of not appear to play a significant role in urolithiasis
the urinary calculi investigated in this study has been (Wandt and Underhill 1988).
found to consist mainly of either a calcium oxalate or The insufficient detection of phosphate minerals in
a calcium phosphate salt (Al-Kinani et al. 1984; uric acid (uricite) stones can lead to important clinical
Samuell and Kasidas 1995; Al-Maliki 1998; Jhau- consequences. Alkalization therapy should be
meer-L and Subratty 1999; Abboud 2006; Al-Fawaaz avoided even if there is only a small amount of
2006). It has long been hoped that knowledge of the phosphate minerals in uric acid. This is due to the fact
relative concentrations of the different components that the highest precipitation rate of phosphate is
present in calculi would lead to an understanding of reached in the alkaline pH range. An exact urinary pH
the mechanisms of stone nucleation and growth. control is important if oxalate stones have low
Trace elements determinations are currently being phosphate minerals content and acidification below
investigated by many researchers (Meyer and Angino pH 6.2 might be necessary for metaphylaxis (Joost
1977; Levinson et al. 1978; Meyer and Thomas 1982; and Tessadri 1987). Phosphate stones may belong to
Wandt et al. 1984; Durak et al. 1988; Wandt and the non-infection urinary stones (Abdel-Halim et al.
Underhill 1988; Abu-Farsakh 1997; Al-Maliki 1998; 1993; Sobhi 2006).
Saw et al. 2000; Torzewska et al. 2003; Chutipong- The average calcium and magnesium contents
tanate et al. 2005; Reynolds 2005; Al-Fawaaz 2006; (48.18, 3.08%, respectively) have been higher than
Abboud 2006). Some concentrations of Ca, P, S, F, that of stone analysis in other correlation studies,
Cl, Al, Mn, Cu, Mg and Na in urinary stones have except for the fact that Ca presence in Al-Fawaaz
been found to be much higher than normal and it has study (2006) (Table 2). The high concentration of the
been suggested that elements with high concentra- Ca2+ and Mg2+ cations present in calculi samples
tions might play a significant part in stone formation with cholesterol could promote the formation of large
either in association with the structure of the numbers of cholesten. This may increase the rate of
conglomerate crystals or in combination with organic development of gall stones (Neithercut 1989). In
molecules (Al-Kinani et al. 1984; Durak et al. 1988). addition, Ca phosphate and Ca carbonate have been
In the present study, high concentrations of some found in cholesterol (cholesten) gall stones (Malet
elements (Ca, P, S) have been recognized (Table 1). et al. 1986). Scott et al. (1982) suggested that high
Table 2 gives a comparison of all results obtained calcium levels are a risk factor in the development of
with the findings of other researches. The results stone disease.
show that average zinc and strontium contents (0.7, The average potassium and sodium contents (0.9,
0.306% respectively), have been higher when com- 1.56% respectively) have been higher than that of
pared to others (Table 2). It has been indicated that stones analysis in other correlation studies, except for
Zn is positively correlated with Sr (Wandt and Al-Fawaaz study (2006) (Table 2). K and Na
Underhill 1988) and predominantly associated with elements can substitute Ca in apatite (Simpson
apatite, which is substantiated by correlations estab- 1968) as with Sr and Zn. Generally, these elements
lished between the Zn and P content of the stones. are mainly limited to the crystal surface (Wandt and
This supports previous findings by Sutor (1969), Underhill 1988).
Schneider et al. (1970), King (1971), and Wandt and The average iron content (1.17%) has been slightly
Underhill (1988). higher than that of stones analysis in other correlation
Strontium competes with Ca for the apatite lattice studies (Table 2). Urinary iron is thought to arise
(Sobel et al. 1949 in Wandt and Underhill 1988). It is from microhaematuria and epithelial cells in the renal
so similar to Ca in its metabolism that it is generally tubules. Iron ion presence in calculi is further
known to be a companion to the latter in salts, where explained by the adsorption of Fe2+ and Fe3+ ions
Sr can exchange isomorphically with Ca in the lattice on CaOx and Ca-phosphate (Wandt and Underhill
(Neuman and Neuman 1953 in Wandt and Underhill 1988).
1988). This can be concluded due to the fact that The average aluminum content (0.49%) has been
there is a positive correlation between the amount of slightly higher than that of stones analysis in other
apatite and Sr in the phosphate stones and with P and correlation studies, except for Al-Fawaaz study
Sr in the calcium oxalate/phosphate stones. Sr does (2006) (Table 2). Aluminum can make a very well

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 Environ Geochem Health

correlation with phosphorous in phosphate calculi The concentration of K, Mg, Fe, Mn, S and Sr in
(apatite, struvite). This result confirms that of Wandt Jordanian patients of urinary calculi has been com-
and Underhill’s (1988) study. Sutor (1969) found that patible with that of other patients in the many studies
very small concentrations of Al3+ removed oxalate around the world (Table 2). While Ca, Na and P
ions and thus prevented the crystallization of CaOx. presence in the Jordanian patients urinary calculi has
This association might result from its incorporation slightly higher concentration than that of other
into the apatite lattice, where it probably substitutes patients around the world, these concentrations may
for P (Levinson et al. 1978). be dependent on to the quality and quantity of
The average copper and molybdenum contents drinking water and food intakes. Water intake for
(0.19, 0.2% respectively), have been slightly higher Jordanian patients is highly concentrated with Ca2+
than that of stones analysis in other correlation ions because water is drawn carbonate reserve. Food
studies, except for Al-Fawaaz study (2006) (Table 2). intake is also rich in Ca (like eggs, milk and green
Cu2+ ion can compete with Ca2+ in calcification leaf of vegetables). Concentration of Na+ ions in
(Sobel et al. 1949 in Wandt and Underhill 1988). urinary calculi of Jordanian patients may be due to
Neithercut (1989) and Abu-Farsakh (1997) clearly the concentration of this ion during the depletion of
show that Cu2+ and Zn2+ have been present in gall water through irrigation processes. Concentration of
stones in micromolar concentrations and there have P ions in urinary calculi of Jordanian patients is
been no significant difference in Cu2+ and Zn2+ closely related to food intake like eggs, milk and
concentration in gall stones. The presence of Cu2+ green vegetable leafs.
and Zn2+ in calculi could be explained as simple
co-precipitation with cholesterol (cholesten) Acknowledgements This research has been sponsored by Al
al-Bayt University. The researcher would like to express his
(Abu-Farsakh 1997). Molybdenum can make a good appreciation for the help of Prof. Dr. Nadher Al Ansari, Dr. Ali
correlation with magnesium (Wandt and Underhill Ahmed Bani Nasser, and Mr. Musa Al-Zghoul for their
1988). All other trace and heavy metals in this study invaluable comments during the different stages of carrying out
have played only a minor role in the chemical effects of this research.
of mineral formation. This is because of the very low
concentrations at which these metals have been
present.
The average sulfur content (1.88% with range References
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