Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence

Tanaka, Yutaro; Tsujino, Ichiro; Yoshikawa, Hiroshi Y.; Takano, Kazufumi; Okada, Atsushi; Kohri, Kenjiro; Yasui, Takahiro; Yoshimura, Masashi; Mori, Yusuke; Maruyama, Mihoko

doi:https://doi.org/10.1007/s00240-025-01820-2

Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence

Tanaka, Yutaro; Tsujino, Ichiro; Yoshikawa, Hiroshi Y. et al.

Urolithiasis, 2025, 53, 172

Number of Access:9（2025-11-16 18:29 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/103001

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Title	Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence
Creator	NRID 1000070813434 1000070813434 researchmap permalink yutaro-tanaka yutaro-tanaka ORCID 0000-0003-3154-170X 0000-0003-3154-170X Scopus Author ID 57204873731 57204873731 CreatorName Tanaka, Yutaro
	CreatorName Tsujino, Ichiro
	NRID 1000050551173 1000050551173 ORCID 0000-0003-0624-6039 0000-0003-0624-6039 researchmap permalink read0108058 read0108058 Scopus Author ID 55708129100 55708129100 CreatorName Yoshikawa, Hiroshi Y.
	NRID 1000040346185 1000040346185 CreatorName Takano, Kazufumi
	NRID 1000070444966 1000070444966 CreatorName Okada, Atsushi
	NRID 1000030122047 1000030122047 CreatorName Kohri, Kenjiro
	NRID 1000040326153 1000040326153 CreatorName Yasui, Takahiro
	NRID 1000060314382 1000060314382 ORCID 0000-0002-0770-1251 0000-0002-0770-1251 researchmap permalink read0191199 read0191199 Scopus Author ID 7403136552 7403136552 CreatorName Yoshimura, Masashi
	NRID 1000090252618 1000090252618 ORCID 0000-0003-2952-7458 0000-0003-2952-7458 researchmap permalink mori_yusuke mori_yusuke Scopus Author ID 7404197134 7404197134 CreatorName Mori, Yusuke
	NRID 1000020623903 1000020623903 ORCID 0000-0002-3453-8007 0000-0002-3453-8007 researchmap permalink marumarumi marumarumi Scopus Author ID 35307485800 35307485800 CreatorName Maruyama, Mihoko
Subject	24 hours urine
	Brushite
	Calcium oxalate
	Cooling urine
	Crystalluria
	Kidney stone
Description	The version of record of this article, first published in Urolithiasis 53, 172 (2025), is available online at Publisher’s website: https://doi.org/10.1007/s00240-025-01820-2
Abstract	Kidney stones have a high recurrence rate—10% within 5 years and 50% within 10. Crystalluria reflects the urinary physicochemical environment and may serve as a recurrence marker, but key crystals like brushite are rarely detected under ambient conditions. This study aimed to identify novel recurrence markers by inducing crystallization through urine cooling and analyzing crystal composition. The analyzed urine samples from 164 stone formers, including first-time stone formers (FSF, n = 77) and recurrent stone formers (RSF, n = 87). The RSF group was further stratified into low-risk (n = 43) and high-risk (n = 44) groups based on recurrence intervals. A 24-hour urine test assessed mineral composition and supersaturation indices. Urine samples were then cooled to induce crystallization; precipitated crystals were analyzed using microscopy and Raman spectroscopy. The presence, size, and quantity of brushite crystals were compared among the groups. Before cooling, crystals were detected in only 10.9% of samples, whereas after cooling, crystallization occurred in 76.2%, revealing six crystal types, including calcium oxalate dihydrate (COD) and brushite. COD prevalence did not differ significantly among the groups, whereas brushite crystals were significantly more frequent in the high-risk RSF (47.7%) than in low-risk RSF (16.3%) and FSF (16.9%) (p = 0.002) groups. Additionally, the high-risk RSF group had greater quantity and larger size of brushite crystals than did other groups. Cooling-induced brushite crystallization is a promising risk marker for early stone recurrence, with higher crystal quantity and larger size strongly associated with high-risk patients. This method might enhance predictive accuracy beyond traditional 24-hour urine tests, providing a simple, cost-effective tool for recurrence prevention.
Publisher	Springer Science and Business Media Deutschland GmbH
Source Title	Urolithiasis
Volume (Issue)	53
Page	172
Date of Issued	2025-09-06
Language	English
Handle URL	https://hdl.handle.net/11094/103001
PISSN	21947228
eISSN	21947236
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s00240-025-01820-2
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Urolithiasis. 2025, 53, p. 172
DC.title	Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence
DC.creator	Tanaka, Yutaro
	Tsujino, Ichiro
	Yoshikawa, Hiroshi Y.
	Takano, Kazufumi
	Okada, Atsushi
	Kohri, Kenjiro
	Yasui, Takahiro
	Yoshimura, Masashi
	Mori, Yusuke
	Maruyama, Mihoko
DC.publisher	Springer Science and Business Media Deutschland GmbH
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-09-06
DC.identifier	https://doi.org/10.1007/s00240-025-01820-2
DC.subject	24 hours urine
	Brushite
	Calcium oxalate
	Cooling urine
	Crystalluria
	Kidney stone
DC.description	The version of record of this article, first published in Urolithiasis 53, 172 (2025), is available online at Publisher’s website: https://doi.org/10.1007/s00240-025-01820-2
DCTERMS.abstract	Kidney stones have a high recurrence rate—10% within 5 years and 50% within 10. Crystalluria reflects the urinary physicochemical environment and may serve as a recurrence marker, but key crystals like brushite are rarely detected under ambient conditions. This study aimed to identify novel recurrence markers by inducing crystallization through urine cooling and analyzing crystal composition. The analyzed urine samples from 164 stone formers, including first-time stone formers (FSF, n = 77) and recurrent stone formers (RSF, n = 87). The RSF group was further stratified into low-risk (n = 43) and high-risk (n = 44) groups based on recurrence intervals. A 24-hour urine test assessed mineral composition and supersaturation indices. Urine samples were then cooled to induce crystallization; precipitated crystals were analyzed using microscopy and Raman spectroscopy. The presence, size, and quantity of brushite crystals were compared among the groups. Before cooling, crystals were detected in only 10.9% of samples, whereas after cooling, crystallization occurred in 76.2%, revealing six crystal types, including calcium oxalate dihydrate (COD) and brushite. COD prevalence did not differ significantly among the groups, whereas brushite crystals were significantly more frequent in the high-risk RSF (47.7%) than in low-risk RSF (16.3%) and FSF (16.9%) (p = 0.002) groups. Additionally, the high-risk RSF group had greater quantity and larger size of brushite crystals than did other groups. Cooling-induced brushite crystallization is a promising risk marker for early stone recurrence, with higher crystal quantity and larger size strongly associated with high-risk patients. This method might enhance predictive accuracy beyond traditional 24-hour urine tests, providing a simple, cost-effective tool for recurrence prevention.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	103001
citation_title	Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence
citation_author	Tanaka, Yutaro
	Tsujino, Ichiro
	Yoshikawa, Hiroshi Y.
	Takano, Kazufumi
	Okada, Atsushi
	Kohri, Kenjiro
	Yasui, Takahiro
	Yoshimura, Masashi
	Mori, Yusuke
	Maruyama, Mihoko
citation_publisher	Springer Science and Business Media Deutschland GmbH
citation_language	English
citation_date	2025-09-06
citation_journal_title	Urolithiasis
citation_volume	53
citation_firstpage	172
citation_doi	https://doi.org/10.1007/s00240-025-01820-2
citation_public_url	https://hdl.handle.net/11094/103001

Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence

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