INTRODUCTION

Kidney stone disease is one of the most common kidney diseases. An estimated 2.3 percent of the Philippine population suffer from kidney stones [1]. A kidney stone may form when substances, such as calcium and oxalates, normally present in urine in small quantities reach high concentrations, accumulate and solidifies. Kidney stone formation may also be triggered when urine do not contain high enough concentrations of substances such as citrate, which prevent some types of kidney stones from forming [2]. There are four main types of kidney stone such as: uric acid, cystine and struvite, but calcium oxalate accounts for 75-89% of all kidney stones.[3]

Kidney stones can form in any part of the urinary system and do not usually cause any symptoms until they start to pass. Kidney stones vary in sizes, very small stones could pass through the urinary system without causing pain while larger stones can block the ow of urine, which can damage the kidneys due to the pressure of urine backing up into the kidneys [4,5]. The common symptoms of Kidney Stone disease is said to be severe, crampy pain in the back or abdomen. If left untreated kidney stones may cause further complications such as urinary tract infection, kidney scarring/damage, and lost or reduced kidney function [6].

Occasionally stones do not show any symptoms but they can be growing, causing irreversible damage to kidneys. There are different ways in diagnosing the presence of kidney stones in a patient, which may be imaging/radiologic tests or metabolistic-related diagnostic tests.

The usual procedure done in diagnosing if a patient is suffering from kidney stones is first, a detailed medical history and physical examination. The clinical diagnosis should be supported by an appropriate imaging procedure to know if the clinical diagnosis is indeed correct. Some of these imaging procedures are Plain abdominal X-rays, Ultrasound, and Noncontrast helical CT scanning (spiral).

Plain abdominal x-rays may be used in detecting calcium oxalate stones, which are visible on plain radiography. An ultrasound examination is said to be the safest because there is no risk of radiation but its accuracy is low. While Non-contrast helical CT scanning (spiral) is said to be the technique which has superior sensitivity and specicity over other imaging

methods. It increases diagnostic certainty by identifying alternate diagnoses not suspected on clinical grounds alone [7]. Other radiological methods are Computed Tomography(CT), Intravenous Urography(IVU), Kidney-Ureter-Bladder radiograph(KUB) and Non-contrast

Enhanced Computed Tomography(NCCT)[8].

Blood Analysis is one way of determining the risk of a patient from Calcium Oxalate Stones, this requires measurement of creatinine, sodium, potassium, chloride, ionized calcium (or total calcium and albumin), uric acid, and in case of increased calcium levels PTH (Intact parathyroid hormone). Another way is through urinalysis which requires measurement of urine volume, urine pH profile, specific weight, calcium, oxalate, uric acid, citrate, and magnesium[8].

A study performed by Ross et.al shows that dietary factors have a role in stone disease in their study using pediatric mouse models. The experiment performed by Ross et. al showed that diet could alter urine parameters in pediatric mouse models.

Early detection of kidney stones is an advantage to prevent further damage to the kidneys. To contribute to this need of the medical industry, the group propose a method that would determine Calcium level concentration in urine and its relationship to the risk of a patient having calcium oxalate kidney stone.

The method is precipitation of calcium oxalate in the microlevel and using spectrophotometry to detect if the level of calcium oxalate precipitated is an indication if the patient is already at risk of kidney stone.

For many years, different methods of predicting the formation of kidney stones are developed. Some of these methods are EQUILS, Supersaturation, and more recent Bonn Risk Index Methods. But these methods demand robust laboratory analysis and even more complex computation programs. The potential of predicting formation of kidney stones by simple

spectrophotometry with the groups proposed method is a relatively faster, easier, and costeffective method compared with the aforementioned methods.

The method proposed may be used as a monitoring tool during dietary restrictions for management of kidney stones, since several metabolic disturbances could modify urine composition which could lead to supersaturation and crystal formation. Through the method proposed, insight into the risk of stone formation can aid in determining optimal preventive management of kidney stones in patients.

As a statement your problem: To find an alternative method of diagnosing kidney stones using urine as the analyte. The conventional methods are expensive and requiring special skills. Try to deal with methods of determining kidney stones more than the kidney problem. The kidney problem is for the medical physician not yours. You might want to talk more about the ways of determining the Ca in urine.

1. Escudero, N. (2011, January).

2M Pinoy may kidney stones. Retrieved from

http://www.philstar.com/bansa/651141/2m-pinoy-may-kidney-stones. 2. The Kidney: A Guide for Patients. http://www.renalresource.com/pdf/kb10.pdf. Retrieved date: March 3, 2013. 3. A Litholink Patient Resource Guide:Kidney Stone Prevention Guide. http://www.denvernephrology.com/wpcontent/uploads/2012/12/Stone_PreventionGuide.pdf. Retrieved date: March 3, 2013.

4. UNC Kidney Center: A Patients Guide to Chronic Kidney Disease. http://www.unckidneycenter.org/kidneyhealthlibrary/CKD/CKD%20Education%20Book.p df. Retrieved date: March 3, 2013. 5. American Kidney Fund: Kidney Stones. http://www.kidneyfund.org/kidneyhealth/brochures/brochure-pdf/kidney-stones.pdf. Retrieved date: March 3, 2013. 6. Kidney Stones. http://caresinfo.com/uploadedFiles/File/Kidney_Stones.pdf. retrieved date: March 3, 2013. 7. Radiological Diagnosis of Kidney Stones. http://www.cari.org.au/CKD_stones_list_published/Radiological_diagnosis_of_kidney_st ones_310107.pdf. Retrieved date: March 3, 2013. 8. European Association of Eurology: Guidelines on Urolithiasis. http://www.uroweb.org/gls/pdf/18_Urolithiasis.pdf. Retrieved date: March 3, 2013