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Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies

INTRODUCTION: Dietary factors in the form of citrus juices (e.g orange, grapefruits, cranberry, lemonade and lime) appear to affect the ability of urine to inhibit calcium oxalate crystallization. In South Africa, previous studies have demonstrated that black and white individuals respond differentl...

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Main Author: Bvumbi, Mpelegeng Victoria
Other Authors: Rodgers, Allen
Format: Thesis
Language:English
Published: Department of Chemistry 2016
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access_status_str Open Access
author Bvumbi, Mpelegeng Victoria
author2 Rodgers, Allen
author_browse Bvumbi, Mpelegeng Victoria
Rodgers, Allen
author_facet Rodgers, Allen
Bvumbi, Mpelegeng Victoria
author_sort Bvumbi, Mpelegeng Victoria
collection Thesis
description INTRODUCTION: Dietary factors in the form of citrus juices (e.g orange, grapefruits, cranberry, lemonade and lime) appear to affect the ability of urine to inhibit calcium oxalate crystallization. In South Africa, previous studies have demonstrated that black and white individuals respond differently to lithogenic and antilithogenic dietary supplements. OBJECTIVES: The current project was undertaken to study the inhibitory activity of lime in artificial urine and in the real urine of South African black and white subjects and also to assess the effects on urinary risk factors in these subjects after its ingestion. SUBJECTS AND METHODS: Experiments commenced with the preparation of artificial urine (AU) in which the effects of lime solutions (0.125-1.00 mglml) were tested by carrying out various crystallization experiments. These included the determination of the calcium oxalate (CaOx) metastable limit (MSL); particle volume-size distribution (PSD), nucleation, aggregation and growth assays. Crystal deposition was studied using scanning electron microscopy (SEM). In vitro experiments were then conducted in 24 hour urine samples from healthy South African black (n = 5) and white males (n = 5). The above-mentioned crystallization experiments were repeated in these urines. In addition, free Ca²⁺ values and the Bonn risk index (BRI) of CaOx crystallization were determined. Thereafter, a trial study in which 5 black and 4 white subjects ingested solutions of lime powder for 7 days was conducted. 24 hour urine samples were collected by subjects before and after the ingestion of lime. Urines were analysed for pH, sodium, potassium, calcium, oxalate, citrate, uric acid chloride, magnesium, phosphate, and creatinine. Urine composition values were used as input data for the calculation of relative supersaturation (RS) values for calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), brushite and uric acid using the computer programme EQUIL and Tiselius Risk Index (TRI) was also determined. The above-mentioned CaOx crystallization experiments were also performed. Urine compositions, crystallization data and physicochemical risk indices were analyzed statistically using analysis of variance (ANOVA). RESULTS: None of the lime solutions did affect the CaOx MSL of the AU or the real urine (in vitro). However CaOx crystal nucleation was promoted while CaOx crystal growth and aggregation were inhibited. In the trial study, after ingestion of lime solutions, significant increases in urinary magnesium (1.80 vs 2.75 mmol/24h, p = 0.0001) and phosphate (20.9 vs 24.6 mmol/24h, p = 0.023) were observed in black subjects. On the other hand, in white subjects, a significant decrease in urinary oxalate (0.313 vs 0.205 mmol/24h, p = 0.023) and TRI (304 vs 187, p = 0.0102) were noted. However, lime did not increase citrate levels to a significant degree in either group. CONCLUSIONS: The results presented in this dissertation have shown that lime may be regarded as a potential therapeutic agent for reducing the risk of CaOx kidney stones in the white group based on the trial study. The results also provide further evidence in support of the hypothesis that there is a difference between the black and white populations with respect to their handling of lithogenic and antilithogenic dietary challenges. However, rigorous controlled trials in healthy subjects and in kidney stone patients need to be conducted in future studies to explicitly confirm these findings.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/19038 Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies Bvumbi, Mpelegeng Victoria Rodgers, Allen Chemistry INTRODUCTION: Dietary factors in the form of citrus juices (e.g orange, grapefruits, cranberry, lemonade and lime) appear to affect the ability of urine to inhibit calcium oxalate crystallization. In South Africa, previous studies have demonstrated that black and white individuals respond differently to lithogenic and antilithogenic dietary supplements. OBJECTIVES: The current project was undertaken to study the inhibitory activity of lime in artificial urine and in the real urine of South African black and white subjects and also to assess the effects on urinary risk factors in these subjects after its ingestion. SUBJECTS AND METHODS: Experiments commenced with the preparation of artificial urine (AU) in which the effects of lime solutions (0.125-1.00 mglml) were tested by carrying out various crystallization experiments. These included the determination of the calcium oxalate (CaOx) metastable limit (MSL); particle volume-size distribution (PSD), nucleation, aggregation and growth assays. Crystal deposition was studied using scanning electron microscopy (SEM). In vitro experiments were then conducted in 24 hour urine samples from healthy South African black (n = 5) and white males (n = 5). The above-mentioned crystallization experiments were repeated in these urines. In addition, free Ca²⁺ values and the Bonn risk index (BRI) of CaOx crystallization were determined. Thereafter, a trial study in which 5 black and 4 white subjects ingested solutions of lime powder for 7 days was conducted. 24 hour urine samples were collected by subjects before and after the ingestion of lime. Urines were analysed for pH, sodium, potassium, calcium, oxalate, citrate, uric acid chloride, magnesium, phosphate, and creatinine. Urine composition values were used as input data for the calculation of relative supersaturation (RS) values for calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), brushite and uric acid using the computer programme EQUIL and Tiselius Risk Index (TRI) was also determined. The above-mentioned CaOx crystallization experiments were also performed. Urine compositions, crystallization data and physicochemical risk indices were analyzed statistically using analysis of variance (ANOVA). RESULTS: None of the lime solutions did affect the CaOx MSL of the AU or the real urine (in vitro). However CaOx crystal nucleation was promoted while CaOx crystal growth and aggregation were inhibited. In the trial study, after ingestion of lime solutions, significant increases in urinary magnesium (1.80 vs 2.75 mmol/24h, p = 0.0001) and phosphate (20.9 vs 24.6 mmol/24h, p = 0.023) were observed in black subjects. On the other hand, in white subjects, a significant decrease in urinary oxalate (0.313 vs 0.205 mmol/24h, p = 0.023) and TRI (304 vs 187, p = 0.0102) were noted. However, lime did not increase citrate levels to a significant degree in either group. CONCLUSIONS: The results presented in this dissertation have shown that lime may be regarded as a potential therapeutic agent for reducing the risk of CaOx kidney stones in the white group based on the trial study. The results also provide further evidence in support of the hypothesis that there is a difference between the black and white populations with respect to their handling of lithogenic and antilithogenic dietary challenges. However, rigorous controlled trials in healthy subjects and in kidney stone patients need to be conducted in future studies to explicitly confirm these findings. 2016-04-20T14:14:06Z 2016-04-20T14:14:06Z 2009 Master Thesis Masters MSc http://hdl.handle.net/11427/19038 eng application/pdf Department of Chemistry Faculty of Science University of Cape Town
spellingShingle Chemistry
Bvumbi, Mpelegeng Victoria
Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies
thesis_degree_str Master's
title Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies
title_full Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies
title_fullStr Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies
title_full_unstemmed Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies
title_short Investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines : in vitro and in vivo studies
title_sort investigation of the effect of a solution of lime powder on urinary calcium oxalate kidney stone risk factors in artificial and real urines in vitro and in vivo studies
topic Chemistry
url http://hdl.handle.net/11427/19038
work_keys_str_mv AT bvumbimpelegengvictoria investigationoftheeffectofasolutionoflimepowderonurinarycalciumoxalatekidneystoneriskfactorsinartificialandrealurinesinvitroandinvivostudies