Whitlockite structures in kidney stones indicate infectious origin: a scanning electron microscopy and Synchrotron Radiation investigation

In this contribution dedicated to kidney stones containing Whitlockite (Wk), we addressed three questions, namely, the presence of iron in Wk, the relationship between bacterial imprints and the presence of Wk, and finally the relationship between the crystal size of Wk-bearing stones and infection. The complete dataset indicates that iron is not present in our Wk stoichiometry. We also note the presence of bacterial imprints for kidney stones with a high, but sometimes a low content, of Wk. Finally, we propose FE-SEM as a diagnostic tool for stone patients who have a negative urine culture associated with kidney stones containing less than 20% by weight Wk, a low level of carbonate in apatite, and no struvite. Such a diagnostic tool would represent a significant benefit to the clinician.

Automated summary

This contribution investigated the presence of iron in kidney stones containing Whitlockite (Wk), the relationship between bacterial imprints and the presence of Wk, and the connection between the crystal size of Wk-bearing stones and infection. The findings showed that iron is not present in the stoichiometry of Wk. Bacterial imprints were observed in kidney stones with varying levels of Wk content. The study also proposed FE-SEM as a diagnostic tool for stone patients with negative urine culture but with Wk-containing stones, low carbonate levels in apatite, and no struvite. Such a diagnostic tool would greatly benefit clinicians.