LITHORISK.COM: the novel version of a software for calculating and visualizing the risk of renal stone
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ORIGINAL PAPER
LITHORISK.COM: the novel version of a software for calculating and visualizing the risk of renal stone Martino Marangella1 · Michele Petrarulo2 · Corrado Vitale3 · Piergiuseppe Daniele4 · Silvio Sammartano5 Received: 27 May 2020 / Accepted: 29 October 2020 © The Author(s) 2020
Abstract Estimation of state of saturation with stone-forming salt represents a reliable tool to assess the overall risk. The available methods are based on computer-assisted ab initio calculations. Our earlier method URSUS was subsequently substituted by Lithorisk®, a software including visualization of risk profiles. Unfortunately, Lithorisk does not adapt to new versions of Windows® and Macintosh® Apple, neither runs on smartphones or tablets. We propose a novel version of the software which can be directly used online on any device equipped by different operating systems. Upon online connection and after registration, the software is ready for unlimited accesses, in either Italian, English or French. After digiting input variables (urea and creatinine also included) in a fixed dashboard, state of saturation is promptly given. In addition to state of saturation (ß) with calcium oxalate, brushite and uric acid, ß struvite and cystine are available. Both input variables and ß results are graphically depicted as green or red horizontal bars to indicate recommended values. The software was implemented with equations allowing to omit sulphate and ammonium excretion for users with difficult access to these measurements. This simplified version, tested for ßCaOx and ßBsh on 100 urine samples showed close correlation with the full version. The software gives a list of total and free concentrations and soluble complex species distribution. Results can be printed or saved as PDF. So, we propose an easily accessible software to estimate state of saturation usable on any operating system and personal device. Keywords State of saturation · Soluble complex species · Stability constant · Calcium oxalate · Brushite · Struvite · Cystine · Uric acid
Introduction The essential condition for a renal stone to form is supersaturation of urine with respect to lithogenic salts [1–3]. While supersaturation fully defines some types of stone disease, i.e., cystine, uric acid, struvite stones, it is not sufficient Silvio Sammartano—Deceased. * Martino Marangella [email protected] 1
Fondazione Scientifica Mauriziano Hospital, Turin, Italy
2
Kidney Stone Laboratory, Mauriziano Hospital, Turin, Italy
3
Nephrology and Dialysis Unit, Mauriziano Hospital, Turin, Italy
4
Department of Analytical Chemistry, University of Turin, Turin, Italy
5
Department of Inorganic Analytical and Physical Chemistry, Messina, Italy
to explain calcium containing renal stones. In this subset, stones are thought to result from imbalance between promoters and inhibitors of crystal formation [4]. Therefore, in addition to thermodynamic processes, well described by the state of saturation, kinetic processes including nucleation, growth and aggregation, ro
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