Further stable isotope investigations of human urinary stones: comparison with other body components

Carbon and sulphur isotope investigations of human urinary stones have been expanded to relate such data to various body components and to diet. Techniques include isotopic determinations for various body components, for example, hair and urine, as well as trace sulphate and sulphide in apatite-struvite stones. Hair from individuals in Calgary was found to be, on average, about 3‰ depleted in ¹³C in comparison to samples from Hawaii. Uric acid stones from both locations were found to be 1 to 3‰ enriched in ¹³C, compared to hair. Oxalate stones from Calgary had δ¹³C values very close to those of hair. In contrast, oxalate stones from 31 patients from Honolulu fit the regression line δ¹³C_oxalate = 0.8 δ¹³C_hair - 4.4‰, with a correlation coefficient of 0.77. It remains debatable as to whether the isotopic differences between the stones and hair reflects preferential incorporation of dietary components or kinetic isotope effects during biochemical conversions. There was no evidence in the data from Honolulu that ethnic background significantly influenced the carbon isotope composition of hair or kidney stones. There was a suggestion that recent arrivals had hair and stones slightly depleted in ¹³C as compared to longer residents. The δ³⁴S values of cystine stones from Calgary were markedly consistent, near 0‰, and isotopic variations among different body components of individuals were of the order of 1‰. The trace sulphate content of a bladder stone from Papua New Guinea, was 300ppm S, whereas the sulphide content was negligible (determined by in vacuo Kiba extraction). The total S content of three samples from Calgary averaged 250 ppm, whereas 150 ppm was found for two stones each from Quito, Ecuador and Honolulu, Hawaii. For stones other than the speciment from Papua New Guinea, the sulphate-to-sulphide ratio varied from 1 to 4. The source of sulphide is uncertain but degradation of organic S could contribute to this fraction during Kiba extraction. The small range of δ³⁴S values (+3.5 to +7.4‰) for trace total S in the phosphate-containing urinary stones is believed to reflect only a fraction of the global variation of these materials. Trace sulphate was variably enriched in ³⁴S (0 to 9‰) as compared to sulphide. Neither these enrichments, nor the sulphate-to-sulphide ratio, could be related to the struvite-to-apatite ratio. There were no significant differences in the carbon and sulphur isotope compositions of hair from patients and non-stone formers. Both the carbon and sulphur isotope variations can be attributed to the isotopic compositions of diets and the superposition of small kinetic isotope effects during biochemical conversions.