The Hindu : `Well water users face risk of kidney stone'

Online edition of India's National Newspaper
Sunday, Nov 30, 2003

Southern States

Southern States - Kerala

`Well water users face risk of kidney stone'

By Our Staff Reporter

KOZHIKODE NOV. 29. Well water users who suffer from kidney stone disease demonstrate a higher crystal growth potential and the other users stand a higher chance to develop a stone disease, according to a paper presented at the 13th Swadeshi Science Congress at Kalpetta recently.

The study by Jayan Stephen, Y.M. Fazil Marickar, P.P. Preetha and Anil Chandran of the Department of Surgery of the Thiruvananthapuram Medical College establishes the relationship between the differences in the composition of water consumed by patients who suffer from the disease and the pattern of in-vitro calcium oxalate crystal growth (grown in-vitro in silica gel media in Hanes tubes by simple diffusion method) emphasising on the Scanning Electron Microscopic morphology of these crystals.

The study was conducted in three stages -- water analysis, crystal growth and scanning electron microscopy.

In water analysis, water samples that were used for drinking by urinary stone disease patients were collected and labelled as tap or well water depending on the source. Samples were analysed for 10 trace elements and six other parameters that determine the quality of drinking water at the Kerala Ground Water Department, Thiruvananthapuram, using atomic absorption spectrometry.

The commonly seen calcium oxalate crystals in human beings `Whewellite' (calcium oxalate monohydrate) and `Weddelite' (calcium oxalate dihydrate) were grown in-vitro in silica gel media in Hanes tubes by simple diffusion method.

The crystals were cleared of the gel by repeated washing with distilled water and filtered through micro-pore filter paper on the 30th day.

In all, 65 water samples were studied. Calcium was found to be higher in well water samples and these have in turn showed higher mean crystal sizes on Scanning Electron Microscopy study.

The well water group has significantly higher values of dissolved solids, total hardness and calcium.

The maximum in-vitro crystal growth occurred in well-water samples.

Well water added crystals showed a very high degree of inter-penetrant twinning. The study concluded that the difference in the contents of water might have been responsible for the altered crystal morphology. It can be said that higher levels of calcium, hardness and higher values of total dissolved solids in the water favour crystallisation.

The clinical severity of the disease was also higher in the well water sample groups. The study postulates that though there was no appreciable difference in the urine biochemistry of the well water users, they all demonstrated a higher crystal growth potential and hence had a higher chance to develop a stone disease.

Hence pure biochemical parameter study of the urine was inadequate to predict the propensity of an individual to get stone disease.

The crystallisation property of the urine could also be playing an important role. The component which is responsible for this may not have been screened in the routine biochemical examination of the patients' urine.

There may be an alternation in the uromucoid in those individuals who consume well water, which provides for the nucleus upon which further crystallisation occurs.

The study concluded that there is an appreciable difference in the in-vitro crystal growth among patients who consume well and tap water, the cause of which has to be probed into.

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