1. RENAL STONE ANALYSIS : FTIR, the METHOD OF CHOICE
Dr Sunita Kapoor
MBBS, DNB. Path, MNAMS DGO, MS. Biomed.Sc,,BITS Pilani PGDHM,  NIHFW
Director & Lab Head, City X- Ray & Scan Clinic
Director, Neogenetics laboratory
CEO, City Imaging & clinical labs
Technical Assessor, NABL

2. Nephrolithiasis
Nephrolithiasis is a recurrent condition with considerable morbidity.
Knowledge of kidney stone composition and is the key for establishing the etiology of stone disease.
Accurate identification of all components present in calculi is necessary for understanding mechanism of urolithiasis

11. Analysis of calculus
Identifying the crystalline form is very useful for planning therapy, Uric acid & Cystine calculi need medical therapy only.
The purpose of stone analysis is qualitative differentiation of all stone components and their semiquantitative determination.
A number of analytical methods may be applied to stone analysis, but only a few of them are able to quickly and easily provide extensive information on both stone structure and composition relevant for clinical diagnosis

12. Fourier Transform Infrared (FTIR spectroscopy) method
FTIR is a popular and reliable
method for in vitro quantitative analysis of calculi.
It is a specific, rapid, and versatile method, which uses IR radiation
Assessment of renal calculi by means of a computerized IR spectrometer has the advantage that it greatly reduces the likelihood of errors because of operator bias in the subjective interpretation of spectral data.

13. FTIR Advantages of FTIR: Moderate cost Quick Examination
Efficient
Accurate
All calculi must be accurately analysed before treatment
Determines
exact quantitation of stone constituents
Moderate cost
Quick Examination
Identifies organic components or non crystalline substances, eg purines, proteins or fat and drug metabolites also
Semiquantitative evaluation possible applying search match functions

14. OTHER METHODS FOR STONE ANALYSIS
Wet chemical analysis:
can only identify the presence of individual ions and radicals without differentiating a specific compound in many stone types and mixtures
Thermogravimetry (TGA)
Limitations of TGA are that it requires large amount of material for optimal resolution.
Optic Polarising Microscopy
It uses the principle of interaction of polarised light with crystals of stones and is cumbersome.
Scanning Electron microscopy
Technique for the study of morphology of urinary calculi.
X-Ray Powder Diffraction (XRD)
X-ray powder diffraction uses monochromatic X-rays for identifying the constituents of a renal stone based on the unique diffraction patterns produced by a crystalline material. Radiation intensive.

15. Conclusion
Treatment of urinary stone can be painful, stone removal often requires surgery, and renal failure occurs in about 3% of patients.
Furthermore, the recurrence rates may be as high as 10 % to 23 % per year and may reach 50% within 5 years if a proper management, stone analysis, and follow-up are not applied

16. Take home message !!
Test the stone, and test it with the best method: “ F T I R “ THANK YOU !!!