The specific role of trace elements in kidney stone formation remains poorly understood, despite various theories proposed to explain stone formation and growth mechanisms. Existing studies have yet to clearly link specific trace elements in blood, urine, or stones to stone disease pathogenesis. This study aims to address this gap by analyzing and comparing a panel of 15  trace elements in blood, urine, and stone samples from kidney stone formers and non-stone formers. Understanding the role of these elements may help identify risk factors, predict recurrence, and inform targeted pharmacological treatments.

All patients with kidney stone disease who were eligible for PCNL underwent a metabolic evaluation, and only those with a normal metabolic profile were included in the study. Subjects of known cases of UPJ obstruction for pyeloplasty without previous history of renal stone were enrolled as controls. Blood, urine and stone samples for all patients and blood and urine samples of controls were sent for quantification of trace elements using ICP-MS. Stone fragments after PCNL were also analysed for their chemical composition and structure using FTIR. This study was ethically approved by the institutional ethics committee.

The study analysed demographics for cases (150) and controls (100), finding no significant differences in age, gender, BMI, or dietary habits between groups. Most participants were aged 31-50, and 65.3% of cases were male. Among cases, 11.2% had comorbidities, 10.6% had recurrent kidney stones, and calcium-containing stones were the most common (90.6%).  Significant trace element differences emerged, with blood cobalt and chromium levels significantly lower in cases (p<0.001). Urinary levels of strontium, cobalt, and manganese were significantly higher in cases (p<0.05). Stone analysis showed elevated levels of selenium, cobalt, manganese, cadmium, and aluminium in patients.

The study found that cases had lower blood cobalt and chromium and higher urinary strontium, cobalt, and manganese, with stone analysis revealing elevated selenium, cobalt, manganese, cadmium, and aluminium.

The study highlights the role of trace elements in kidney stone formation, showing their elevated levels in patients. These findings can guide new interventions for treating and preventing kidney stone disease.