Bulk composition of kidney stones, often analyzed with infrared spectroscopy, plays an essential role in determining the course of treatment for kidney stone disease. Though bulk analysis of kidney stones can hint at the general causes of stone formation, it is necessary to understand kidney stone microstructure to further advance potential treatments that rely on in vivo dissolution of stones rather than surgery. The utility of Raman microscopy is demonstrated for the purpose of studying kidney stone microstructure with chemical maps at ≤ 1 µm scales collected for calcium oxalate, calcium phosphate, uric acid, and struvite stones. Observed microstructures are discussed with respect to kidney stone growth and dissolution with emphasis placed on < 5 µm features that would be difficult to identify using alternative techniques including micro computed tomography. These features include thin concentric rings of calcium oxalate monohydrate within uric acid stones and increased frequency of calcium oxalate crystals within regions of elongated crystal growth in a brushite stone. We relate these observations to potential concerns of clinical significance including dissolution of uric acid by raising urine pH and the higher rates of brushite stone recurrence compared to other non-infectious kidney stones.

肾结石的总体成分通常用红外光谱分析，在确定肾结石疾病的治疗过程中起着至关重要的作用。虽然肾结石的大量分析可以暗示结石形成的一般原因，但有必要了解肾结石的微观结构，以进一步推进依赖体内结石溶解而不是手术的潜在治疗方法。拉曼显微镜的实用性被证明可用于研究肾结石微观结构，并收集草酸钙、磷酸钙、尿酸和鸟粪石结石的 ≤ 1 µm 尺度的化学图。讨论了肾结石生长和溶解方面观察到的微观结构，重点放在使用微型计算机断层扫描等替代技术难以识别的 < 5 µm 特征上。这些特征包括尿酸结石内草酸钙一水合物的薄同心环以及透钙磷石结石中细长晶体生长区域内草酸钙晶体的频率增加。我们将这些观察结果与具有临床意义的潜在问题联系起来，包括通过提高尿液 pH 值来溶解尿酸，以及与其他非感染性肾结石相比透钙磷石结石的复发率更高。