Identifying Calcium Oxalate Crystals in Urine

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Abstract
Proper identification of urine crystals is essential in the routine microscopic examination of urine sediment. Knowledge of structure, solubility, and pH characteristics of urine crystals comes with training and experience. References are available that provide excellent photographs and illustrations to assist with recognition. In addition, these references provide guidelines for specialized testing or polarization characteristics of specific urine crystals to further assist in identification. Although crystals most often seen in urine generally are unrelated to pathology and are considered normal, they must be properly identified and reported because, occasionally, they may have clinical significance. For example, calcium oxalate has been considered one of the normal crystals, but it has been linked to lithiasis. This is the second article in a three-part continuing education update series on urinalysis. Other articles in the series focus on urine sediment diagnosis and urine cytodiagnostics.

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