“…Recent in vitro studies have shown that animal chitosan presence increased the formation of oxalate crystals by approximately 15 times and altered the ratio between CaOx dihydrate (COD) and monohydrate (COM) crystals by 1:4 to 1:2. In addition, the presence of chitosan reduced the size of the COM crystals by approximately 50% and altered the crystal surface charge, making them smaller and less negative and, therefore, more susceptible to adhering to the surface of renal epithelial cells [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”