Histopathology predicts the mechanism of stone formation

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Scopus citations


About 5% of American women and 12% of men will develop a kidney stone at some time in their life and these numbers appear to be on the rise. Despite years of scientific research into the mechanisms of stone formation and growth, limited advances have been made until recently. Randall's original observations and thoughts on the mechanisms for kidney stone formation have been validated for idiopathic calcium oxalate stone formers (ICSF) but not for most other stone forming groups. Our current studies on selected groups of human stone formers using intraoperative papillary biopsies has shown overwhelming evidence for the presence of Randall's plaque in ICSF and that stone formation and growth are exclusively linked to its availability to urinary ions and proteins. Intense investigation of the plaque-stone junction is needed if we are to understand the factors leading to the overgrowth process on exposed regions of plaque. Such information should allow the development of treatment strategies to block stone formation in ICSF patients. Patients who form brushite stones, or who form apatite stones because of distal renal tubular acidosis (dRTA), or patients with calcium oxalale stones due to obesity bypass procedures, or patients with cystinuria. get plugged inner medullary collecting ducts (IMCD) which leads to total destruction of the lining cells and focal sites of interstitial fibrosis. These stone formers have plaque but at levels equal to or below non-stone formers, which would suggest that they form stones by a different mechanism than do ICSF patients.

Original languageEnglish (US)
Title of host publicationRENAL STONE DISEASE
Subtitle of host publication1st Annual International Urolithiasis Research Symposium
PublisherAmerican Institute of Physics Inc.
Number of pages11
ISBN (Print)0735404062, 9780735404069
StatePublished - 2007
Event1st Annual International Urolithiasis Research Symposium - Indianapolis, IN, United States
Duration: Nov 2 2006Nov 3 2006

Publication series

NameAIP Conference Proceedings
ISSN (Print)0094-243X
ISSN (Electronic)1551-7616


Other1st Annual International Urolithiasis Research Symposium
CountryUnited States
CityIndianapolis, IN


  • Kidney stones
  • Papilla biopsies
  • Randall's plaque

ASJC Scopus subject areas

  • Physics and Astronomy(all)

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    Evan, A. P. (2007). Histopathology predicts the mechanism of stone formation. In RENAL STONE DISEASE: 1st Annual International Urolithiasis Research Symposium (pp. 15-25). (AIP Conference Proceedings; Vol. 900). American Institute of Physics Inc.. https://doi.org/10.1063/1.2723555