Pathogenesis of stone disease

Elaine M. Worcester, Andrew P. Evan, Fredric L. Coe

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

1 Scopus citations


All stones share similar presenting symptoms, and urine supersaturation with respect to the mineral phase of the stone is essential for stone formation. However, recent studies using papillary biopsies of stone formers provide a view of the histology of renal crystal deposition which suggests that the early sequence of events leading to stone formation may differ depending on the type of stone and on the urine chemistry leading to supersaturation. Three general patterns of crystal deposition are seen: interstitial apatite plaque in idiopathic calcium oxalate stone formers, which is the site of stone attachment; tubule deposition of apatite, seen in all calcium phosphate stone formers; and mixtures of apatite and another crystal phase, such as cystine or calcium oxalate, seen in patients with cystinuria or enteric hyperoxaluria. The presence of apatite crystal in either the interstitial or tubule compartment (and sometimes both) of the renal medulla in stone formers is the rule, and has implications for the initial steps of stone formation and the potential for renal injury.

Original languageEnglish (US)
Title of host publicationRenal Stone Disease 2 - 2nd International Urolithiasis Research Symposium
Number of pages11
StatePublished - Oct 22 2008
Event2nd International Urolithiasis Research Symposium - Indianapolis, IN, United States
Duration: Apr 17 2008Apr 18 2008

Publication series

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


Other2nd International Urolithiasis Research Symposium
CountryUnited States
CityIndianapolis, IN


  • Calcium oxalate
  • Calcium phosphate
  • Nephrolithiasis
  • Randall's plaque

ASJC Scopus subject areas

  • Physics and Astronomy(all)

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  • Cite this

    Worcester, E. M., Evan, A. P., & Coe, F. L. (2008). Pathogenesis of stone disease. In Renal Stone Disease 2 - 2nd International Urolithiasis Research Symposium (pp. 3-13). (AIP Conference Proceedings; Vol. 1049).