Physiopathology and etiology of stone formation in the kidney and the urinary tract

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

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 have provided a view of the histology of renal crystal deposition which suggests that the early sequence of events leading to stone formation differs greatly, depending on the type of stone and on the urine chemistry leading to supersaturation. Three general pathways for kidney stone formation are seen: (1) stones fixed to the surface of a renal papilla at sites of interstitial apatite plaque (termed Randall's plaque), as seen in idiopathic calcium oxalate stone formers; (2) stones attached to plugs protruding from the openings of ducts of Bellini, as seen in hyperoxaluria and distal tubular acidosis; and (3) stones forming in free solution in the renal collection system, as in cystinuria. The presence of hydroxyapatite crystals 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
Pages (from-to)831-841
Number of pages11
JournalPediatric Nephrology
Volume25
Issue number5
DOIs
StatePublished - May 2010

Fingerprint

Urinary Tract
Kidney
Cystinuria
Urine
Hyperoxaluria
Apatites
Calcium Oxalate
Kidney Calculi
Durapatite
Acidosis
Minerals
Histology
Biopsy
Wounds and Injuries

Keywords

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

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Physiopathology and etiology of stone formation in the kidney and the urinary tract. / Evan, Andrew.

In: Pediatric Nephrology, Vol. 25, No. 5, 05.2010, p. 831-841.

Research output: Contribution to journalArticle

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