Renal crystal deposits and histopathology in patients with cystine stones

Andrew Evan, F. L. Coe, J. E. Lingeman, Y. Shao, B. R. Matlaga, S. C. Kim, S. B. Bledsoe, A. J. Sommer, M. Grynpas, Carrie Phillips, E. M. Worcester

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

We have biopsied the papillae of patients who have cystine stones asking if this stone type is associated with specific tissue changes. We studied seven cystine stone formers (SF) treated with percutaneous nephrolithotomy using digital video imaging of renal papillae for mapping and obtained papillary biopsies. Biopsies were analyzed by routine light and electron microscopy, infrared spectroscopy, electron diffraction, and micro-CT. Many ducts of Bellini (BD) had an enlarged ostium, and all such were plugged with cystine crystals, and had injured or absent lining cells with a surrounding interstitium that was inflamed to fibrotic. Crystal plugs often projected into the urinary space. Many inner medullary collecting ducts (IMCD) were dilated with or without crystal plugging. Apatite crystals were identified in the lumens of loops of Henle and IMCD. Abundance of interstitial Randall's plaque was equivalent in amount to that of non-SF. In the cortex, glomerular obsolescence and interstitial fibrosis exceeded normal. Cystine crystallizes in BD with the probable result of cell injury, interstitial reaction, nephron obstruction, and with the potential of inducing cortical change and loss of IMCD tubular fluid pH regulation, resulting in apatite formation. The pattern of IMCD dilation, and loss of medullary structures is most compatible with such obstruction, either from BD lumen plugs or urinary tract obstruction from stones themselves.

Original languageEnglish
Pages (from-to)2227-2235
Number of pages9
JournalKidney International
Volume69
Issue number12
DOIs
StatePublished - Jun 3 2006

Fingerprint

Cystine
Kidney
Apatites
Loop of Henle
Biopsy
Percutaneous Nephrostomy
Urinary Calculi
Nephrons
Dilatation
Spectrum Analysis
Electron Microscopy
Fibrosis
Electrons
Light
Wounds and Injuries

Keywords

  • Kidney anatomy
  • Kidney biopsy
  • Kidney stones
  • Pathology
  • Renal injury

ASJC Scopus subject areas

  • Nephrology

Cite this

Evan, A., Coe, F. L., Lingeman, J. E., Shao, Y., Matlaga, B. R., Kim, S. C., ... Worcester, E. M. (2006). Renal crystal deposits and histopathology in patients with cystine stones. Kidney International, 69(12), 2227-2235. https://doi.org/10.1038/sj.ki.5000268

Renal crystal deposits and histopathology in patients with cystine stones. / Evan, Andrew; Coe, F. L.; Lingeman, J. E.; Shao, Y.; Matlaga, B. R.; Kim, S. C.; Bledsoe, S. B.; Sommer, A. J.; Grynpas, M.; Phillips, Carrie; Worcester, E. M.

In: Kidney International, Vol. 69, No. 12, 03.06.2006, p. 2227-2235.

Research output: Contribution to journalArticle

Evan, A, Coe, FL, Lingeman, JE, Shao, Y, Matlaga, BR, Kim, SC, Bledsoe, SB, Sommer, AJ, Grynpas, M, Phillips, C & Worcester, EM 2006, 'Renal crystal deposits and histopathology in patients with cystine stones', Kidney International, vol. 69, no. 12, pp. 2227-2235. https://doi.org/10.1038/sj.ki.5000268
Evan, Andrew ; Coe, F. L. ; Lingeman, J. E. ; Shao, Y. ; Matlaga, B. R. ; Kim, S. C. ; Bledsoe, S. B. ; Sommer, A. J. ; Grynpas, M. ; Phillips, Carrie ; Worcester, E. M. / Renal crystal deposits and histopathology in patients with cystine stones. In: Kidney International. 2006 ; Vol. 69, No. 12. pp. 2227-2235.
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