Stone formation is proportional to papillary surface coverage by Randall's plaque

Samuel C. Kim, Fredric L. Coe, William W. Tinmouth, Ramsay L. Kuo, Ryan F. Paterson, Joan H. Parks, Larry C. Munch, Andrew P. Evan, James E. Lingeman

Research output: Contribution to journalArticle

104 Scopus citations

Abstract

Purpose: Randall's plaques are common in calcium oxalate (CaOx) stone formers (SF). Plaque coverage correlates directly with urine calcium excretion and inversely with urine volume. We hypothesize that plaque coverage should increase proportionally with increasing stone number. We measured plaque areas in idiopathic CaOx stone formers and nonstone formers (NSF), and identified significant relationships with quantified stone histories. Materials and Methods: A total of 13 SFs and 4 control NSFs underwent nephroscopic papillary mapping with representative still images and MPEG (Moving Pictures Experts Group) movies used to identify plaque and papillary borders. Stone histories were obtained through patient interviews, and from medical records and radiographs. The relationship of plaque coverage to clinical stone events was assessed by general multivariate linear modeling. Log transformation normalized the distribution of percent plaque coverage and stone number. Results: Plaque surface area in SFs differed significantly from that in NSFs (p <0.0001). The duration of stone disease and the log transformed percent plaque coverage correlated significantly with the number of stones (0.677 and 0.620, p = 0.003 and 0.008, respectively). On multivariate analysis and correcting for the duration of stone disease total percent plaque coverage correlated significantly with the number of stones (R2 = 0.496, p = 0.05). Disease duration and plaque coverage did not correlate significantly (p = 0.257). Conclusions: Percent plaque coverage directly correlates with the number of stones formed even when corrected for the duration of stone disease. However, plaque coverage does not correlate with the duration of stone disease. These results support the hypothesis that the pathogenesis of CaOx stones begins with Randall's plaques.

Original languageEnglish (US)
Pages (from-to)117-119
Number of pages3
JournalJournal of Urology
Volume173
Issue number1
DOIs
StatePublished - Jan 2005
Externally publishedYes

Keywords

  • Calcium
  • Calcium oxalate
  • Kidney
  • Kidney calculi
  • Kidney medulla

ASJC Scopus subject areas

  • Urology

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    Kim, S. C., Coe, F. L., Tinmouth, W. W., Kuo, R. L., Paterson, R. F., Parks, J. H., Munch, L. C., Evan, A. P., & Lingeman, J. E. (2005). Stone formation is proportional to papillary surface coverage by Randall's plaque. Journal of Urology, 173(1), 117-119. https://doi.org/10.1097/01.ju.0000147270.68481.ce