The Role of Randall's Plaques in the Pathogenesis of Calcium Stones

Brian R. Matlaga, Fredric L. Coe, Andrew Evan, James E. Lingeman

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Purpose: Knowledge of the inciting lesion in kidney stone formation has remained rudimentary until quite recently. Randall theorized that areas of apatite plaque on the renal papillae would be an ideal site for an overgrowth of calcium oxalate to develop into a calculus. We reviewed in vivo data that have further defined the role of Randall's plaques in stone disease. Materials and Methods: We examined a set of literature that tested 2 hypotheses, that is 1) Randall's plaques are a specialized disease that begins as apatite in a unique region of the kidney due to local driving forces and anatomy, and 2) stones that arise from causes different from common calcium oxalate stones do not necessarily arise on plaque. Results: Intraoperative papillary and cortical biopsy specimens obtained during percutaneous nephrolithotomy from the kidneys of 3 types of stone formers (idiopathic calcium stone formers, patients with stones due to bariatric procedures and brushite stone formers) showed unique histopathological findings. Conclusions: The metabolic and surgical pathological findings in 3 distinct groups of stone formers demonstrate that the histology of the renal papillae from a stone former is particular to the clinical setting.

Original languageEnglish
Pages (from-to)31-38
Number of pages8
JournalJournal of Urology
Volume177
Issue number1
DOIs
StatePublished - Jan 2007

Fingerprint

Apatites
Calcium Oxalate
Kidney Calculi
Calcium
Kidney
Bariatrics
Percutaneous Nephrostomy
Calculi
Anatomy
Histology
Biopsy
dibasic calcium phosphate dihydrate

Keywords

  • brushite
  • calcium oxalate
  • kidney
  • kidney calculi
  • nephrostomy
  • percutaneous

ASJC Scopus subject areas

  • Urology

Cite this

The Role of Randall's Plaques in the Pathogenesis of Calcium Stones. / Matlaga, Brian R.; Coe, Fredric L.; Evan, Andrew; Lingeman, James E.

In: Journal of Urology, Vol. 177, No. 1, 01.2007, p. 31-38.

Research output: Contribution to journalArticle

Matlaga, Brian R. ; Coe, Fredric L. ; Evan, Andrew ; Lingeman, James E. / The Role of Randall's Plaques in the Pathogenesis of Calcium Stones. In: Journal of Urology. 2007 ; Vol. 177, No. 1. pp. 31-38.
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