Novel insights into renal mineralization and stone formation through advanced imaging modalities

Autor:	Sunita P. Ho, Misun Kang, Marshall L. Stoller, Scott Wiener, Ling Chen, Alex R. Shimotake
Rok vydání:	2018
Předmět:	Urologic Diseases Biomineralization Calcium Phosphates Biochemistry & Molecular Biology Kidney Disease architecture Clinical Sciences Renal and urogenital Biomedical Engineering 030232 urology & nephrology Correlative microscopy Calcium oxalate chemistry.chemical_element Calcium Biochemistry Mineralization (biology) Article Imaging modalities Kidney Calculi 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Rheumatology medicine Humans Orthopedics and Sports Medicine correlative microscopy Molecular Biology Randall’s plaque Kidney Medulla Stone formation Calcium Oxalate X-Ray Microtomography Cell Biology kidney stone medicine.disease Randall's plaque chemistry 030220 oncology & carcinogenesis Biomedical Imaging Kidney stones
Zdroj:	Connective tissue research, vol 59, iss sup1 Wiener, SV; Chen, L; Shimotake, AR; Kang, M; Stoller, ML; & Ho, SP. (2018). Novel insights into renal mineralization and stone formation through advanced imaging modalities. CONNECTIVE TISSUE RESEARCH, 59, 102-110. doi: 10.1080/03008207.2017.1409219. UCSF: Retrieved from: http://www.escholarship.org/uc/item/7j32r2vt
ISSN:	1607-8438 0300-8207
Popis:	Purpose/Aim: The most common kidney stone composed of calcium oxalate forms on interstitial calcium phosphate mineral known as a Randall's plaque (RP). Due to limited information about events leading to the initial deposition of nanometer size interstitial calcium phosphate pre-clusters, there continues to be a debate on the initial site of calcium phosphate deposition and factors leading to stone formation. MATERIALS AND METHODS:High-resolution X-ray micro-computed tomography (CT), and light and electron microscopy techniques were used to characterize human renal pyramids and five representative kidney stones with identifiable stems. Mineral densities of mineralized aggregates within these specimens were correlated with micro- and ultra-structures as seen using light and electron microscopy techniques. RESULTS:The earliest detectable biominerals in the human renal papilla were proximal intratubular plate-like calcium phosphate deposits. Unoccluded tubules in stems connected to calcium phosphate stones were observed by electron microscope and X-ray micro-CT. These tubules were similar in diameter (30-100μm) and shape to those observed in the distal regions of the renal papilla. CONCLUSIONS:Observations were patterned through a novel and unified theory of stepwise-architecture guided biomineralization (a combination of smaller structures leading to a larger but similar structural framework). A plausible stepwise progression in renal biomineralization is proposed; proximal intratubular calcium phosphate deposits can lead to interstitial yet calcium phosphate rich RP and mature into a stem on which a calcium oxalate stone grows within the collecting system of a kidney.
Databáze:	OpenAIRE
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