What can the microstructure of stones tell us?

How stones are retained within the kidney while small in size is still not fully understood. In this paper, we show two examples of how stones are retained during early growth: one is growth on Randall’s (interstitial) plaque, and the other is growth on mineral that has formed as a luminal plug in a...

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Bibliographic Details
Published in:Urolithiasis 2017-02, Vol.45 (1), p.19-25
Main Authors: Williams, James C., Worcester, Elaine, Lingeman, James E.
Format: Article
Language:English
Subjects:
Apatites - analysis
Crystallization
Humans
Invited Review
Kidney Calculi - chemistry
Kidney Calculi - etiology
Medical Biochemistry
Medicine
Medicine & Public Health
Nephrology
Urology
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Summary:How stones are retained within the kidney while small in size is still not fully understood. In this paper, we show two examples of how stones are retained during early growth: one is growth on Randall’s (interstitial) plaque, and the other is growth on mineral that has formed as a luminal plug in a terminal collecting duct. These two mechanisms of stone retention during early growth have distinctive morphologic features that can be seen by methods that show the microscopic structure of the stones. Stones growing on Randall’s plaque display an apatite region that is typically not large in size (1 mm long and >0.5 mm wide), and they are solid, without spaces running through them. We propose that knowing the mechanisms of stone retention during early stone formation could allow for better treatment of stone diseases.
ISSN:2194-7228
2194-7236
DOI:10.1007/s00240-016-0944-z