Randall's plaque of patients with nephrolithiasis begins in basement membranes of thin loops of Henle.
Our purpose here is to test the hypothesis that Randall's plaques, calcium phosphate deposits in kidneys of patients with calcium renal stones, arise in unique anatomical regions of the kidney, their formation conditioned by specific stone-forming pathophysiologies. To test this hypothesis, we performed intraoperative biopsies of plaques in kidneys of idiopathic-calcium-stone formers and patients with stones due to obesity-related bypass procedures and obtained papillary specimens from non-stone formers after nephrectomy. Plaque originates in the basement membranes of the thin loops of Henle and spreads from there through the interstitium to beneath the urothelium. Patients who have undergone bypass surgery do not produce such plaque but instead form intratubular hydroxyapatite crystals in collecting ducts. Non-stone formers also do not form plaque. Plaque is specific to certain kinds of stone-forming patients and is initiated specifically in thin-limb basement membranes by mechanisms that remain to be elucidated.
Evan
Andrew P
AP
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46220, USA. evan@anatomy.iupui.edu
Lingeman
James E
JE
Coe
Fredric L
FL
Parks
Joan H
JH
Bledsoe
Sharon B
SB
Shao
Youzhi
Y
Sommer
Andre J
AJ
Paterson
Ryan F
RF
Kuo
Ramsay L
RL
Grynpas
Marc
M
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000378:metabolism / Q000473:pathology; D002129:Calcium Oxalate / Q000378:metabolism; D006801:Humans; D007422:Intestines / Q000601:surgery; D007669:Kidney Calculi / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D008138:Loop of Henle / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D017550:Spectroscopy, Fourier Transform Infrared; D014961:X-Ray Diffraction
D002129:Calcium Oxalate