title: Recent advances in the pathophysiology of nephrolithiasis.
abstract: Over the past 10 years, major progress has been made in the pathogenesis of uric acid and calcium stones. These advances have led to our further understanding of a pathogenetic link between uric acid nephrolithiasis and the metabolic syndrome, the role of Oxalobacter formigenes in calcium oxalate stone formation, oxalate transport in Slc26a6-null mice, the potential pathogenetic role of Randall's plaque as a precursor for calcium oxalate nephrolithiasis, and the role of renal tubular crystal retention. With these advances, we may target the development of novel drugs including (1) insulin sensitizers; (2) probiotic therapy with O. formigenes, recombinant enzymes, or engineered bacteria; (3) treatments that involve the upregulation of intestinal luminal oxalate secretion by increasing anion transporter activity (Slc26a6), luminally active nonabsorbed agents, or oxalate binders; and (4) drugs that prevent the formation of Randall's plaque and/or renal tubular crystal adhesions.
authors.affiliation: Department of Internal Medicine, Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-8885, USA. Khashayar.Sakhaee@UTSouthwestern.edu
authors.forename: Khashayar
authors.initials: K
authors.lastname: Sakhaee
mesh_terms: D000818:Animals; D002129:Calcium Oxalate / Q000378:metabolism; D006801:Humans; D007669:Kidney Calculi / Q000209:etiology / Q000382:microbiology; D007684:Kidney Tubules / Q000473:pathology; D024821:Metabolic Syndrome; D053040:Nephrolithiasis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D020624:Oxalobacter formigenes; D014527:Uric Acid
chemical_list: D002129:Calcium Oxalate; D014527:Uric Acid