title: On the origin of calcium oxalate monohydrate papillary renal stones.
abstract: Calcium oxalate monohydrate (COM) papillary calculi can be initiated by subepithelial calcification of the renal papillae. Hydroxyapatite disruption of the papillary epithelial layer can become the nidus of a COM papillary calculus. This study evaluated the causes of papillary tissue calcifications in 60 patients with calcium oxalate lithiasis, 30 with COM papillary and 30 with calcium oxalate dihydrate (COD) calculi. Urinary redox potential was higher in the COM than the COD group, suggesting that the former is more deficient in antioxidants due to increased oxidative stress. Urinary calcium was significantly higher in the COD group, whereas urinary oxalate was significantly higher in the COM group, suggesting a greater degree of oxidative injury of renal cells. Evaluations of their diets showed that both groups consumed low amounts of phytate-rich products. Of chronic diseases possibly associated with urolithiasis, only the prevalence of gastroduodenal ulcer differed significantly, being higher in the COM group and suggesting that epithelial lesions are common to gastroduodenal ulcers and COM papillary renal stones. Occupational exposure to cytotoxic products occurred in 47 % of the COM and 27 % of the COD group, but this difference was not statistically significant. These findings indicate that oxidative stress is associated with injury to papillary tissue and that this is the origin of intrapapillary calcifications. The continuation of this process is due to modulators and/or deficiencies in inhibitors of crystallization. Identifying and eliminating the causes of injury may prevent recurrent episodes in patients with papillary COM calculi.
authors.affiliation: Laboratory of Renal Lithiasis Research, Faculty of Sciences, University Institute of Health Sciences Research (IUNICS-IdISPa), University of Balearic Islands, 07122, Palma de Mallorca, Spain, fgrases@uib.es.
authors.forename: Fèlix
authors.initials: F
authors.lastname: Grases
authors.forename: Antonia
authors.initials: A
authors.lastname: Costa-Bauzá
authors.forename: Carlo R
authors.initials: CR
authors.lastname: Bonarriba
authors.forename: Enrique C
authors.initials: EC
authors.lastname: Pieras
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Fernández
authors.forename: Adrián
authors.initials: A
authors.lastname: Rodríguez
mesh_terms: D002114:Calcinosis / Q000209:etiology*; D002129:Calcium Oxalate; D006801:Humans; D007669:Kidney Calculi / Q000209:etiology*; D007674:Kidney Diseases / Q000453:epidemiology; D007679:Kidney Medulla
chemical_list: D002129:Calcium Oxalate
references.citation: Urol Int. 1990;45(1):25-7
references.pmid: 2305491
references.citation: Eur J Nutr. 2010 Sep;49(6):321-6
references.pmid: 20108098
references.citation: Anal Biochem. 1996 Jul 15;239(1):70-6
references.pmid: 8660627
references.citation: Ann Surg. 1937 Jun;105(6):1009-27
references.pmid: 17856988
references.citation: BJU Int. 2002 Aug;90(3):336-44
references.pmid: 12133075
references.citation: J Urol. 1975 Oct;114(4):500-7
references.pmid: 1235369
references.citation: J Urol. 2012 Mar;187(3):1094-100
references.pmid: 22266007
references.citation: Nutr Res. 2012 May;32(5):347-56
references.pmid: 22652374
references.citation: Am J Kidney Dis. 1993 Jun;21(6):643-52
references.pmid: 8503419
references.citation: ScientificWorldJournal. 2006 Apr 18;6:2411-9
references.pmid: 17619710
references.citation: Anal Biochem. 2011 Sep 15;416(2):202-5
references.pmid: 21669177
references.citation: J Am Soc Nephrol. 2004 Jun;15(6):1392-401
references.pmid: 15153550
references.citation: Scanning Microsc. 1993 Sep;7(3):1081-104; discussion 1104-6
references.pmid: 8146609
references.citation: Kidney Int. 2005 Jul;68(1):145-54
references.pmid: 15954903
references.citation: Bone Miner. 1993 Aug;22(2):147-59
references.pmid: 8251766
references.citation: J R Soc Interface. 2005 Sep 22;2(4):373-8
references.pmid: 16849195
references.citation: Front Biosci. 2007 Jan 01;12:2580-7
references.pmid: 17127264
references.citation: Biochemistry. 1986 Mar 11;25(5):1176-80
references.pmid: 3008822
references.citation: Clin Chim Acta. 2002 Aug;322(1-2):29-36
references.pmid: 12104078
references.citation: Urol Res. 2012 Dec;40(6):671-81
references.pmid: 22622371
references.citation: Kidney Int. 2001 Nov;60(5):1784-91
references.pmid: 11703596
references.citation: Chem Rev. 2012 Oct 10;112(10):5092-120
references.pmid: 22809072
references.citation: J Urol. 2005 Jan;173(1):117-9; discussion 119
references.pmid: 15592050
references.citation: Int J Urol. 2006 Mar;13(3):197-201
references.pmid: 16643608
references.citation: Am J Pathol. 2002 Dec;161(6):2035-46
references.pmid: 12466120
references.citation: J Physiol Paris. 2001 Jan-Dec;95(1-6):337-44
references.pmid: 11595458
references.citation: J Biol Inorg Chem. 2011 Mar;16(3):405-16
references.pmid: 21127923
references.citation: Urol Res. 2010 Dec;38(6):439-52
references.pmid: 21063698
references.citation: Scand J Urol Nephrol. 2000 Jun;34(3):162-4
references.pmid: 10961468
references.citation: Urol Res. 2009 Feb;37(1):35-40
references.pmid: 19066877
references.citation: J Clin Invest. 2003 Mar;111(5):607-16
references.pmid: 12618515
references.citation: Eur Urol. 1996;30(3):388-93
references.pmid: 8931975
references.citation: J Urol. 1997 Mar;157(3):1059-63
references.pmid: 9072543
references.citation: Phys Chem Chem Phys. 2010 Nov 21;12(43):14560-6
references.pmid: 20931117
references.citation: J Urol. 1994 Mar;151(3):571-4
references.pmid: 8308959
references.citation: Urol Res. 2005 May;33(2):105-15
references.pmid: 15815943
references.citation: J Endourol. 2010 Mar;24(3):339-45
references.pmid: 20210657
references.citation: J Urol. 1985 Dec;134(6):1255-8
references.pmid: 2997488
references.citation: J Urol. 2013 Mar;189(3):803-11
references.pmid: 23022011
references.citation: Int Braz J Urol. 2013 Jan-Feb;39(1):108-17
references.pmid: 23489503
references.citation: Clin Biochem. 1993 Oct;26(5):351-7
references.pmid: 8299205
references.citation: Anat Rec (Hoboken). 2007 Oct;290(10):1315-23
references.pmid: 17724713