title: Randall's plaque as the origin of calcium oxalate kidney stones.
abstract: Eight decades ago, Alexander Randall identified calcium phosphate deposits at the tip of renal papillae as the origin of renal calculi. The awareness that these "Randall's plaque" promote renal stone formation has been amplified during the past years by the development of endoscopic procedures allowing the in situ visualization of these plaques. Recent studies based upon kidney biopsies evidenced that apatite deposits at the origin of these plaque originate from the basement membranes of thin loops of Henle and then spread in the surrounding interstitium. In addition, scanning electron microscopy examination of calcium oxalate stones developed on Randall's plaque evidenced that plaque may also be made of tubules obstructed by calcium phosphate plugs. Hypercalciuria has been associated to Randall's plaque formation. However, several additional mechanisms may be involved resulting in increased tissular calcium phosphate supersaturation and the role of macromolecules in plaque formation remains elusive. At last, apatite crystals are the main mineral phase identified in plaques, but other calcium phosphates and various chemical species such as purines have been evidenced, revealing thereby that several mechanisms may be responsible for plaque formation.
authors.affiliation: Laboratoire des Lithiases, Service des Explorations Fonctionnelles, Hôpital Tenon, APHP, 4, rue de la Chine, 75970, Paris Cedex 20, France, michel.daudon@tnn.aphp.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Daudon
authors.forename: Dominique
authors.initials: D
authors.lastname: Bazin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Letavernier
mesh_terms: D002114:Calcinosis / Q000150:complications; D002129:Calcium Oxalate; D006801:Humans; D053565:Hypercalciuria / Q000150:complications; D007669:Kidney Calculi / Q000737:chemistry / Q000453:epidemiology / Q000209:etiology*; D007674:Kidney Diseases / Q000150:complications; D007679:Kidney Medulla
chemical_list: D002129:Calcium Oxalate
references.citation: Urol Res. 2006 Apr;34(2):131-3
references.pmid: 16404621
references.citation: Anat Rec (Hoboken). 2014 Apr;297(4):731-48
references.pmid: 24478243
references.citation: J Urol. 1987 May;137(5):1024-9
references.pmid: 3573168
references.citation: J Am Soc Nephrol. 2009 Oct;20(10):2253-9
references.pmid: 19679672
references.citation: J Urol. 2005 Jan;173(1):117-9; discussion 119
references.pmid: 15592050
references.citation: Kidney Int. 2000 Nov;58(5):2061-8
references.pmid: 11044226
references.citation: J Urol. 2006 May;175(5):1720-4; discussion 1724
references.pmid: 16600740
references.citation: J Clin Invest. 2003 Mar;111(5):607-16
references.pmid: 12618515
references.citation: Urol Clin North Am. 2007 Aug;34(3):287-93
references.pmid: 17678980
references.citation: Eur Urol. 2003 Dec;44(6):709-13
references.pmid: 14644124
references.citation: Urol Res. 2006 Apr;34(2):151-6
references.pmid: 16440192
references.citation: Trans Am Clin Climatol Assoc. 1984;95:183-90
references.pmid: 6679136
references.citation: J Urol. 1997 Dec;158(6):2062-4
references.pmid: 9366312
references.citation: J Urol. 1985 Mar;133(3):490-4
references.pmid: 3974005
references.citation: Am J Physiol Renal Physiol. 2008 Nov;295(5):F1286-94
references.pmid: 18715937
references.citation: BJU Int. 2010 Jan;105(2):242-5
references.pmid: 19549258
references.citation: Urolithiasis. 2013 Oct;41(5):369-77
references.pmid: 23963104
references.citation: J Synchrotron Radiat. 2010 May;17(3):374-9
references.pmid: 20400836
references.citation: Ann Urol (Paris). 2005 Dec;39(6):209-31
references.pmid: 16425740
references.citation: Kidney Int. 2003 Dec;64(6):2150-4
references.pmid: 14633137
references.citation: Ann Surg. 1937 Jun;105(6):1009-27
references.pmid: 17856988
references.citation: J Clin Invest. 2003 Mar;111(5):602-5
references.pmid: 12618514
references.citation: Am J Physiol. 1996 Apr;270(4 Pt 2):F604-13
references.pmid: 8967338
references.citation: Kidney Int. 2008 Jan;73(2):139-40
references.pmid: 18165809
references.citation: Kidney Int. 2001 Jun;59(6):2290-8
references.pmid: 11380833
references.citation: Int J Urol. 2005 Jan;12(1):12-6
references.pmid: 15661049
references.citation: Anat Rec (Hoboken). 2007 Oct;290(10):1315-23
references.pmid: 17724713
references.citation: Kidney Int. 1997 Nov;52(5):1291-301
references.pmid: 9350652