Distinguishing characteristics of idiopathic calcium oxalate kidney stone formers with low amounts of randall’s plaque

Xiangling Wang, Amy E. Krambeck, James C. Williams, Xiaojing Tang, Andrew D Rule, Fang Zhao, Eric Bergstralh, Zejfa Haskic, Samuel Edeh, David R. Holmes III, Loren P. Herrera Hernandez, John C Lieske

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background Overgrowth of calcium oxalate on Randall’s plaque is a mechanism of stone formation among idiopathic calciumoxalate stone-formers (ICSFs). It is less clear howstones formwhen there is little or no plaque. Design, setting, participants, & measurements Participants were a consecutive cohort of ICSFs who underwent percutaneous nephroscopic papillary mapping in the kidney or kidneys containing symptomatic stones and a papillary tip biopsy from a representative calyx during a stone removal procedure between 2009 and 2013. The distribution of Randall’s plaque coverage was analyzed and used to divide ICSFs into those with a high (³5%; mean, 10.5%; n=10) versus low (<5%; mean, 1.5%; n=32) amount of plaque coverage per papilla. Demographic and laboratory features were compared between these two groups. Results Low-plaque stone formers tended to be obese (50%versus 10%; P=0.03) and have a history of urinary tract infection (34% versus 0%; P=0.04). They were less likely to have multiple prior stone events (22% versus 80%; P=0.002) and had a lower mean 24-hour urine calcium excretion (187±86 mg versus 291±99 mg; P<0.01). Morphologically, stones from patients with low amounts of plaque lacked a calcium phosphate core by microcomputed tomography. Papillary biopsies fromlowplaque stone-formers revealed less interstitial and basement membrane punctate crystallization. Conclusions These findings suggest that other pathways independent of Randall’s plaquemay contribute to stone pathogenesis among a subgroup of ICSFs who harbor low amounts of plaque.

Original languageEnglish (US)
Pages (from-to)1757-1763
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume9
Issue number10
DOIs
StatePublished - 2014

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Calcium Oxalate
Kidney Calculi
Kidney
Biopsy
X-Ray Microtomography
Crystallization
Basement Membrane
Urinary Tract Infections
Demography
Urine
Calcium
calcium phosphate

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Distinguishing characteristics of idiopathic calcium oxalate kidney stone formers with low amounts of randall’s plaque. / Wang, Xiangling; Krambeck, Amy E.; Williams, James C.; Tang, Xiaojing; Rule, Andrew D; Zhao, Fang; Bergstralh, Eric; Haskic, Zejfa; Edeh, Samuel; Holmes III, David R.; Herrera Hernandez, Loren P.; Lieske, John C.

In: Clinical Journal of the American Society of Nephrology, Vol. 9, No. 10, 2014, p. 1757-1763.

Research output: Contribution to journalArticle

Wang, Xiangling ; Krambeck, Amy E. ; Williams, James C. ; Tang, Xiaojing ; Rule, Andrew D ; Zhao, Fang ; Bergstralh, Eric ; Haskic, Zejfa ; Edeh, Samuel ; Holmes III, David R. ; Herrera Hernandez, Loren P. ; Lieske, John C. / Distinguishing characteristics of idiopathic calcium oxalate kidney stone formers with low amounts of randall’s plaque. In: Clinical Journal of the American Society of Nephrology. 2014 ; Vol. 9, No. 10. pp. 1757-1763.
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abstract = "Background Overgrowth of calcium oxalate on Randall’s plaque is a mechanism of stone formation among idiopathic calciumoxalate stone-formers (ICSFs). It is less clear howstones formwhen there is little or no plaque. Design, setting, participants, & measurements Participants were a consecutive cohort of ICSFs who underwent percutaneous nephroscopic papillary mapping in the kidney or kidneys containing symptomatic stones and a papillary tip biopsy from a representative calyx during a stone removal procedure between 2009 and 2013. The distribution of Randall’s plaque coverage was analyzed and used to divide ICSFs into those with a high (³5{\%}; mean, 10.5{\%}; n=10) versus low (<5{\%}; mean, 1.5{\%}; n=32) amount of plaque coverage per papilla. Demographic and laboratory features were compared between these two groups. Results Low-plaque stone formers tended to be obese (50{\%}versus 10{\%}; P=0.03) and have a history of urinary tract infection (34{\%} versus 0{\%}; P=0.04). They were less likely to have multiple prior stone events (22{\%} versus 80{\%}; P=0.002) and had a lower mean 24-hour urine calcium excretion (187±86 mg versus 291±99 mg; P<0.01). Morphologically, stones from patients with low amounts of plaque lacked a calcium phosphate core by microcomputed tomography. Papillary biopsies fromlowplaque stone-formers revealed less interstitial and basement membrane punctate crystallization. Conclusions These findings suggest that other pathways independent of Randall’s plaquemay contribute to stone pathogenesis among a subgroup of ICSFs who harbor low amounts of plaque.",
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T1 - Distinguishing characteristics of idiopathic calcium oxalate kidney stone formers with low amounts of randall’s plaque

AU - Wang, Xiangling

AU - Krambeck, Amy E.

AU - Williams, James C.

AU - Tang, Xiaojing

AU - Rule, Andrew D

AU - Zhao, Fang

AU - Bergstralh, Eric

AU - Haskic, Zejfa

AU - Edeh, Samuel

AU - Holmes III, David R.

AU - Herrera Hernandez, Loren P.

AU - Lieske, John C

PY - 2014

Y1 - 2014

N2 - Background Overgrowth of calcium oxalate on Randall’s plaque is a mechanism of stone formation among idiopathic calciumoxalate stone-formers (ICSFs). It is less clear howstones formwhen there is little or no plaque. Design, setting, participants, & measurements Participants were a consecutive cohort of ICSFs who underwent percutaneous nephroscopic papillary mapping in the kidney or kidneys containing symptomatic stones and a papillary tip biopsy from a representative calyx during a stone removal procedure between 2009 and 2013. The distribution of Randall’s plaque coverage was analyzed and used to divide ICSFs into those with a high (³5%; mean, 10.5%; n=10) versus low (<5%; mean, 1.5%; n=32) amount of plaque coverage per papilla. Demographic and laboratory features were compared between these two groups. Results Low-plaque stone formers tended to be obese (50%versus 10%; P=0.03) and have a history of urinary tract infection (34% versus 0%; P=0.04). They were less likely to have multiple prior stone events (22% versus 80%; P=0.002) and had a lower mean 24-hour urine calcium excretion (187±86 mg versus 291±99 mg; P<0.01). Morphologically, stones from patients with low amounts of plaque lacked a calcium phosphate core by microcomputed tomography. Papillary biopsies fromlowplaque stone-formers revealed less interstitial and basement membrane punctate crystallization. Conclusions These findings suggest that other pathways independent of Randall’s plaquemay contribute to stone pathogenesis among a subgroup of ICSFs who harbor low amounts of plaque.

AB - Background Overgrowth of calcium oxalate on Randall’s plaque is a mechanism of stone formation among idiopathic calciumoxalate stone-formers (ICSFs). It is less clear howstones formwhen there is little or no plaque. Design, setting, participants, & measurements Participants were a consecutive cohort of ICSFs who underwent percutaneous nephroscopic papillary mapping in the kidney or kidneys containing symptomatic stones and a papillary tip biopsy from a representative calyx during a stone removal procedure between 2009 and 2013. The distribution of Randall’s plaque coverage was analyzed and used to divide ICSFs into those with a high (³5%; mean, 10.5%; n=10) versus low (<5%; mean, 1.5%; n=32) amount of plaque coverage per papilla. Demographic and laboratory features were compared between these two groups. Results Low-plaque stone formers tended to be obese (50%versus 10%; P=0.03) and have a history of urinary tract infection (34% versus 0%; P=0.04). They were less likely to have multiple prior stone events (22% versus 80%; P=0.002) and had a lower mean 24-hour urine calcium excretion (187±86 mg versus 291±99 mg; P<0.01). Morphologically, stones from patients with low amounts of plaque lacked a calcium phosphate core by microcomputed tomography. Papillary biopsies fromlowplaque stone-formers revealed less interstitial and basement membrane punctate crystallization. Conclusions These findings suggest that other pathways independent of Randall’s plaquemay contribute to stone pathogenesis among a subgroup of ICSFs who harbor low amounts of plaque.

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