Exploring the Interplay between Calcium Oxalate Crystals and Renal Tubular Epithelial Cell Injury: Implications for the Formation and Prevention of Kidney Stones

Abstract

Kidney stones are a prevalent and clinically significant disease that affects millions of individuals worldwide, which have emerged as a significant global public health concern. The majority of kidney stones are composed of calcium oxalate (CaOx). The mechanisms of stone formation and development are unclear, involving a complex interplay of physical and biochemical processes. The injury of tubular epithelial cells (TECs) represents a pivotal event in the pathogenesis of this condition, as it initiates oxidative stress and immune-inflammatory reactions. Macrophages play a pivotal role in the inflammatory process, interacting with a multitude of molecules and pathways, thereby influencing the stone formation. Furthermore, apoptosis and autophagy induce TECs injury and contribute to the pathogenesis of CaOx stones. The current treatment strategies mainly focus on the management of crystal-cell interactions and the protection of TECs, in conjunction with the application of antioxidants, anti-inflammatory agents, and inhibitors of apoptosis and autophagy. These strategies have demonstrated promising results. Future research will aim to modulate the immune-inflammatory response, offering hope for the effective prevention of stone recurrence.