Mechanisms of genesis and growth of calculi

Vermeulen, C.W.; Lyon, Edward S.

doi:10.1016/0002-9343(68)90204-0

Cited by 113 publications

(33 citation statements)

References 25 publications

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“…The formation of the nidus may be analagous to the first stage in physiologic calcification of bone in which a nucleus of calcium phosphate develops in an organic matrix (1)(2)(3)(4). Alternatively, the nidus may form spontaneously by precipitation from a supersaturated urine (5)(6)(7)(8). If this occurs, the organic phase may represent only secondary constituent of a stone, not etiologically important in its formation.…”

Section: Introductionmentioning

confidence: 99%

Physicochemical basis for formation of renal stones of calcium phosphate origin: calculation of the degree of saturation of urine with respect to brushite

Pak¹

1969

J. Clin. Invest.

129

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A B S T R A C T Brushite (CaHPO42H2O) was considered to govern the formation of renal calculus of calcium phosphate origin. The degree of saturation of urine with respect to this phase was therefore calculated. This value was obtained from the ratio of the activity product of Ca"+ and HP04-(K.,) before and after incubation of urine with brushite. The errors in the calculation of K.p were largely eliminated by this procedure.The urine of patients with idiopathic hypercalciuria and recurrent calcium-containing renal calculi was supersaturated with respect to brushit largely because of the high urinary concentration of Ca'. The urine of normocalciuric subjects was undersaturated except at high urinary pH. This technique of estimating the degree of saturation of urine should allow a quantitative assessment of the various therapeutic regimens recommended for patients with nephrolithiasis.

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Section: Introductionmentioning

confidence: 99%

Physicochemical basis for formation of renal stones of calcium phosphate origin: calculation of the degree of saturation of urine with respect to brushite

Pak¹

1969

J. Clin. Invest.

129

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“…In 1978, Finlayson and Reid (2) advocated the fixed-particle theory as opposed to the free-particle theory that was advanced 10 yr earlier by Vermeulen and Lyon (25). The free-particle theory was based on experiments that were performed in rats that received large amounts of hyperoxaluric agents and showed that particles grow fast enough to obstruct the ducts of Bellini.…”

Section: Free-and Fixed-particle Theorymentioning

confidence: 99%

Crystal Retention in Renal Stone Disease

Verkoelen¹

2006

Journal of the American Society of Nephrology

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The mechanisms that are involved in renal stone disease are not entirely clear. In this article, the various concepts that have been proposed during the past century are reviewed briefly and integrated into current insights. Much attention is dedicated to hyaluronan (HA), an extremely large glycosaminoglycan that may play a central role in renal stone disease. The precipitation of poorly soluble calcium salts (crystal formation) in the kidney is the inevitable consequence of producing concentrated urine. HA is a major constituent of the extracellular matrix in the renal medullary interstitium and the pericellular matrix of mitogen/stress-activated renal tubular cells. HA is an excellent crystal-binding molecule because of its size, negative ionic charge, and ability to form hydrated gel-like matrices. Crystal binding to HA leads to crystal retention in the renal tubules (nephrocalcinosis) and to the formation of calcified plaques in the renal interstitium (Randall's plaques). It remains to be determined whether one or both forms of renal crystal retention are involved in the development of kidney stones (nephrolithiasis).

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“…In this schema for the pathogenesis of renal calculi, brushite is considered to constitute the nidus and to regulate the subsequent growth of the nidus into a stone, whether that nidus is formed by spontaneous precipitation (3) or under the influence of an organic matrix (1, 2). In this communication we shall provide experimental evidence that brushite is the solid phase which is formed from urine in an organic matrix.…”

Section: Introductionmentioning

confidence: 99%

Calcification of collagen by urine in vitro: dependence on the degree of saturation of urine with respect to brushite

Pak¹,

Ruskin²

1970

J. Clin. Invest.

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A B S T R A C T A state of supersaturation of urine with respect to brushite is considered to be important in the formation of renal stones composed of calcium phosphate. 56 supersaturated urine specimens and 44 undersaturated specimens were incubated with collagen (Sigma collagen). Most of the supersaturated specimens calcified the collagen, whereas none of the undersaturated ones did so. Among samples which calcified the collagen, the activity product of Ca"+ and HPO4 after incubation with collagen was essentially the same as that after incubation of the same specimen with brushite; it usually differed from that obtained after incubation with octacalcium phosphate or hydroxyapatite. The molar calcium-tophosphorus ratio of the solid phase in collagen was approximately 1. These results suggested that the solid phase formed in collagen is brushite. This conclusion was confirmed by the direct identification of brushite in collagen by X-ray diffraction.

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Mechanisms of genesis and growth of calculi

Cited by 113 publications

References 25 publications

Physicochemical basis for formation of renal stones of calcium phosphate origin: calculation of the degree of saturation of urine with respect to brushite

Physicochemical basis for formation of renal stones of calcium phosphate origin: calculation of the degree of saturation of urine with respect to brushite

Crystal Retention in Renal Stone Disease

Calcification of collagen by urine in vitro: dependence on the degree of saturation of urine with respect to brushite

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