In attempts to create an in vitro model system for studying the physiochemical mechanisms involved in the formation of kidney stones, the PILP mineralization process was employed. Here it is hypothesized that the acidic proteins present in urine and renal tissue play a central role in idiopathic nephrolithiasis, where non-classical crystallization may take place. In this two stage process, it has been proposed that calcium phosphate (CaP) is first deposited in the basement membrane of the renal tubules and then grows through the renal interstitium reaching the papillary surface to form sub-epithelial plaque called Randall's plaque (RP). The RP, once exposed to urine in the renal pelvis, becomes coated with calcium oxalate (CaOx) to form a stone. This work is the initial foray into determining the influence of a negatively charged polymer upon the formation of calcium oxalate.
INTRODUCTIONPathological biomineralization is a complex process, especially in the formation of kidney stones where the unique and changing urinary environment influences the type and frequency of stone occurrence. While most kidney stones are composed of CaOx and/or some CaP, there is also the presence of an organic matrix composed mainly of acid-rich proteins commonly found in the urine 1 · 2 . These urinary macromolecules are thought to modulate mineral precipitation in the urine, which at times is supersaturated with CaOx 3, 4 . The underlying hypothesis of this work is that these macromolecules, although intended to inhibit precipitates, could also play a role in the formation of kidney stones. Work in our group has shown that mimics for these acid-rich proteins (such as polyaspartate) can emulate the biomineralization of bone by enabling intrafibrillar mineralization of collagen 5,6 ' 7 ' 8 . In what is termed the polymer-induced liquid-precursor (PILP) process, the presence of negatively charged polypeptides in CaP crystallization solutions results in the formation of an amorphous CaP precursor. The fluidic nature of this precursor allows for infiltration of collagen fibrils, where the precursor then solidifies to amorphous CaP, and then crystallizes to hydroxapatite. It is thought that the acid-rich proteins found in urine, such as osteopontin, could direct an amorphous CaOx precursor in the same way these proteins do in the bone mineralization system.Evidence by Evans and coworkers has identified the importance of Randall's plaque in the formation of idiopathic kidney stones 9 ' 10 ' "' l2 . What they observed was that spherules of CaP on the order of 50 run are deposited in the basement membrane of the kidney. In our studies, we found that mineralization proceeds through collagen supported crystallization of CaP, finally reaching the renal papillary surface and deposition of CaP as sub-epithelial plaques, the Randall's plaques' 3 . Exposure of the RP to the urinary environment results in coating with CaOx, where the coating is often in the form of multiple concentric spherical laminations. These CaOx laminations suggest a CaOx amor...