Novel Insights into Crystal-Induced Kidney Injury

Abstract

Background: The entity of crystal nephropathies encompasses a spectrum of different kidney injuries induced by crystal-formed intrinsic minerals, metabolites, and proteins or extrinsic dietary components and drug metabolites. Depending on the localization and dynamics of crystal deposition, the clinical presentation can be acute kidney injury, progressive chronic kidney disease, or renal colic. Summary: The molecular mechanisms involving crystal-induced injury are diverse and remain poorly understood. Type 1 crystal nephropathies arise from crystals in the vascular lumen (cholesterol embolism) or the vascular wall (atherosclerosis) and involve kidney infarcts or chronic ischemia, respectively. Type 2 crystal nephropathies arise from intratubular crystal deposition causing obstruction, interstitial inflammation, and tubular cell injury. NLRP3 inflammasome and necroptosis drive renal necroinflammation in acute settings. Type 3 is represented by crystal and stone formation in the draining urinary tract, i.e., urolithiasis, causing renal colic and chronic obstruction. Key Messages: Dissecting the types of injury is the first step towards a better understanding of the pathophysiology of crystal nephropathies. Crystal-induced acti­vation of the inflammasome and necroptosis, crystal adhesion, crystallization inhibitors, extratubulation, and granulo­ma formation are only a few of certainly many involved pathomechanisms that deserve further studies to eventually form the basis for innovative cures for these diseases.

Comparison of Local Administration of Aminophylline Versus Normal Saline on Transureteral Lithotripsy in Patients Presenting With Acute Renal Colic

“…Barzegarnezhad et al, reported that local administration of aminophylline during TUL leads to 95% success rate in interventional [9] group as compared to placebo (72%) . Mulay et al, reported that aminophylline group did not [11] show any side effects similar to our study . Rodger et al reported that aminophylline is DISCUSSION: 8.4±2.9) .…”

Multiple Myeloma–Associated Ig Light Chain Crystalline Cast Nephropathy

“…Deposits of crystals cause kidney injury involving a broad variety of different pathophysiologic mechanisms. Mulay et al 6 recently proposed a classification of crystalline nephropathies based on the localization of crystal deposits: vascular calcification or crystal embolism causing renal ischemia (type 1), intra-and Figure 2. Primary structure of the variable (V L ) and joining (J L ) regions in BJP-l AK aligned with highly homologous germline gene V L segments of IGLV subgroup 3 (A) 5 (IGLV3S2, S11 V2-14, S12 and Humlv318 S13 ) and J L segment of IGLJ3 (Jl3 5,S14 ), using the Clustal Omega program.…”

“…6 Monoclonal Ig LC crystals are rarely deposited in the proximal tubular epithelial cells, causing proximal tubulopathy with or without Fanconi syndrome, and in the tubular lumens, causing cast nephropathy. 6,7 Monoclonal Ig LC crystals also precipitate in intrarenal phagocytes, causing crystal-storing histiocytosis. 6 Table 1 summarizes the clinicopathologic findings in 9 cases of MM-associated Ig LC crystalline cast nephropathy reported since 2000 S1-S8 and in our case.…”

“…6,7 Monoclonal Ig LC crystals also precipitate in intrarenal phagocytes, causing crystal-storing histiocytosis. 6 Table 1 summarizes the clinicopathologic findings in 9 cases of MM-associated Ig LC crystalline cast nephropathy reported since 2000 S1-S8 and in our case.…”

Clinical efficacy and safety of statin treatment after carotid artery stenting

“…With the introduction of endovascular techniques into the management of cardiovascular diseases, increasing demand of contrast media may damage kidney function, thus leading to high occurrence of CIN. The pathogenesis of CIN may be linked to excessive activation of inflammasome and necroptosis induced by crystal media [26]. CIN represents a leading reason of hospital-acquired acute kidney failure, resulting in high hospital costs, prolonged hospital stay and increases in short-and long-term mortality [27].…”