Microstructures of Randall's plaques and their interfaces with calcium oxalate monohydrate kidney stones reflect underlying mineral precipitation mechanisms

Autoren

Ingo Sethmann
Gunnar Wendt-Nordahl
Thomas Knoll
Frieder Enzmann
Ludwig Simon
Hans-Joachim Kleebe

DOI

10.1007/s00240-016-0925-2

eISSN

2194-7236

ISSN

2194-7228

Ausgabe der Veröffentlichung

3

Zeitschrift

Urolithiasis

Sprache

en

Online publication date

2016

Paginierung

235 - 248

Datum der Veröffentlichung

2017

Status

Published

Herausgeber

Springer Science and Business Media LLC

Herausgeber URL

http://dx.doi.org/10.1007/s00240-016-0925-2

Datum der Datenerfassung

2022

Titel

Microstructures of Randall’s plaques and their interfaces with calcium oxalate monohydrate kidney stones reflect underlying mineral precipitation mechanisms

Ausgabe der Zeitschrift

45

Datenquelle: Crossref

Abstract

Randall's plaques (RP) are preferred sites for the formation of calcium oxalate monohydrate (COM) kidney stones. However, although processes of interstitial calcium phosphate (CaP) plaque formation are not well understood, the potential of plaque microstructures as indicators of CaP precipitation conditions received only limited attention. We investigated RP-associated COM stones for structural details of the calcified tissues and microstructural features of plaque-stone interfaces as indicators of the initial processes of stone formation. Significantly increased CaP supersaturation can be expected for interstitial fluid, if reabsorbed ions from the tubular system continuously diffuse into the collagenous connective tissue. Densely packed, fine-grained CaP particles were found in dense textures of basement membranes while larger, laminated particles were scattered in coarse-meshed interstitial tissue, which we propose to be due to differential spatial confinements and restrictions of ion diffusion. Particle morphologies suggest an initial precipitation as metastable amorphous calcium phosphate (ACP). Morphologies and arrangements of first COM crystals at the RP-stone interface ranged from stacked euhedral platelets to skeletal morphologies and even porous, dendritic structures, indicating, in this order, increasing levels of COM supersaturation. Furthermore, these first COM crystals were often coated with CaP. On this basis, we propose that ions from CaP-supersaturated interstitial fluid may diffuse through porous RP into the urine, where a resulting local increase in COM supersaturation could trigger crystal nucleation and, hence, initiate stone formation. Ion-depleted fluid in persistent pores of initial COM layers may get replenished from interstitial fluid, leading to CaP precipitation in porous COM.

Addresses

Institut für Angewandte Geowissenschaften, Technische Universität Darmstadt, Schnittspahnstr. 9, 64287, Darmstadt, Germany. sethmann@geo.tu-darmstadt.de.

Autoren

Ingo Sethmann
Gunnar Wendt-Nordahl
Thomas Knoll
Frieder Enzmann
Ludwig Simon
Hans-Joachim Kleebe

DOI

10.1007/s00240-016-0925-2

eISSN

2194-7236

Externe Identifier

PubMed Identifier: 27695926

Funding acknowledgements

Deutsche Forschungsgemeinschaft: KL 615/18

Open access

false

ISSN

2194-7228

Ausgabe der Veröffentlichung

3

Zeitschrift

Urolithiasis

Schlüsselwörter

Kidney Medulla
Basement Membrane
Extracellular Fluid
Humans
Kidney Calculi
Calcium Phosphates
Calcium Oxalate
Tomography, X-Ray Computed
Microscopy, Electron, Scanning
Nephrolithotomy, Percutaneous

Sprache

eng

Medium

Print-Electronic

Online publication date

2016

Paginierung

235 - 248

Datum der Veröffentlichung

2017

Status

Published

Datum der Datenerfassung

2016

Titel

Microstructures of Randall's plaques and their interfaces with calcium oxalate monohydrate kidney stones reflect underlying mineral precipitation mechanisms.

Sub types

Journal Article

Ausgabe der Zeitschrift

45

Datenquelle: Europe PubMed Central

Abstract

Randall's plaques (RP) are preferred sites for the formation of calcium oxalate monohydrate (COM) kidney stones. However, although processes of interstitial calcium phosphate (CaP) plaque formation are not well understood, the potential of plaque microstructures as indicators of CaP precipitation conditions received only limited attention. We investigated RP-associated COM stones for structural details of the calcified tissues and microstructural features of plaque-stone interfaces as indicators of the initial processes of stone formation. Significantly increased CaP supersaturation can be expected for interstitial fluid, if reabsorbed ions from the tubular system continuously diffuse into the collagenous connective tissue. Densely packed, fine-grained CaP particles were found in dense textures of basement membranes while larger, laminated particles were scattered in coarse-meshed interstitial tissue, which we propose to be due to differential spatial confinements and restrictions of ion diffusion. Particle morphologies suggest an initial precipitation as metastable amorphous calcium phosphate (ACP). Morphologies and arrangements of first COM crystals at the RP-stone interface ranged from stacked euhedral platelets to skeletal morphologies and even porous, dendritic structures, indicating, in this order, increasing levels of COM supersaturation. Furthermore, these first COM crystals were often coated with CaP. On this basis, we propose that ions from CaP-supersaturated interstitial fluid may diffuse through porous RP into the urine, where a resulting local increase in COM supersaturation could trigger crystal nucleation and, hence, initiate stone formation. Ion-depleted fluid in persistent pores of initial COM layers may get replenished from interstitial fluid, leading to CaP precipitation in porous COM.

Date of acceptance

2016

Autoren

Ingo Sethmann
Gunnar Wendt-Nordahl
Thomas Knoll
Frieder Enzmann
Ludwig Simon
Hans-Joachim Kleebe

Autoren-URL

https://www.ncbi.nlm.nih.gov/pubmed/27695926

DOI

10.1007/s00240-016-0925-2

eISSN

2194-7236

Ausgabe der Veröffentlichung

3

Zeitschrift

Urolithiasis

Schlüsselwörter

Calcium oxalate monohydrate
Calcium phosphate
Interstitial plaque
Microstructure
Nephrolithiasis
Precipitation mechanism
Basement Membrane
Calcium Oxalate
Calcium Phosphates
Extracellular Fluid
Humans
Kidney Calculi
Kidney Medulla
Microscopy, Electron, Scanning
Nephrolithotomy, Percutaneous
Tomography, X-Ray Computed

Sprache

eng

Country

Germany

Paginierung

235 - 248

PII

10.1007/s00240-016-0925-2

Datum der Veröffentlichung

2017

Status

Published

Datum, an dem der Datensatz öffentlich gemacht wurde

2018

Titel

Microstructures of Randall's plaques and their interfaces with calcium oxalate monohydrate kidney stones reflect underlying mineral precipitation mechanisms.

Sub types

Journal Article

Ausgabe der Zeitschrift

45

Datenquelle: PubMed

Microstructures of Randall's plaques and their interfaces with calcium oxalate monohydrate kidney stones reflect underlying mineral precipitation mechanisms

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