Randall's plaque of patients with nephrolithiasis begins in basement membranes of thin loops of Henle |
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| Authors: | Evan Andrew P Lingeman James E Coe Fredric L Parks Joan H Bledsoe Sharon B Shao Youzhi Sommer Andre J Paterson Ryan F Kuo Ramsay L Grynpas Marc |
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| Affiliation: | Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46220, USA. evan@anatomy.iupui.edu |
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| Abstract: | Our purpose here is to test the hypothesis that Randall's plaques, calcium phosphate deposits in kidneys of patients with calcium renal stones, arise in unique anatomical regions of the kidney, their formation conditioned by specific stone-forming pathophysiologies. To test this hypothesis, we performed intraoperative biopsies of plaques in kidneys of idiopathic-calcium-stone formers and patients with stones due to obesity-related bypass procedures and obtained papillary specimens from non-stone formers after nephrectomy. Plaque originates in the basement membranes of the thin loops of Henle and spreads from there through the interstitium to beneath the urothelium. Patients who have undergone bypass surgery do not produce such plaque but instead form intratubular hydroxyapatite crystals in collecting ducts. Non-stone formers also do not form plaque. Plaque is specific to certain kinds of stone-forming patients and is initiated specifically in thin-limb basement membranes by mechanisms that remain to be elucidated. |
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