Randall's plaque: pathogenesis and role in calcium oxalate nephrolithiasis

Kidney International
A EvanE Worcester

Abstract

The purpose of these studies was to test the hypothesis that Randall's plaque develops in unique anatomical sites of the kidney and their formation is conditioned by specific stone-forming pathophysiologies. We performed intraoperative papillary biopsies from kidneys of idiopathic-calcium oxalate (CaOx), intestinal bypass for obesity, brushite (BR) and cystine stone formers (SF) during percutaneous nephrolithotomy. Tissues were examined by infrared analysis and light and electron microscopy. Our analysis revealed a distinct pattern of mineral deposition and papillary pathology for each type of SF. CaOx SF had interstitial apatite crystals beginning at thin loops of Henle. These deposits termed Randall's plaque are thought to serve as sites for stone attachment. No tubular injury was noted. Intestinal bypass patients possessed intraluminal apatite deposits in inner medullary collecting ducts (IMCD) with associated cell injury. BR SF showed the most severe form of cortical and medullary changes with sites of Randall's plaque, and yellowish intraluminal deposits of apatite in IMCD. Cystine SF had plugging of ducts of Bellini with cystine crystals and apatite deposits in IMCD and loops of Henle. Intratubular sites of crystalline de...Continue Reading

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Citations

Jan 6, 2007·Urological Research·Jennifer C AndersonAndré J Sommer
Jun 2, 2007·Urological Research·Chanchai BoonlaPiyaratana Tosukhowong
Apr 23, 2010·Urological Research·Fredric L CoeJames E Lingeman
Jul 14, 2010·Urological Research·Laurie B GowerSaeed R Khan
Nov 9, 2010·Urological Research·Nicole L MillerJames E Lingeman
Jan 21, 2011·Urological Research·Allen L RodgersHans-Göran Tiselius
Mar 5, 2011·Urological Research·John H WiessnerNeil S Mandel
Aug 22, 2013·Urolithiasis·Hans-Göran Tiselius
May 11, 2012·European Radiology·Alexandru CiudinAntonio Alcaraz Asensio
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Jul 2, 2010·American Journal of Physiology. Renal Physiology·Yan LiuXue-Ru Wu
Mar 14, 2008·American Journal of Physiology. Renal Physiology·Saeed R Khan, Patricia A Glenton
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Apr 13, 2007·Kidney International·C F Verkoelen, A Verhulst
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Jan 20, 2015·Crystal Growth & Design·Baoquan XieGeorge H Nancollas
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Jun 15, 2012·European Journal of Radiology·Stefan GoetschiDominik Weishaupt
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Aug 7, 2014·Urolithiasis·James C WilliamsAndrew P Evan
Aug 12, 2014·Urolithiasis·Andrew P EvanJames E Lingeman
Aug 15, 2014·Urolithiasis·Saeed R Khan, Benjamin K Canales
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Jun 15, 2016·Journal of the American Society of Nephrology : JASN·Kazumi TaguchiTakahiro Yasui
Aug 24, 2016·Nature Reviews. Urology·Michael S BorofskyJames E Lingeman

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