Abrogation of store-operated Ca entry protects against crystal-induced ER stress in human proximal tubular cells.

Calcium crystal internalization into proximal tubular (PT) cells results in acute kidney injury, nephrocalcinosis, chronic kidney disease (CKD), and kidney-stone formation. Ca supersaturation in PT luminal fluid induces calcium crystal formation, leading to aberrant crystal internalization into PT cells. While such crystal internalization produces reactive oxygen species (ROS), cell membrane damage, and apoptosis; the upstream signaling events involving dysregulation of intracellular Ca homeostasis and ER stress, remain largely unknown.

Evidence for a regulated Ca entry in proximal tubular cells and its implication in calcium stone formation.

Calcium phosphate (CaP) crystals, which begin to form in the early segments of the loop of Henle (LOH), are known to act as precursors for calcium stone formation. The proximal tubule (PT), which is just upstream of the LOH and is a major site for Ca reabsorption, could be a regulator of such CaP crystal formation. However, PT Ca reabsorption is mostly described as being paracellular.