Discrepancy Between Stone and Tissue Mineral Type in Patients with Idiopathic Uric Acid Stones.

To describe the papillary pathology found in uric acid (UA) stone formers, and to investigate the mineral form of tissue deposits. We studied eight UA stone formers treated with percutaneous nephrolithotomy. Papillae were imaged intraoperatively using digital endoscopy, and cortical and papillary biopsies were taken.

Label-free proteomic methodology for the analysis of human kidney stone matrix composition.

Background: Kidney stone matrix protein composition is an important yet poorly understood aspect of nephrolithiasis. We hypothesized that this proteome is considerably more complex than previous reports have indicated and that comprehensive proteomic profiling of the kidney stone matrix may demonstrate relevant constitutive differences between stones. We have analyzed the matrices of two unique human calcium oxalate stones (CaOx-Ia and CaOx-Id) using a simple but effective chaotropic reducing solution for extraction/solubilization combined with label-free quantitative mass spectrometry to generate a comprehensive profile of their proteomes, including physicochemical and bioinformatic analysis.

Mechanism by which shock wave lithotripsy can promote formation of human calcium phosphate stones.

Human stone calcium phosphate (CaP) content correlates with higher urine CaP supersaturation (SS) and urine pH as well as with the number of shock wave lithotripsy (SWL) treatments. SWL does damage medullary collecting ducts and vasa recta, sites for urine pH regulation. We tested the hypothesis that SWL raises urine pH and therefore Cap SS, resulting in CaP nucleation and tubular plugging.

Contrasting histopathology and crystal deposits in kidneys of idiopathic stone formers who produce hydroxy apatite, brushite, or calcium oxalate stones.

Our previous work has shown that stone formers who form calcium phosphate (CaP) stones that contain any brushite (BRSF) have a distinctive renal histopathology and surgical anatomy when compared with idiopathic calcium oxalate stone formers (ICSF). Here we report on another group of idiopathic CaP stone formers, those forming stone containing primarily hydroxyapatite, in order to clarify in what ways their pathology differs from BRSF and ICSF. Eleven hydroxyapatite stone formers (HASF) (2 males, 9 females) were studied using intra-operative digital photography and biopsy of papillary and cortical regions to measure tissue changes associated with stone formation.

A new world revealed: early experience with digital ureteroscopy.

Purpose: The latest digital ureteroscope, the DUR-D (Gyrus ACMI Inc., Southborough, Massachusetts) offers image quality that greatly exceeds current analog image capabilities. The purpose of this report was to document the applicability of this device in studying the earliest stages of stone formation.

Techniques for fluoroscopic percutaneous renal access.

Purpose: Percutaneous nephrolithotomy has undergone considerable evolution since its introduction in the 1970s, which has been driven by advances in access techniques, instrumentation and endoscopic technology. Recent reports suggest an increase in the number of percutaneous stone treatments being performed. However, despite the increasing use of percutaneous nephrolithotomy a minority of urologists obtain their own access.

The role of Randall's plaques in the pathogenesis of calcium stones.

Purpose: Knowledge of the inciting lesion in kidney stone formation has remained rudimentary until quite recently. Randall theorized that areas of apatite plaque on the renal papillae would be an ideal site for an overgrowth of calcium oxalate to develop into a calculus. We reviewed in vivo data that have further defined the role of Randall's plaques in stone disease.