Physiopathology and etiology of stone formation in the kidney and the urinary tract.
Physiopathology and etiology of stone formation in the kidney and the urinary tract.
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DOI：
10.1007/s00467-009-1116-y
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发表时间：
2010-05
影响因子：
3
通讯作者：
Evan, Andrew P.
中科院分区：
文献类型：
--
作者：
Evan, Andrew P.
所有结石都有相似的症状，尿液相对于结石矿物相的过饱和是结石形成的关键。然而，最近对结石形成者的乳头活检的研究提供了一种肾脏晶体沉积的组织学观点，表明导致结石形成的早期事件序列有很大不同，这取决于结石的类型和导致过饱和的尿液化学。肾结石的形成一般有三种途径：(1)结石固定在肾乳头表面的间质磷灰石斑块位置(称为兰德尔斑块)，如特发性草酸钙结石形成；(2)结石附着在从Bellini管开口突出的塞子上，如高草酸尿和远端小管酸中毒；以及(3)结石在肾脏收集系统中以游离溶液形成，如胱氨酸尿症。结石患者肾髓质的间质或小管腔(有时两者)中都有羟基磷灰石晶体的存在，这是一种规律，对结石形成的最初步骤和肾脏损伤的可能性有一定的影响。
All stones share similar presenting symptoms, and urine supersaturation with respect to the mineral phase of the stone is essential for stone formation. However, recent studies using papillary biopsies of stone formers have provided a view of the histology of renal crystal deposition which suggests that the early sequence of events leading to stone formation differs greatly, depending on the type of stone and on the urine chemistry leading to supersaturation. Three general pathways for kidney stone formation are seen: (1) stones fixed to the surface of a renal papilla at sites of interstitial apatite plaque (termed Randall’s plaque), as seen in idiopathic calcium oxalate stone formers; (2) stones attached to plugs protruding from the openings of ducts of Bellini, as seen in hyperoxaluria and distal tubular acidosis; and (3) stones forming in free solution in the renal collection system, as in cystinuria. The presence of hydroxyapatite crystals in either the interstitial or tubule compartment (and sometimes both) of the renal medulla in stone formers is the rule and has implications for the initial steps of stone formation and the potential for renal injury.
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影响因子：
4.5
作者：
Miller NL;Gillen DL;Williams JC Jr;Evan AP;Bledsoe SB;Coe FL;Worcester EM;Matlaga BR;Munch LC;Lingeman JE
通讯作者：
Lingeman JE
影响因子：
6.1
作者：
Parks, Joan H.;Coe, Fredric L.;Worcester, Elaine M.
通讯作者：
Worcester, Elaine M.
影响因子：
19.6
作者：
Evan, Andrew E.;Lingeman, James E.;Worcester, Elaine M.
通讯作者：
Worcester, Elaine M.
影响因子：
19.6
作者：
Evan, A. P.;Bledsoe, S.;Bergsland, K. J.
通讯作者：
Bergsland, K. J.
影响因子：
19.6
作者：
KOK, DJ;KHAN, SR
通讯作者：
KHAN, SR