Mechanisms of human kidney stone formation.
Mechanisms of human kidney stone formation.
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DOI：
10.1007/s00240-014-0701-0
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发表时间：
2015-01
期刊：
影响因子：
3.1
通讯作者：
Lingeman JE
中科院分区：
文献类型：
--
作者：
Evan AP;Worcester EM;Coe FL;Williams J Jr;Lingeman JE
肾结石形成和生长的确切机制尚不完全清楚，尽管人类结石疾病似乎是医学上已知的最古老的疾病之一。随着新的数字内窥镜的出现和对表型良好的结石形成者进行的详细的肾脏生理研究，我们对最常见的结石形成类型--特发性草酸钙结石形成(ICSF)以及其他9种结石形成类型的发病机制的认识取得了实质性进展。我们小组对人类结石形成者的观察以及其他人对模型系统的观察表明，肾结石的形成有四种完全不同的途径。对于高钙尿症患者，草酸钙结石生长在兰德尔斑块上似乎是结石形成的主要方式。贝里尼管塞末端的过度生长在大多数结石表型中都被注意到了，它们会导致临床结石吗？微小结石的形成确实发生在扩张的膀胱尿性结石患者的内髓集合管的管腔内，并且似乎局限于这个空间。最后，胱氨酸尿性结石形成者也有许多小的、椭圆形的、光滑的黄色肾盏结石，提示在自由溶液中形成。回顾了这四种结石形成模式的科学基础，并将其用于探索新的研究机会。
The precise mechanisms of kidney stone formation and growth are not completely known, even though human stone disease appears to be one of the oldest diseases known to medicine. With the advent of the new digital endoscope and detailed renal physiological studies performed on well phenotyped stone formers, substantial advances have been made in our knowledge of the pathogenesis of the most common type of stone former, the idiopathic calcium oxalate stone former (ICSF) as well as nine other stone forming groups. The observations from our group on human stone formers and those of others on model systems have suggested four entirely different pathways for kidney stone formation. Calcium oxalate stone growth over sites of Randall’s plaque appear to be the primary mode of stone formation for those patients with hypercalciuria. Overgrowths off the ends of Bellini duct plugs have been noted in most stone phenotypes, do they result in a clinical stone? Micro-lith formation does occur within the lumens of dilated inner medullary collecting ducts of cystinuric stone formers and appear to be confined to this space. Lastly, cystinuric stone formers also have numerous small, oval, smooth yellow appearing calyceal stones suggestive of formation in free solution. The scientific basis for each of these four modes of stone formation are reviewed and used to explore novel research opportunities.
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影响因子：
19.6
作者：
Evan, Andrew P.;Lingeman, James E.;Worcester, Elaine M.;Bledsoe, Sharon B.;Sommer, Andre J.;Williams, James C., Jr.;Krambeck, Amy E.;Philips, Carrie L.;Coe, Fredric L.
通讯作者：
Coe, Fredric L.
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：
2.7
作者：
Canales, Benjamin K.;Anderson, Lorraine;Monga, Manoj
通讯作者：
Monga, Manoj
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：
Evan, A. P.;Lingeman, J.;Worcester, E.
通讯作者：
Worcester, E.