RANDALL'S PLAQUES-- PATHOGENESIS AND RELATIONSHIP TO NEPHROLITHIASIS

兰德尔斑块——发病机制及其与肾结石的关系

• 批准号: 7311585
• 负责人: JAMES E LINGEMAN
• 金额: $ 7.44万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7311585
• 关键词: biopsy; calcium; calcium phosphate; clinical research; computed axial tomography; endoscopy; histology; human subject; kidney; nephrolithiasis; oxalates; pathologic process; patient oriented research; phenotype; renal tubule acidosis; urinary calculi; urinary tract imaging /visualization; urinary tract obstruction

The sequence of events culminating in a renal calculus of clinically significant size remains to be established. Our work with thorough clinical, endoscopic, metabolic, and histologic examination of stone formers (SF) suggests that specific physiologic events in the kidney result in characteristic patterns of crystal deposition and eventual stones. Aim 1 will extend our work, which began with the confirmation and elaboration of the work of Randall in common calcium oxalate SF and is extending to include other crystal deposits and stone phenotypes. In Aim 2 we hypothesize that rigorous examination of common calcium oxalate SF undergoing endoscopic stone removal will demonstrate either stone attached to plaque or evidence of plaque in any non-attached stones. As with Aim 1, the protocol of Aim 2 will be extended to other stone phenotypes. With the development of multi-detector CT technology, non-invasive visualization of Randall's plaque (RP) is now possible. Using our now well established endoscopic mapping techniques as a standard, Aim 3 will attempt to define and quantitate CT plaque characteristics and will investigate radiographic criteria for distinguishing RP from stone. Finally, Aim 4 will explore the relationship of urinary stasis to stone formation, a topic that heretofore has not been subjected to rigorous science. Two models (calyceal diverticula, ureteropelvic junction obstruction) will be utilized in this Aim.

事件的顺序最终在临床上显着的大小肾结石仍有待建立。我们对结石形成者（SF）进行了全面的临床、内镜、代谢和组织学检查，结果表明肾脏中的特定生理事件导致晶体沉积和最终结石的特征性模式。目标1将扩展我们的工作，开始于兰德尔在普通草酸钙SF中的工作的确认和阐述，并扩展到包括其他晶体沉积物和结石表型。 在目标2中，我们假设对普通草酸钙SF进行内镜下取石的严格检查将显示结石附着于斑块或任何未附着结石中的斑块证据。与目标1一样，目标2的方案将扩展到其他结石表型。随着多探测器CT技术的发展，兰德尔斑块（RP）的非侵入性可视化现在是可能的。使用我们现在完善的内镜标测技术作为标准，目标3将尝试定义和定量CT斑块特征，并将研究区分RP和结石的放射学标准。最后，目标4将探讨尿潴留与结石形成的关系， 迄今为止还没有经过严格的科学检验。本研究将使用两种模型（肾盏憩室、肾盂输尿管连接部梗阻）。