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Plaques and Plugs: Pathogenesis and Relationship to Nephrolithiasis

斑块和栓塞：发病机制及其与肾结石的关系

基本信息

批准号：
9359532
负责人：
JAMES E LINGEMAN
金额：
$ 11.6万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/9359532
关键词：
Address Adult Apatites Appearance Biopsy Calcium Calcium Oxalate Childhood Chronic Chronic Kidney Failure Cimetidine Classification Clinical Creatinine clearance measurement Crystallization Disease Disease susceptibility Duct (organ) structure Ductal Endoscopy Event Excision Flank Pain Functional disorder Gender Histologic Histology Histopathology Inflammation Inflammatory Injury Intervention Intrinsic factor Kidney Kidney Calculi Kidney Papilla Knowledge Language Link Measurable Measures Microalbuminuria Microscopic Nephrolithiasis Obstruction Operative Surgical Procedures Outcome Pain Papillary Pathogenesis Pathology Pathway interactions Patient Care Patients Pattern Formation Phenotype Physiology Plug-in Process Provider Recurrence Renal function Reproducibility Research Resources Risk Risk Factors Salvelinus Secondary to Side Standardization Symptoms System Testing Time Tissues Tubular formation Urinary Calculi Urine Urologist Visual base calcium phosphate clinical practice cohort improved inflammatory marker insight metabolic abnormality assessment microCT novel prospective therapy development tongue papilla tool urinary

项目摘要

Summary Project 2 will test the hypothesis that injury to the renal papilla as documented by our papillary injury grading system (PGS) will reflect and predict stone disease, specifically we will determine the influence of intrinsic patient factors such as renal physiology and stone passage events, as well as on the influence of extrinsic patient factors, particularly surgical treatments. To investigate the time course of papillary disease, we will quantify the extent of papillary changes in a co-hort of pediatric calcium stone formers. We will test the hypothesis that our PGS will predict calcium stone type, as well as the relative percentage of calcium phosphate present in stones. In a related hypothesis, we will test whether application of the PGS is able to predict calcium stone type as classified by formation pattern (tubular plugging vs plaque overgrowth). We hypothesize that papilla with high injury scores will correlate with renal injury as quantified by cimetidine blocked creatinine clearance and microalbuminuria. We have documented that tubular plugging is histologically associated with significant inflammatory changes in the papilla. We will test the hypothesis that these changes will be reflected by elevated levels of inflammatory markers in urine, as well as tissue. We have previously documented that percantage of Randall's plaque papillary coverage correlates directly with stone activity. We will determine whether papillary injury is also associated with stone activity. Finally, we will test the hypothesis that inflammation secondary to ductal plugging is associated with chronic flank pain in the setting of non-obstructing renal stones and, further, whether the treatment of such stones is associated with improvement in patient symptoms. RELEVANCE

总结