Tubular and interstitial nephrocalcinosis.
Tubular and interstitial nephrocalcinosis.
复制标题
肾小管和间质性肾钙质沉着症。
DOI：
10.1016/j.juro.2007.05.008
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
C. Verkoelen
中科院分区：
文献类型：
--
作者：
M. Kummeling;B. D. de Jong;C. Laffeber;D. Kok;P. Verhagen;G. V. van Leenders;R. V. van Schaik;C. V. van Woerden;A. Verhulst;C. Verkoelen
目的我们确定肾钙质沉着症是否常见，以及其检测是否受到肾组织处理的影响。材料和方法从因肿瘤学指征而摘除的 15 个肾脏的未受影响部分中获取肾皮质和乳头组织。在因慢性肾盂肾炎导致肾钙质沉着症的肾脏中研究了组织处理对晶体损失的影响。通过偏振光和拉曼光谱分析立即冷冻和甲醛固定的切片，并进行钙 (Yasue) 和透明质酸染色。 结果 尽管来自肿瘤肾脏的 15 个速冻切片中的 13 个在肾小管中含有双折射颗粒（平均值 ± SD 3.2 ± 2.9 个颗粒/cm2），但这不被视为肾钙质沉着症，因为晶体不附着在上皮衬里。 15 个肿瘤肾脏中有 3 个（20%）经 Yasue 染色发现间质性肾钙质沉着症。仅在乳头状间质中发现钙沉积物，并且总是与透明质酸在一起。来自肾盂肾炎肾脏的甲醛固定切片比立即冷冻切片含有更少的肾小管细胞相关双折射颗粒（9.4±1.9 vs 41.6±1.2/cm2）。颗粒由一水草酸钙（Yasue 和 Raman）组成。结论 肾钙质沉着症有 2 种不同形式，包括管状肾钙质沉着症，这似乎是为慢性肾盂肾炎和间质性肾钙质沉着症等特定病症保留的。由于常规组织学处理过程中晶体的损失，肾小管草酸钙肾钙沉着症的发生率可能被低估。晶体结合分子透明质酸可能在两种形式的肾钙质沉着症中发挥作用。
PurposeWe determined whether nephrocalcinosis is common and whether its detection is influenced by renal tissue processing.Materials and MethodsRenal cortical and papillary tissue was obtained from the unaffected parts of 15 kidneys removed due to an oncological indication. The effect of tissue processing on the loss of crystals was studied in a kidney with nephrocalcinosis due to chronic pyelonephritis. Immediately frozen and formaldehyde fixed sections were analyzed by polarized light and Raman spectroscopy, and stained for calcium (Yasue) and hyaluronan.ResultsAlthough 13 of 15 snap-frozen sections from tumor kidneys contained birefringent particles (mean ± SD 3.2 ± 2.9 particles per cm2) in the renal tubules, this was not considered nephrocalcinosis because the crystals were not attached to the epithelial lining. Interstitial nephrocalcinosis was found on Yasue stain in 3 of 15 kidneys with tumor (20%). Calcium deposits were found in the papillary interstitium only, always together with hyaluronan. Formaldehyde fixed sections from the pyelonephritis kidney contained fewer renal tubular cell associated birefringent particles than immediately frozen sections (9.4 ± 1.9 vs 41.6 ± 1.2 per cm2). Particles were composed of calcium oxalate monohydrate (Yasue and Raman).ConclusionsThere are 2 distinct forms of nephrocalcinosis, including tubular nephrocalcinosis, which seems to be reserved for specific conditions such as chronic pyelonephritis, and interstitial nephrocalcinosis. The incidence of tubular calcium oxalate nephrocalcinosis could be underestimated due to the loss of crystals during tissue processing for routine histology. The crystal binding molecule hyaluronan may have a role in the 2 forms of nephrocalcinosis.