Micro computed tomography analysis of mineral in renal papillae shows that randall's plaque formation occurs independently of upstream ductal plugging in the medulla

You have accessJournal of UrologyCME1 Apr 2023MP05-01 MICRO COMPUTED TOMOGRAPHY ANALYSIS OF MINERAL IN RENAL PAPILLAE SHOWS THAT RANDALL'S PLAQUE FORMATION OCCURS INDEPENDENTLY OF UPSTREAM DUCTAL PLUGGING IN THE MEDULLA Victor Hugo Canela, Keegan Admiral Steele, Patrick Huddleston, Sharon Bledsoe, Elaine Worcester, Ronald Boris, James C. Williams, and James E. Lingeman Victor Hugo CanelaVictor Hugo Canela More articles by this author , Keegan Admiral SteeleKeegan Admiral Steele More articles by this author , Patrick HuddlestonPatrick Huddleston More articles by this author , Sharon BledsoeSharon Bledsoe More articles by this author , Elaine WorcesterElaine Worcester More articles by this author , Ronald BorisRonald Boris More articles by this author , James C. WilliamsJames C. Williams More articles by this author , and James E. LingemanJames E. Lingeman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003216.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Interstitial mineralization in the renal papilla tip is associated with retention and early kidney stone formation. A recent hypothesis proposes that upstream mineral plugging of renal tubules initiates downstream calcifications that lead to formation of Randall’s plaques (RP) at the papilla tip. The objective of the present study was to test this hypothesis by assessing the correlation between upstream mineral plugs and downstream RP formations at the papilla tip. METHODS: Papilla specimens (22 in total, including 16 biopsies from 11 patients and 6 papillae from 5 nephrectomy samples) were scanned by micro computed tomography (CT) and measurements were collected by two investigators blinded to the number of plugs and to the presence of RP. RESULTS: Of the 22 papillae, 3 nephrectomy specimens showed RP by micro CT along with 6.0±5.6 plugs (range, 1 to 12 plugs), with an average plug distance of 1.8±0.89 mm from the papilla tip. The remaining 3 nephrectomy specimens did not contain RP but still displayed 6.7±2.25 plugs (range, 5 to 9 plugs) and an average distance of 2.4±1.7 mm from the papilla tip. Ten (10) biopsy specimens showed evidence for RP along with 12.3±15.1 plugs (range, 1 to 51 plugs) and an average plug distance of 1.0±0.35 mm from the papilla tip, while 6 biopsy specimens without RP displayed 7.8±2.9 plugs with an average distance of 1.1±0.33 mm from the papilla tip. Our analyses revealed that neither the number of intratubular plugs nor the distances from the papilla tip to the plugs differed by the presence of RP at the papilla tip (p=0.72 and p=0.34, respectively). CONCLUSIONS: Our results suggest that RP is not correlated with upstream mineral formation. Further investigation on the development of RP using multi-omics and high-resolution imaging technologies may help to elucidate essential cellular and molecular effectors that drive the formation of RP in patients with stone disease. Source of Funding: Funded by: NIH P01 DK056788 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e43 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Victor Hugo Canela More articles by this author Keegan Admiral Steele More articles by this author Patrick Huddleston More articles by this author Sharon Bledsoe More articles by this author Elaine Worcester More articles by this author Ronald Boris More articles by this author James C. Williams More articles by this author James E. Lingeman More articles by this author Expand All Advertisement PDF downloadLoading ...