Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Video Abstracts
  • Reviews
    • View all reviews ...
    • Pancreatic Cancer (Jul 2025)
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • Substance Use Disorders (Oct 2024)
    • Clonal Hematopoiesis (Oct 2024)
    • Sex Differences in Medicine (Sep 2024)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Video Abstracts
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Randall’s plaque of patients with nephrolithiasis begins in basement membranes of thin loops of Henle
Andrew P. Evan, … , Ramsay L. Kuo, Marc Grynpas
Andrew P. Evan, … , Ramsay L. Kuo, Marc Grynpas
Published March 1, 2003
Citation Information: J Clin Invest. 2003;111(5):607-616. https://doi.org/10.1172/JCI17038.
View: Text | PDF
Article Aging Article has an altmetric score of 11

Randall’s plaque of patients with nephrolithiasis begins in basement membranes of thin loops of Henle

  • Text
  • PDF
Abstract

Our purpose here is to test the hypothesis that Randall’s plaques, calcium phosphate deposits in kidneys of patients with calcium renal stones, arise in unique anatomical regions of the kidney, their formation conditioned by specific stone-forming pathophysiologies. To test this hypothesis, we performed intraoperative biopsies of plaques in kidneys of idiopathic-calcium-stone formers and patients with stones due to obesity-related bypass procedures and obtained papillary specimens from non–stone formers after nephrectomy. Plaque originates in the basement membranes of the thin loops of Henle and spreads from there through the interstitium to beneath the urothelium. Patients who have undergone bypass surgery do not produce such plaque but instead form intratubular hydroxyapatite crystals in collecting ducts. Non–stone formers also do not form plaque. Plaque is specific to certain kinds of stone-forming patients and is initiated specifically in thin-limb basement membranes by mechanisms that remain to be elucidated.

Authors

Andrew P. Evan, James E. Lingeman, Fredric L. Coe, Joan H. Parks, Sharon B. Bledsoe, Youzhi Shao, Andre J. Sommer, Ryan F. Paterson, Ramsay L. Kuo, Marc Grynpas

×

Figure 1

Options: View larger image (or click on image) Download as PowerPoint
Selected urine values. Common-stone formers are represented by open circ...
Selected urine values. Common-stone formers are represented by open circles, bypass patients by filled circles, and normal subjects by triangles. The values for a comparison of stone formers with bypass patients are as follows: urine calcium, 312 ± 89 versus 81 ± 29; oxalate, 40 ± 13 versus 106 ± 11; citrate, 485 ± 278 versus 144 ± 107; supersaturation with respect to CaOx monohydrate, 11 ± 4 versus 5 ± 2; and supersaturation with respect to calcium phosphate, 1.4 ± 8 versus 0.09 ± .05. P < 0.01 for all values by t test and Kolmogorov-Smirnov nonparametric testing. For normal subjects, values for calcium, oxalate, citrate, supersaturation with respect to CaOx, and supersaturation with respect to calcium phosphate were 113 ± 67, 32 ± 9, 482 ± 193, 3.5 ± 1.3, and 0.42 ± .16, respectively; P = < 0.01 versus stone formers by t test and Kolmogorov-Smirnov for calcium, supersaturation with respect to CaOx, and supersaturation with respect to calcium phosphate; P < 0.0001 versus bypass by t test and Kolmogorov-Smirnov for oxalate; P = 0.022 by t test and 0.0001 by Kolmogorov-Smirnov for supersaturation with respect to calcium phosphate; and P = 0.03 by t test and was not significant by Kolmogorov-Smirnov for citrate. The other comparisons of normal subjects to patient groups were not significant by both t test and Kolmogorov-Smirnov. SS, supersaturation.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts

Blogged by 1
Posted by 2 X users
Referenced in 2 Wikipedia pages
166 readers on Mendeley
See more details