Experimental Calcium Oxalate Nephrolithiasis and the Formation of Human Urinary Stones

Calcium oxalate nephrolithiasis in rats requires induction of hyperoxaluria which results in increased urinary calcium oxalate supersaturation. As a result of low to mild chronic hyperoxaluria, calcium oxalate crystals deposit first in the papillary collecting ducts. Crystal deposition in the kidneys is preceded by calcium oxalate crystalluria and starts with the retention of aggregated calcium oxalate crystals in the renal tubules. Retained crystals move from the tubules to the interstitium, and in the process, become anchored to the tubular basement membrane. Crystal aggregates present in the superficial peripheral collecting ducts of the renal papillae ulcerate through to the papillary surface and grow into the stones

Heterogeneous Nucleation of Calcium Oxalate Crystals in Mammalian Urine

It is generally recognized that calcium oxalate crystal formation in urine is induced by heterogeneous nucleation. However, there is no consensus as to the nature of the nucleation substrate. Evidence is provided in this paper that membranous cellular degradation products are the most likely candidates because they: (1) are ubiquitous in urine and urinary stones; (2) are found in close association with crystal deposits in the kidneys; and (3) can induce nucleation of crystals from a meta-stable solution of calcium oxalate in vitro and metastable urine in vivo

Studies on the in vitro and in vivo antiurolithic activity of Holarrhena antidysenterica

Background: Holarrhena antidysenterica has a traditional use in the treatment of urolithiasis, therefore, its crude extract has been investigated for possible antiurolithic effect. Materials and methods: The crude aqueous-methanolic extract of Holarrhena antidysenterica (Ha.Cr) was studied using the in vitro and in vivo methods. Results: In the in vitro experiments, Ha.Cr demonstrated a concentration-dependent (0.25–4 mg/ml) inhibitory effect on the slope of aggregation. It decreased the size of crystals and transformed the calcium oxalate monohydrate (COM) to calcium oxalate dehydrate (COD) crystals, in calcium oxalate metastable solutions. It also showed concentration-dependent antioxidant effect against 2,2-diphenyl-1-picrylhydrazyl free radical (DPPH) free radicals and lipid peroxidation induced in rat kidney tissue homogenate. Ha.Cr (0.3 mg/ml) reduced (p \u3c 0.05) the cell toxicity and LDH release in renal epithelial cells (MDCK) exposed to oxalate (0.5 mM) and COM (66 μg/cm2) crystals. In male Wistar rats, receiving 0.75% ethylene glycol (EG) for 21 days along with 1% ammonium chloride (AC) in drinking water, Ha.Cr treatment (30–100 mg/kg) prevented the toxic changes caused by lithogenic agents; EG and AC, like loss of body weight, polyurea, oxaluria, raised serum urea and creatinine levels and crystal deposition in kidneys compared to their respective controls. Conclusion: These data indicate that Holarrhena antidysenterica possesses antiurolithic activity, possibly mediated through inhibition of CaOx crystal aggregation, antioxidant and renal epithelial cell protective activities and may provide base for designing future studies to establish its efficacy and safety for clinical use

Role of Scanning Electron Microscopy and X-Ray Microanalysis in the Identification of Urinary Crystals

Urinary crystals can be identified by using analytical electron microscopic techniques of scanning electron microscopy and energy dispersive x-ray microanalysis. Crystal habit can be recognised by scanning electron microscopy and their chemical nature by elemental analysis. With a conventional detector the lightest element that can routinely be detected is sodium, but with a windowless or thin window detector even carbon can be detected. Thus almost all the commonly occurring urinary crystals including uric acid can be analysed by energy dispersive x-ray microanalysis

Retention of Calcium Oxalate Crystals in Renal Tubules

Crystal retention within the renal tubules is essential for nephrolithiasis and the development of urinary stone disease. We studied the mechanisms involved in this process by inducing calcium oxalate crystal deposition within the rat renal tubules and examining them using various microscopic techniques. Crystals appeared to be retained either by attachment to the tubular epithelium or by aggregating with other crystals thus becoming large enough to be retained by their collective size

Histochemistry of Colloidal Iron Stained Crystal Associated Material in Urinary Stones and Experimentally Induced Intrarenal Deposits in Rats

Organic material associated with the calcium oxalate crystals in urinary stones and experimentally induced nephrolithiasis was stained with colloidal iron and analysed by energy dispersive x-ray microanalysis using standard techniques. Iron was positively identified in the stained specimens indicating that some of the organic material is an acidic mucosubstance. The results also indicate that some of the organic material of urinary stones may originate in the kidneys

Bladder Stone in a Human Female: The Case of an Abnormally Located Intrauterine Contraceptive Device

A single 4.7 x 3.3 x 1.5 cm solid nodule was removed from the bladder of a 24 years old white female who had lost an intrauterine contraceptive device (IUD) installed approximately four years ago. The nodule showed no external evidence of an IUD or its string. An examination of the nodular surface by scanning electron microscopy (SEM) showed mostly amorphous material with some adherent filamentous structures. Its energy dispersive x-ray microanalysis revealed the presence of calcium and phosphorus suggesting that the nodule was actually a urolith. Fracturing the nodule exposed an embedded entity consistent with being a copper IUD. Apparently, the lost IUD had migrated from the uterus into the bladder where it became mineralized. Thus the solid nodule was actually a foreign body stone

Structure of Rat Kidneys Following Microwave Accelerated Fixation

In contrast to fixation of tissue in externally heated fixative, microwave-irradiation can generate uniform internal heat, which is of utmost importance for successful fixation of biological tissue. To evaluate the effectiveness of microwave-accelerated chemical fixation, we compared the structure of rat kidney fixed by a conventional method and a microwave-accelerated method, by scanning and transmission electron microscopy. Following perfusion, rat kidney pieces 1-2 mm in size were irradiated in Karnovsky\u27s fixative in a domestic Amana microwave oven, till the temperature of the fixative reached 45-50°C. For conventional fixation, tissue pieces were fixed overnight at room temperature in the same fixative. Both types of samples were processed further for electron microscopy using identical protocols. The microwave fixed samples showed excellent preservation of structure comparable to the samples fixed by the conventional method. Glomeruli and the renal tubules showed normal morphology with no cellular swelling. The cytoplasm and nuclear matrix of the epithelial cells was uniformly dense. Other fixation sensitive organelles like mitochondria and Golgi apparatus showed superior preservation with continuous membranes. These results demonstrate that microwave accelerated chemical fixation results in excellent preservation of tissue structure, reduces processing time significantly and is therefore a practical alternative to conventional protocols

Presence of Calcium Oxalate Crystals in the Mammalian Thyroid Gland

Birefringent crystals of calcium oxalate have been previously identified in the colloid of human thyroid glands. We found such crystals in 19/20 adult thyroids at autopsy, in 4/ 20 infants at autopsy, and, using frozen sections, in 19/20 thyroids partially or totally removed at surgery. These crystals were soluble in hydrochloric acid, insoluble in acetic acid, and contained only calcium by energy dispersive X-ray microanalysis, confirming their calcium oxalate character. Similar crystals were found in equine and ovine thyroids