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Replacement of hydroxylapatite by whewellite: implications for kidney-stone formation

Published online by Cambridge University Press:  05 July 2018

I. Sethmann ,
B. Grohe  and
H.-J. Kleebe
I. Sethmann*
Affiliation:
Institut für Angewandte Geowissenschaften, Technische Universität Darmstadt, 64287 Darmstadt, Germany
B. Grohe
Affiliation:
Schulich School of Medicine & Dentistry, School of Dentistry, University of Western Ontario (Western University), London, Ontario, Canada N6A 5C1
H.-J. Kleebe
Affiliation:
Institut für Angewandte Geowissenschaften, Technische Universität Darmstadt, 64287 Darmstadt, Germany
*
*E-mail: sethmann@geo.tu-darmstadt.de
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Abstract

Kidney stones consisting predominantly of whewellite (calcium oxalate monohydrate, COM) are often found attached to hydroxylapatite (HA) plaques that form in the soft tissue of kidneys, cause lesions and become exposed to urine. Although the processes of stone formation are not entirely known, it is an established view that so-called Randall’s plaques serve as substrates for COM crystal nucleation and growth from correspondingly supersaturated urine. However, the results presented here suggest an additional mineral replacement process is involved. In an experimental approach, HA was reacted in 0.25 mM, 0.5 mM and 1.0 mM oxalate solutions with pH ranging from 4.5 to 7.5, simulating normal to harsh conditions encountered in urine. Extremely acidic solutions induce dissolution of HA crystals coupled with re-precipitation of the released Ca2+ ions as COM on the HA surface. When, instead, bone was used as a substrate, being more similar to the pathological plaque (aggregated HA nanocrystals within an organic matrix), the HA-COM mineral-replacement reaction is induced even under much milder fluid conditions, commonly found in urine. Hence, a process of COM partly replacing and encrusting Randall’s plaque may take place in the urinary tract of idiopathic stone formers, representing a potential starting event for nephrolithiasis.

Keywords

hydroxylapatitewhewellitereplacementkidney stone
Type
Research Article
Information
Mineralogical Magazine , Volume 78 , Issue 1 , February 2014 , pp. 91 - 100
Copyright
Copyright © The Mineralogical Society of Great Britain and Ireland 2014

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