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Three pathways for human kidney stone formation.
[cystinuria]
No
single
theory
of
pathogenesis
can
properly
account
for
human
kidney
stones
,
they
are
too
various
and
their
formation
is
too
complex
for
simple
understanding
.
Using
human
tissue
biopsies
,
intraoperative
imaging
and
such
physiology
data
from
ten
different
stone
forming
groups
,
we
have
identified
at
least
three
pathways
that
lead
to
stones
.
The
first
pathway
is
overgrowth
on
interstitial
apatite
plaque
as
seen
in
idiopathic
calcium
oxalate
stone
formers
,
as
well
as
stone
formers
with
primary
hyperparathyroidism
,
ileostomy
,
and
small
bowel
resection
,
and
in
brushite
stone
formers
.
In
the
second
pathway
,
there
are
crystal
deposits
in
renal
tubules
that
were
seen
in
all
stone
forming
groups
except
the
idiopathic
calcium
oxalate
stone
formers
.
The
third
pathway
is
free
solution
crystallization
.
Clear
examples
of
this
pathway
are
those
patient
groups
with
cystinuria
or
hyperoxaluria
associated
with
bypass
surgery
for
obesity
.
Although
the
final
products
may
be
very
similar
,
the
ways
of
creation
are
so
different
that
in
attempting
to
create
animal
and
cell
models
of
the
processes
one
needs
to
be
careful
that
the
details
of
the
human
condition
are
included
.
Diseases
Validation
Diseases presenting
"overgrowth on interstitial"
symptom
cystinuria
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