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Crystal Surface Adhesion Explains the Pathological Activity of Calcium Oxalate Hydrates in Kidney Stone Formation

Xiaoxia Sheng^*, Michael D. Ward^* and Jeffrey A. Wesson

^* Department of Chemical Engineering and Materials Science, University of Minnesota, Minneapolis, Minnesota; and Nephrology Division, Department of Veteran Affairs Medical Center and the Medical College of Wisconsin, Milwaukee, Wisconsin

Address correspondence to: Dr. Michael D. Ward, Department of Chemical Engineering and Materials Science, University of Minnesota, 421 Washington Avenue SE, Minneapolis, MN 55455. Phone: 612-625-3062; Fax: 612-626-7805; E-mail:wardx004{at}umn.edu

Renal tubular fluid in the distal nephron of the kidney is supersaturated with calcium oxalate (CaOx), which crystallizes in the tubules as either calcium oxalate monohydrate (COM) or calcium oxalate dihydrate (COD). Kidney stones are aggregates, most commonly containing microcrystals of COM as the primary inorganic constituent. Stones also contain small amounts of embedded proteins, which are thought to play an adhesive role in these aggregates, and they often are found attached to the tip of renal papilla, presumably through adhesive contacts. Voided urine, however, often contains COD in the form of single micron-sized crystals. This suggests that COD formation protects against stone disease because of its reduced capacity to form stable aggregates and strong adhesion contacts to renal epithelial cells. Using atomic force microscopy configured with tips modified with biologically relevant functional groups, we have compared the adhesion strengths of the morphologically important faces of COM and COD. These measurements provide direct experimental evidence, at the near molecular level, for poorer adhesion at COD crystal faces, which explains the benign character of COD and has implications for resolving one of the mysteries of kidney stone formation.

This article has been cited by other articles:

				J. A. Wesson and M. D. Ward Pathological Biomineralization of Kidney Stones Elements, December 1, 2007; 3(6): 415 - 421. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673