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World J Nephrol. Nov 6, 2014; 3(4): 256-267
Published online Nov 6, 2014. doi: 10.5527/wjn.v3.i4.256
From crystalluria to kidney stones, some physicochemical aspects of calcium nephrolithiasis
Johannes M Baumann, Beat Affolter
Johannes M Baumann, Beat Affolter, Stone Research Center Viollier, CH-2502 Biel, Switzerland
Author contributions: Baumann JM and Affolter B solely contributed to this paper.
Correspondence to: Johannes M Baumann, MD, Professor, Stone Research Center, Viollier, Alpenstrasse 21A, CH-2502 Biel/Bienne, Switzerland. johannes.denise.baumann@bluewin.ch
Telephone: +41-32-3231010 Fax: +41-32-3231025
Received: June 20, 2014
Revised: July 23, 2014
Accepted: September 6, 2014
Published online: November 6, 2014
Core Tip

Core tip: The state of urinary saturation with respect to Ca salts is governed by pH, Ca and Ox concentration. Growth of calcium oxalate (CaOx) in urine is too slow that single crystals could acquire a size to be trapped in nephron. The aggregation (AGN) of CaOx in urine was lacking or severely delayed due to inhibition by urinary macromolecules (UM’s). Albumin, after temporary adsorption on calcium phosphate, showed self aggregation and promoted AGN of CaOx. Self aggregated UM’s probably overwhelm the electrostatic repulsion of crystals coated by negatively charged UM’s. This mechanism may explain the effect of Randall’s plaques.