Urinary matrix calculi consisting of microfibrillar protein in patients on maintenance hemodialysis.

Abstract:

:In seven patients on maintenance hemodialysis, de novo recurrent renal stone formation was observed. In all patients, the underlying disease was glomerulonephritis, with or without the nephrotic syndrome. All patients had considerable persistent proteinuria. The stones consisted predominantly of protein, as revealed by amino acid analysis, and had a negligible carbohydrate and lipid content. Only in some specimens, X-ray diffraction and scanning electron microscopy revealed the presence of small amounts of whewellit (calcium oxalate monohydrate) and/or uric acid. In semithin sections, the stones had a laminated texture and exhibited structural anisotropy under polarized light. With transmission electron microscopy, they were found to consist of peculair microfibrils. The proteinaceous material differed from fibrin or Tamm-Horsfall-protein, as indicated by ultrastructure, carbohydrate analysis, and amino acid analysis. Symptomatic de novo matrix stone formation constitutes another complication of dialyzed patients which has not been reported so far.

journal_name

Kidney Int

journal_title

Kidney international

authors

Bommer J,Ritz E,Tschöpe W,Waldherr R,Gebhardt M

doi

10.1038/ki.1979.188

subject

Has Abstract

pub_date

1979-12-01 00:00:00

pages

722-8

issue

6

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)32202-X

journal_volume

16

pub_type

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