1. Supersaturación Calcium Stones
2. Nucleación
3. Crecimiento Uric Acid Stones
4. Agregación → piedra Calcium oxalate Calcium Phosphate (Brushite)
Epidemiology 75% <5% 10%
- Primary hyperparathyroidism - Renal Tubular Acidosis - Gout attack
- Idiopathic hypercalciuria type I (distal) - Tumor lysis syndrome
● I → absorptive *NOT in type II - ↑ purine diet intake
● II → renal - PCT failure leads to
● III → w/ hypophosphatemia citraturia
Etiology - Hypocitraturia ← ↓urinary pH - Urine is acid ⇥ CaPO4
- Hyperoxaluria aggregation
● Dietary → ↑spinach, chocolate, beets, peanuts, Vit C
● Enteric → malabsorption diseases ↑ permeability
● Primary → mutations
- Tamm-Horsfall mutation
Risk factors: RTA1 Risk factors: Str
● ↓ urinary volume - Inability to acidify urine → - Persistently acidic pH ph
● ↑Calcium & oxalate excretion alkaline urine - Chemo patient -U
● ↓ citrate excretion - Acidemia - ↑ meat dietary intake am
● ↑ epithelial damage → ↑heterogeneous nucleation - ↑ citrate reabsorption in
● Hydroxyapatite (Randall plaques) → nucleation PCT → ↓citraturia
Pathogenesis
● Hyperuricosuria - gout - ↑Bone resorption → -S
Protective factors ↑CaPO4 in urine →
● Tamm-horsfall protein ⇥ aggregation → Supersaturation & nucleation -C
● Nephrocalcin & uropontin ⇥ growth, aggregation & sto
nucleation
→ CaOxalate supersaturation and nucleation
pH in which they form Acid Alkaline Acid
- Envelope (dihydrate) & biconcave (monohydrate) - Wedge-shaped - Rounded rhomboid or rosette -C
Crystal shape
- Dark brown - Orange
2. Nucleación
3. Crecimiento Uric Acid Stones
4. Agregación → piedra Calcium oxalate Calcium Phosphate (Brushite)
Epidemiology 75% <5% 10%
- Primary hyperparathyroidism - Renal Tubular Acidosis - Gout attack
- Idiopathic hypercalciuria type I (distal) - Tumor lysis syndrome
● I → absorptive *NOT in type II - ↑ purine diet intake
● II → renal - PCT failure leads to
● III → w/ hypophosphatemia citraturia
Etiology - Hypocitraturia ← ↓urinary pH - Urine is acid ⇥ CaPO4
- Hyperoxaluria aggregation
● Dietary → ↑spinach, chocolate, beets, peanuts, Vit C
● Enteric → malabsorption diseases ↑ permeability
● Primary → mutations
- Tamm-Horsfall mutation
Risk factors: RTA1 Risk factors: Str
● ↓ urinary volume - Inability to acidify urine → - Persistently acidic pH ph
● ↑Calcium & oxalate excretion alkaline urine - Chemo patient -U
● ↓ citrate excretion - Acidemia - ↑ meat dietary intake am
● ↑ epithelial damage → ↑heterogeneous nucleation - ↑ citrate reabsorption in
● Hydroxyapatite (Randall plaques) → nucleation PCT → ↓citraturia
Pathogenesis
● Hyperuricosuria - gout - ↑Bone resorption → -S
Protective factors ↑CaPO4 in urine →
● Tamm-horsfall protein ⇥ aggregation → Supersaturation & nucleation -C
● Nephrocalcin & uropontin ⇥ growth, aggregation & sto
nucleation
→ CaOxalate supersaturation and nucleation
pH in which they form Acid Alkaline Acid
- Envelope (dihydrate) & biconcave (monohydrate) - Wedge-shaped - Rounded rhomboid or rosette -C
Crystal shape
- Dark brown - Orange
