Hautmann R, Lehmann A, Komor S
J Urol. 1980 Mar;123(3):317-9. doi: 10.1016/s0022-5347(17)55914-5.
On the basis of what we know about urinary supersaturation and particle growth inhibitors stone formation is unlikely to start from free crystalluric particles in the renal tubule. Therefore, the object of this study is to report data on the intrarenal distribution of calcium and oxalate in man and to examine a possible relationship between calcium and oxalate concentrations in the renal tissue and stone formation. Fresh human renal tissue was obtained at operation from 7 subjects. The calcium concentrations in the papilla, medulla and cortex were measured by atomic absorption spectrophotometry. A radioenzymatic procedure was used to determine the corresponding oxalate concentrations. Significantly higher concentrations of calcium and oxalate were observed in the papilla compared to the medulla. The medulla, in turn, contained higher concentrations than the cortex. Calcium and oxalate concentrations were 6 and 25 times higher in the normal papilla than in the urine, respectively. The ion product of calcium oxalate concentrations in the human renal tissue have not been investigated, although the frequent finding of calcification in the renal papilla suggests that they may exist. The observed intrarenal calcium and oxalate concentration gradients seem to be a significant mechanism in the pathogenesis of papillary calcification and a strong indication for renal stone formation to start from fixed crystalluric particles in the papilla.
基于我们对尿液过饱和和颗粒生长抑制剂的了解，肾结石不太可能从肾小管中的游离晶体颗粒开始形成。因此，本研究的目的是报告人体肾脏内钙和草酸盐分布的数据，并研究肾组织中钙和草酸盐浓度与结石形成之间的可能关系。从7名受试者手术中获取新鲜的人体肾脏组织。通过原子吸收分光光度法测量乳头、髓质和皮质中的钙浓度。采用放射酶法测定相应的草酸盐浓度。与髓质相比，乳头中观察到的钙和草酸盐浓度显著更高。反过来，髓质中的浓度高于皮质。正常乳头中的钙和草酸盐浓度分别比尿液中高6倍和25倍。尽管在肾乳头中经常发现钙化提示它们可能存在，但尚未对人体肾组织中草酸钙浓度的离子积进行研究。观察到的肾脏内钙和草酸盐浓度梯度似乎是乳头钙化发病机制中的一个重要机制，也是肾结石从乳头中的固定晶体颗粒开始形成的有力指征。
