The mechanisms that lead to kidney stones
The formation of kidney stones happens quietly. Until it hurts, what has accumulated for years, or months, is hoped to be reversed, but what else can be done? For today’s blog, seasoned urologist Dr. Cletus Georges will explain the biological mechanisms that lead to those pea-sized formations that imperil the body’s filtering system.
Crystal Nucleation
The formation of a “nucleus” or “nidus,” when supersaturated urine is left inside the kidney, is the first step in kidney stone formation. A supersaturated liquid has free atoms, ions, or molecules that form into microscopic clusters that precipitate into crystals and become insoluble.
Crystal Growth
This happens when urine crystals stick together to form a small hard mass. This process is also known as secondary nucleation. It usually takes time, as the process is quite slow before the stone growth can obstruct the renal tubules.
Crystal Aggregation
When crystal growth accelerates exponentially, where the small hard mass in solution sticks together to create a larger stone, it is then called aggregation. It is widely considered to be the most critical step in the formation of kidney stones. And all models of CaOx urolithiasis agree that aggregation is likely to be “involved in crystal retention within the kidneys.”
Crystal-Cell Interaction
Another term for this process is called crystal retention. This happens, for instance, when grown crystals attach to the renal tubule lining of epithelial cells. Crystal-cell interaction is caused by the “movement of crystals from the “basolateral side” of cells to the “basement membrane” of the kidneys.
Dr. Cletus Georges is a urologist from the Health Orlando Urology in Kissimmee, Florida. He is professionally licensed in Florida and by the US Department of Justice, Drug Enforcement Administration. He is also certified by The American Board of Urology. For more about Dr. Cletus Georges, click here.
