Abstract
Over the past 10 years, major progress has been made in the pathogenesis of uric acid and calcium stones. These advances have led to our further understanding of a pathogenetic link between uric acid nephrolithiasis and the metabolic syndrome, the role of Oxalobacter formigenes in calcium oxalate stone formation, oxalate transport in Slc26a6-null mice, the potential pathogenetic role of Randall's plaque as a precursor for calcium oxalate nephrolithiasis, and the role of renal tubular crystal retention. With these advances, we may target the development of novel drugs including (1) insulin sensitizers; (2) probiotic therapy with O. formigenes, recombinant enzymes, or engineered bacteria; (3) treatments that involve the upregulation of intestinal luminal oxalate secretion by increasing anion transporter activity (Slc26a6), luminally active nonabsorbed agents, or oxalate binders; and (4) drugs that prevent the formation of Randall's plaque and/or renal tubular crystal adhesions.
Original language | English (US) |
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Pages (from-to) | 585-595 |
Number of pages | 11 |
Journal | Kidney international |
Volume | 75 |
Issue number | 6 |
DOIs | |
State | Published - 2009 |
Keywords
- Calcium oxalate
- Kidney stone
- Metabolic syndrome
- Nephrolithiasis
- Uric acid
ASJC Scopus subject areas
- Nephrology