Mechanisms Underlying Calcium Nephrolithiasis.

IF 15.7 1区医学 Q1 PHYSIOLOGY

Annual review of physiology Pub Date : 2022-02-10 Epub Date: 2021-10-26 DOI:10.1146/annurev-physiol-052521-121822

R T Alexander, D G Fuster, H Dimke

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引用次数: 11

Abstract

Nephrolithiasis is a worldwide problem with increasing prevalence, enormous costs, and significant morbidity. Calcium-containing kidney stones are by far the most common kidney stones encountered in clinical practice, and thus, hypercalciuria is the greatest risk factor for kidney stone formation. Hypercalciuria can result from enhanced intestinal absorption, increased bone resorption, or altered renal tubular transport. Kidney stone formation is complex and driven by high concentrations of calcium-oxalate or calcium-phosphate in the urine. After discussing the mechanism mediating renal calcium salt precipitation, we review recent discoveries in renal tubular calcium transport from the proximal tubule, thick ascending limb, and distal convolution. Furthermore, we address how calcium is absorbed from the intestine and mobilized from bone. The effect of acidosis on bone calcium resorption and urinary calcium excretion is also considered. Although recent discoveries provide insight into these processes, much remains to be understood in order to provide improved therapies for hypercalciuria and prevent kidney stone formation.

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钙性肾结石的机制。

肾结石是一个世界性的问题，发病率不断上升，费用巨大，发病率显著。含钙肾结石是目前临床上最常见的肾结石，因此高钙尿是肾结石形成的最大危险因素。高钙尿可由肠道吸收增强、骨吸收增加或肾小管运输改变引起。肾结石的形成是复杂的，由尿液中高浓度的草酸钙或磷酸钙驱动。在讨论了肾钙盐沉淀的机制后，我们回顾了最近发现的肾小管钙从近端小管、厚升肢和远端卷积运输的情况。此外，我们讨论了钙是如何从肠道吸收和从骨骼动员的。酸中毒对骨钙吸收和尿钙排泄的影响也被考虑在内。尽管最近的发现对这些过程提供了深入的了解，但为了提供更好的治疗高钙尿症和预防肾结石形成的方法，还有很多有待了解的地方。

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来源期刊

Annual review of physiology 医学-生理学

CiteScore

35.60

自引率

0.00%

发文量

期刊介绍： Since 1939, the Annual Review of Physiology has been highlighting significant developments in animal physiology. The journal covers diverse areas, including cardiovascular physiology, cell physiology, ecological, evolutionary, and comparative physiology, endocrinology, gastrointestinal physiology, neurophysiology, renal and electrolyte physiology, respiratory physiology, and special topics.