| Endoscopic renal papillary biopsies: a tissue retrieval technique for histological studies in patients with nephrolithiasis. | |
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MedLine Citation:
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PMID: 14634375 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The mechanisms behind calcium nephrolithiasis remain unclear. Previous research has relied on animal models or cell lines, yielding limited insight into the pathophysiology of human calcium stone disease. To determine changes occurring in the human kidney during active stone disease we used an endoscopic renal papillary biopsy protocol in calcium stone formers undergoing percutaneous nephrolithotomy. MATERIALS AND METHODS: Following stone burden clearance via percutaneous nephrolithotomy 15 idiopathic calcium oxalate and 4 ileal bypass stone formers underwent flexible and rigid nephroscopy. Biopsies from select papillae in the peripheral and interpolar regions were obtained with 5Fr flexible cup biopsy forceps. A papilla adjacent to the accessed calix was biopsied with 10Fr cup biopsy forceps. Cortical biopsies along the access tract were also obtained with the 10Fr forceps. RESULTS: All patients had successful biopsy completion. No complications were attributable to the biopsy process and no blood transfusions were required. Of the 19 patients 12 were contacted for followup at a mean of 21.7 +/- 9.0 months with none experiencing adverse sequelae such as bleeding or significant pain. A total of 14 patients had followup serum creatinine available showing that the difference in mean preoperative and postoperative values was not clinically significant (1.00 +/- 0.27 and 1.11 +/- 0.27 mg/dl, respectively). The quality of biopsied tissue permitted accurate immunohistochemical staining of crystal deposits and mineral analysis. CONCLUSIONS: Endoscopic papillary biopsies were performed safely in a small patient population. Tissue obtained using this protocol can be used for detailed histological and analytical studies, which may lead to significant advances in our understanding of stone formation mechanisms. |
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Authors:
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Ramsay L Kuo; James E Lingeman; Andrew P Evan; Ryan F Paterson; Sharon B Bledsoe; Samuel C Kim; Larry C Munch; Fredric L Coe |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Journal of urology Volume: 170 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-11-24 Completed Date: 2004-02-03 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 2186-9 Citation Subset: AIM; IM |
Affiliation:
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Methodist Hospital Institute for Kidney Stone Disease and Indiana University School of Medicine, Indianapolis, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Biopsy
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adverse effects,
methods* Calcium Oxalate / analysis Endoscopy / methods* Female Humans Immunohistochemistry Kidney Calculi / chemistry, pathology*, surgery Kidney Medulla / pathology* Male Middle Aged Nephrostomy, Percutaneous / adverse effects |
| Grant Support | |
ID/Acronym/Agency:
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P01 DK56788/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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25454-23-3/Calcium Oxalate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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