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Nanouric acid or nanocalcium phosphate as central nidus to induce calcium oxalate stone formation: a high-resolution transmission electron microscopy study on urinary nanocrystallites

Authors Gao J, Xue J, Xu M, Gui B, Wang F, Ouyang J

Received 11 April 2014

Accepted for publication 4 July 2014

Published 16 September 2014 Volume 2014:9(1) Pages 4399—4409

DOI https://doi.org/10.2147/IJN.S66000

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Jie Gao,1 Jun-Fa Xue,2 Meng Xu,2 Bao-Song Gui,1 Feng-Xin Wang,2 Jian-Ming Ouyang2

1Department of Nephrology, the Second Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Institute of Biomineralization and Lithiasis Research, Jinan University, Guangzhou, People’s Republic of China

Purpose: This study aimed to accurately analyze the relationship between calcium oxalate (CaOx) stone formation and the components of urinary nanocrystallites.
Method: High-resolution transmission electron microscopy (HRTEM), selected area electron diffraction, fast Fourier transformation of HRTEM, and energy dispersive X-ray spectroscopy were performed to analyze the components of these nanocrystallites.
Results: The main components of CaOx stones are calcium oxalate monohydrate and a small amount of dehydrate, while those of urinary nanocrystallites are calcium oxalate monohydrate, uric acid, and calcium phosphate. The mechanism of formation of CaOx stones was discussed based on the components of urinary nanocrystallites.
Conclusion: The formation of CaOx stones is closely related both to the properties of urinary nanocrystallites and to the urinary components. The combination of HRTEM, fast Fourier transformation, selected area electron diffraction, and energy dispersive X-ray spectroscopy could be accurately performed to analyze the components of single urinary nanocrystallites. This result provides evidence for nanouric acid and/or nanocalcium phosphate crystallites as the central nidus to induce CaOx stone formation.

Keywords: nanocrystallites, calcium oxalate stones, heterogeneous nucleation, HRTEM, EDS

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