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Thrombi Within the Urinary Tract May Serve as a Nidus for Rapid Stone Recurrence: A Report of Two Cases
Ashley V Alford1, Matthew Mocol1, Michael S Borofsky1
1Department of Urology, School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Insights
Rapidly recurrent kidney stones in two men were found to have a blood clot core. This suggests urinary tract thrombi can accelerate kidney stone formation and growth.
Area of Science:
- Urology
- Nephrology
Background:
- Nephrolithiasis is a common and costly urologic condition.
- Calcium oxalate stones are the most prevalent type, forming 75% of idiopathic stones.
- Stone formation is usually gradual but can be accelerated by certain factors.
Observation:
- Two adult white men presented with rapidly recurrent symptomatic kidney stones.
- Both patients had a history of nephrolithiasis and recent hematuria.
- The kidney stones had an outer mineral shell and an inner core of blood clot.
Findings:
- Urinary tract thrombi can act as a nidus for kidney stone formation.
- This nidus can lead to the development of various stone types, including calcium oxalate and uric acid stones.
- Stones originating from a thrombus may exhibit accelerated growth.
Implications:
- Understanding the role of thrombi in kidney stone formation is crucial for managing recurrent cases.
- This finding may lead to new diagnostic or therapeutic strategies for nephrolithiasis.
- Further research into the mechanisms of thrombus-induced stone formation is warranted.
Abstract:
Nephrolithiasis is increasingly becoming one of the most prevalent and costly urologic conditions in the United States. The most common type of kidney stone in humans is calcium oxalate, accounting for 75% of idiopathic stones in first-time stone formers. Stone formation is typically a gradual process; however, certain factors can accelerate stone development and recurrence. We present two cases of adult white men who were found to have rapidly recurrent symptomatic kidney stones that were ultimately determined to be comprised of an outer mineral shell with an inner core of blood clot. Both patients had a history of nephrolithiasis and recent hematuria. Urine supersaturation values at time of presentation supported formation of kidney stones. Thrombi within the urinary tract can serve as a nidus for formation of multiple types of kidney stones, including calcium oxalate and uric acid stones. Stones arising from such a nidus may exhibit unusually rapid growth.
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