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Calcium bilirubinate at the Randall's plaque-kidney stone interface: first description
Els Van de Perre1,2, Dominique Bazin3, Antoine Boury3
1Department of Nephrology and Arterial Hypertension, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Journal of Nephrology
|April 9, 2026
Summary
Red/orange deposits on kidney stones, specifically Randall's plaques, are rare and composed of calcium bilirubinate. Further research is needed to link these findings to liver or biliary conditions.
Area of Science:
- Nephrology
- Pathology
- Biochemistry
Background:
- Randall's plaque is a common precursor in kidney stone formation.
- Red/orange deposits on Randall's plaques are observed in a small percentage of kidney stones.
Purpose of the Study:
- To determine the prevalence of red/orange deposits on Randall's plaques.
- To characterize the composition of these deposits.
Main Methods:
- Retrospective analysis of 44,213 kidney stones (1989-2023).
- Morphological examination for red/orange deposits on Randall's plaques.
- Analysis using scanning electron microscopy, energy-dispersive X-ray absorptiometry, and Fourier-transform infrared spectroscopy.
Main Results:
- 1.1% of kidney stones with Randall's plaques (142/12,587) showed red/orange deposits.
- Deposits were identified as calcium bilirubinate crystals.
- Iron was notably absent in the analyzed deposits.
Conclusions:
- Red/orange deposits, identified as calcium bilirubinate, are found in a minority of Randall's plaques.
- The clinical significance and association with hepatic or biliary disease warrant further investigation.
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