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A chemical model to investigate the risk of kidney stone formation in humans in terms of urinary supersaturation

Hill, Michael Geoffrey (2019) A chemical model to investigate the risk of kidney stone formation in humans in terms of urinary supersaturation. PhD thesis, Murdoch University.

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The formation of kidney stones is a significant human health problem. Despite much research, the processes involved in calcium oxalate and calcium phosphate stone formation remain poorly understood and hence reliable procedures to prevent their formation have yet to be discovered.

A model has been developed to investigate the solution chemistry of the kidney filtration process. The model simulates both long and short nephrons and illustrates the different properties of the fluid in the nephrons of different lengths. It can be used to examine the effects of different physiologic conditions on nephron fluid properties. An important function of the model is its ability to calculate nephron fluid concentrations given a specified urine composition. The substance concentrations calculated by the model have been used as input for the Joint Expert Speciation System. The resultant log(SI) values and speciation profiles allow the behaviour of the fluid in the nephron to be assessed and changes in stone formation risk to be evaluated. A new criterion based on Ostwald’s Rule of Stages is developed, indicating that brushite is the solid phase most likely to precipitate in the loop of Henle.

The model has been used to analyse for the first time fluid concentration variations and associated changes in stone formation risk for different values of blood and urine concentrations, hormone fluctuations and some pathological changes in reabsorption. These developments will help researchers better understand the pathogenesis of kidney stone formation which may in turn lead to further improvements in the methodology of treatment of this disease.

Item Type: Thesis (PhD)
Murdoch Affiliation(s): Chemistry and Physics
Supervisor(s): Königsberger, Erich
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