WCE 2019: Pathogenesis of Stone Disease: Lessons Learned from Non-Urologists

Abu Dhabi, United Arab Emirates (UAE) (UroToday.com) Dr. Marshall Stoller, Professor of Urology at the University of California, San Francisco (UCSF), presented on the importance of looking outside of urology to help answer clinical questions. He mentioned the lack of innovation in medications used to treat kidney stones over the past 25 years. Given this, he emphasized that experts in other fields may help us find answers to questions we have in our own field.

Dr. Stoller described several of the collaborations he has had over the years and how it has helped advance our knowledge of kidney stone pathophysiology. For example, a rise in medical comorbidities is thought to be a factor in the increasing prevalence of kidney stones. This observation led to a collaboration with Dr. John Kane at the Cardiovascular Research Institution. Their collaborative research endeavor found an association between aortic calcifications and kidney stones, suggesting possible common pathophysiology between systemic biomineralization and stone formation.

Additional collaborations with basic scientists that work with drosophila have also led to some interesting findings. For example, elevated uric acid is a risk factor for recurrent kidney stones. Using an established Drosophila melanogaster model with reduced expression of the orthologous Uro gene they have identified potential therapeutic targets for treating uric acid associated pathologies including gout and kidney stones.

Other important collaborations include their work with Dr. Robert Grubbs, a Nobel Prize awarded chemist. This work led to a novel stone cavitation system that uses tagged microbubbles that attach to stones and can be used to fragment calculi in an outpatient setting. Additional multi-disciplinary research teams at UCSF have used correlative microscopy to better understand the form and function of the renal papilla as it relates to urinary stone disease.

Dr. Stoller’s talk concluded with a plea. We have clinical questions that need answers. We are surrounded by amazing people, such as cardiologists, geologists, chemists, and even zookeepers. Create relationships and leverage this to better understand kidney stone disease.

Presented by: Marshall Stoller, MD, Department of Urology, University of California, San Francisco

Written by: Roshan M. Patel, MD, Department of Urology, University of California, Irvine, Medical Writer for UroToday.com, @rpatel26, at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates

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