Inflammatory Cells in Nephrectomy Tissue from Patients without and with a History of Urinary Stone Disease

Pegah Dejban, Elena M. Wilson, Muthuvel Jayachandran, Loren P. Herrera Hernandez, Zejfa Haskic, Linda E. Wellik, Sutapa Sinha, Andrew D. Rule, Aleksandar Denic, Kevin Koo, Aaron M. Potretzke, John C. Lieske

Research output: Contribution to journalArticlepeer-review


Background and objectives Urinary stone disease has been associated with inflammation, but the specific cell interactions that mediate events remain poorly defined. This study compared calcification and inflammatory cell patterns in kidney tissue from radical nephrectomy specimens of patients without and with a history of urinary stone disease. Design, setting, participants, & measurements Nontumor parenchyma of biobanked radical nephrectomy specimens from age-and sex-matched stone formers (n544) and nonstone formers (n582) were compared. Calcification was detected by Yasue staining and inflammatory cell populations by immunohistochemistry for CD68 (proinflammatory M1 macrophages), CD163 and CD206 (anti-inflammatory M2 macrophages), CD3 (T lymphocytes), and tryptase (mast cells). Calcifications and inflammatory cells were quantified in cortex and medulla using Image-Pro analysis software. Results Calcification in the medulla of stone formers was higher than in nonstone formers (P,0.001). M1 macrophages in the cortex and medulla of stone formers were greater than in nonstone formers (P,0.001), and greater in stone former medulla than stone former cortex (P50.02). There were no differences in age, sex, body mass index, tumor characteristics (size, stage, or thrombus), vascular disease status, or eGFR between the groups. M2 macrophages, T lymphocytes, and mast cells did not differ by stone former status. There was a correlation between M1 macrophages and calcification in the medulla of stone formers (rho50.48; P50.001) and between M2 macrophages and calcification in the medulla of nonstone formers (rho50.35; P50.001). T lymphocytes were correlated with calcification in the cortex of both nonstone formers (rho50.27; P50.01) and stone formers (rho50.42; P50.004), whereas mast cells and calcification were correlated only in the cortex of stone formers (rho50.35; P50.02). Conclusions Higher medullary calcification stimulated accumulation of proinflammatory rather than anti-inflammatory macrophages in stone formers.

Original languageEnglish (US)
Pages (from-to)414-422
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Issue number3
StatePublished - Mar 2022


  • Calcification
  • Inflammation
  • Macrophage
  • Medulla
  • Nephrectomy
  • Nephrolithiasis
  • Urologic diseases

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation


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