ESWL-Derived Particle Size Distribution and Fracture Geometries: A Contextual GeoBioMed Framework for Assessment of Kidney Stone Recurrence

Todorov, Lauren G

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https://hdl.handle.net/2142/115811 Copy

Description

Title

ESWL-Derived Particle Size Distribution and Fracture Geometries: A Contextual GeoBioMed Framework for Assessment of Kidney Stone Recurrence

Author(s)

Todorov, Lauren G

Issue Date

2022-04-28

Director of Research (if dissertation) or Advisor (if thesis)

Fouke, Bruce W

Department of Study

Geology

Discipline

Geology

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

M.S.

Degree Level

Thesis

Keyword(s)

• nephrolithiasis
• urolithiasis
• mineralogy
• stratigraphy, crystalline architecture
• extracorporeal shock wave lithotripsy
• ESWL
• fragments
• particles
• grain size, reactive surface area, super-resolution autofluorescence
• SRAF

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is a common worldwide clinical treatment for human kidney stones. Yet its 60% success rate is counterbalanced by recurrence rates of 50% within 10 years with no effective treatments currently available. This study has applied GeoBioMed approaches to determine the fracture patterns and grain size distributions of ESWL-derived particles within the context of their original crystalline architecture as revealed by high- and super-resolution autofluorescence (SRAF) microscopy. Calcium oxalate (CaOx) stones were removed from a Mayo Clinic patient using standard percutaneous nephrolithotomy (PCNL) and shock pulse lithotripsy (SPL). This produced ~4-12mm-diameter PCNL-derived fragments that were treated ex vivo to form 100’s of smaller ESWL-derived particles. ESWL-induced fractures propagated in a variety of geometric orientations relative to the original crystalline architecture of each fragment to form rectangular, pointed, concentrically spalled, and irregular, ESWL-derived particles size frequency distributions ranged from very fine silt (4-8m) to very fine pebbles (2-4mm), with a mean of fine sand (125-250m). These particles are smaller than the 3-4mm-diameter detection limit of clinical microcomputed tomography (micro-CT) and are hydrodynamically retained on internal kidney membrane surfaces. ESWL therefore produces small undetectable crystallization seed points distributed throughout the kidney that dramatically increase geochemical reactive surface area and kinetically enhance stone recurrence.

Graduation Semester

2022-05

Type of Resource

Thesis

Copyright and License Information

Copyright 2022 Lauren Todorov

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