# Plaques and Plugs: Pathogenesis and Relationship to Nephrolithiasis

> **NIH NIH P01** · UNIVERSITY OF CHICAGO · 2021 · $128,745

## Abstract

Summary 
 Project 2 will test the hypothesis that injury to the renal papilla as documented by our papillary injury 
grading system (PGS) will reflect and predict stone disease, specifically we will determine the influence of 
intrinsic patient factors such as renal physiology and stone passage events, as well as on the influence of 
extrinsic patient factors, particularly surgical treatments. To investigate the time course of papillary 
disease, we will quantify the extent of papillary changes in a co-hort of pediatric calcium stone formers. We 
will test the hypothesis that our PGS will predict calcium stone type, as well as the relative percentage of 
calcium phosphate present in stones. In a related hypothesis, we will test whether application of the PGS 
is able to predict calcium stone type as classified by formation pattern (tubular plugging vs plaque 
overgrowth). We hypothesize that papilla with high injury scores will correlate with renal injury as 
quantified by cimetidine blocked creatinine clearance and microalbuminuria. We have documented that 
tubular plugging is histologically associated with significant inflammatory changes in the papilla. We will 
test the hypothesis that these changes will be reflected by elevated levels of inflammatory markers in 
urine, as well as tissue. We have previously documented that percantage of Randall's plaque papillary 
coverage correlates directly with stone activity. We will determine whether papillary injury is also 
associated with stone activity. Finally, we will test the hypothesis that inflammation secondary to ductal 
plugging is associated with chronic flank pain in the setting of non-obstructing renal stones and, further, 
whether the treatment of such stones is associated with improvement in patient symptoms. 
RELEVANCE

## Key facts

- **NIH application ID:** 10246877
- **Project number:** 5P01DK056788-20
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** JAMES E LINGEMAN
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $128,745
- **Award type:** 5
- **Project period:** 2000-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246877

## Citation

> US National Institutes of Health, RePORTER application 10246877, Plaques and Plugs: Pathogenesis and Relationship to Nephrolithiasis (5P01DK056788-20). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10246877. Licensed CC0.

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