Intrarenal distribution of oxalic acid, calcium, sodium, and potassium in man

The renal papilla in man has been shown to contain a high concentration of oxalate (5 . 5 +/- 0 . 8 mmole/kg wet weight, mean +/- SEM, n = 7 kidneys), and that there is a significant concentration gradient between oxalate in the papilla and that of the medulla (0 . 4 +/- 0 . 08, P < 0 . 05) and the cortex (0 . 3 +/- 0 . 06, P < 0 . 05). Significant calcium and sodium gradients between renal papilla and medulla and cortex were confirmed and parallel that of oxalate. Potassium showed a significant decrease in the papilla (33 . 1 +/- 0 . 9) as compared to the medulla (42 . 1 +/- 1 . 9 P < 0 . 05). The concentrations of oxalate and calcium in the papilla were respectively 25-fold and 6-fold higher than the urinary concentration of oxalate and calcium. It is concluded that these high concentrations of oxalate and calcium in the renal papilla are related to the formation of Randall's plaques and may be an essential factor in the pathogenesis of renal stones which is still far from clear.