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. Author manuscript; available in PMC: 2019 Dec 1.
Published in final edited form as: Connect Tissue Res. 2018 Dec;59(SUP1):102–110. doi: 10.1080/03008207.2017.1409219

Figure 5. Model of mineral progression from proximal papilla to Randall’s Plaque and a stone on a stem:

Figure 5.

A schematic representation of a human renal papilla is presented on the left. Intratubular minerals can be seen within the top portion of the papilla. As ions coalesce to form pre-clusters and calcified nanoparticles (CNPs), they subsequently agglomerate into higher ordered calcium phosphate phases such as amorphous calcium phosphate (Stages 1–3 plus rightward progression). Amorphous calcium phosphate will eventually form fully developed Randall’s plaque (bottom left and center). Randall’s plaque (stage 3) erodes through the subsurface layers of the papillary tip to form a stem, and serves as the nucleator of stone growth in the urinary space (bottom left). Note: Schematic not drawn to scale.