PATHOMORPHOLOGICAL ALTERATIONS OF THE RENAL PELVIS IN DIABETES-ASSOCIATED NEPHROLITHIASIS
Keywords:
diabetes mellitus, nephrolithiasis, renal pelvis, urothelial injury, fibrosis, diabetic microangiopathyAbstract
Diabetes mellitus is a chronic systemic metabolic disorder that profoundly affects
renal physiology and significantly increases susceptibility to kidney stone formation.
Diabetes-associated nephrolithiasis is characterized not only by metabolic
derangements but also by distinct structural and pathological changes within the renal
pelvis. Persistent hyperglycemia, insulin resistance, altered urinary composition,
oxidative stress, and recurrent urinary tract infections create a pathological
microenvironment that promotes crystal nucleation, aggregation, and retention within
the pelvicalyceal system. Continuous mechanical irritation by calculi, combined with
chronic inflammation and diabetic microangiopathy, leads to progressive urothelial
damage, subepithelial fibrosis, vascular remodeling, and impairment of pelvic
peristalsis. These alterations contribute to urinary stasis, obstruction, hydronephrosis,
and secondary renal parenchymal injury. This article provides a comprehensive
analysis of the pathogenetic mechanisms, histopathological characteristics, and clinical
implications of renal pelvic pathology in diabetes-associated kidney stone disease
based on contemporary experimental and clinical data.
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