Fredric Coe

Fredric Coe
University of Chicago | UC

About

315
Publications
16,520
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16,342
Citations
Citations since 2016
32 Research Items
4578 Citations
20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600
20162017201820192020202120220200400600
Introduction
Skills and Expertise

Publications

Publications (315)
Article
Introduction: Lowering kidney stone risk and urine calcium oxalate supersaturation is a primary clinical focus for kidney stone prevention and can be achieved with multiple strategies. Common strategies include advice to increase fluid intake, restrict dietary sodium, or prescribing a thiazide-type diuretic. We investigated how physicians make the...
Article
Full-text available
We examined how physicians made therapeutic choices to decrease stone risk in patients with bowel disease without colon resection, many of whom have enteric hyperoxaluria (EH), at a single clinic. We analyzed clinic records and 24-h urine collections before and after the first clinic visit, among 100 stone formers with bowel disease. We used multiv...
Preprint
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Kidney stone disease causes significant morbidity and increases health care utilization. The pathogenesis of stone disease is not completely understood, due in part to the poor characterization of the cellular and molecular makeup of the kidney papilla and its alteration with disease. We deciphered the cellular and molecular niche of the human rena...
Article
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Background: Animal models have demonstrated an interactive relationship between the epithelial anion exchanger SLC26A6 and transporter NaDC-1 that regulates citrate and oxalate homeostasis. This relationship is a potential mechanism to protect against kidney stones as higher urine oxalate is accompanied by higher urine citrate but it has not been...
Article
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Models of acid–base balance include acid production from (1) oxidation of sulfur atoms on amino acids and (2) metabolically produced organic acid anions. Acid load is balanced by alkali from metabolism of GI anions; thus, net acid production is equivalent to the sum of urine sulfate and organic anion (measured by titration in urine), minus GI anion...
Article
Background and objectives: Incidence of kidney stone disease is rising. It is not known whether mechanisms of stone formation differ across racial groups. Our objective was to identify differing lithogenic risk factors across racial groups in idiopathic nephrolithiasis. Design, setting, participants, & measurements: We conducted a retrospective...
Chapter
Renal stones are common, with a prevalence of 5 to 10% worldwide. Acute stone passage almost always produces the severe pain of renal colic, but stones are often asymptomatic and discovered incidentally on imaging. Prevalence of both symptomatic and asymptomatic disease appears to be rising, although the relative contributions of increasing use of...
Article
Objectives: To describe the papillary pathology found in uric acid (UA) stone formers, and to investigate the mineral form of tissue deposits. Materials and methods: We studied 8 UA stone formers treated with percutaneous nephrolithotomy. Papillae were imaged intra-operatively using digital endoscopy and cortical and papillary biopsies were take...
Article
Background: Reduced estimated glomerular filtration rate (eGFR) in older adults is common and may reflect normal aging or significant kidney disease. Our objective was to develop a predictive model to better triage these individuals using routine laboratory data. Materials and methods: Using a large US laboratory data set, we calculated individu...
Article
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The surgical creation of an artery–vein connection via a Brachicephalic fistula (BCF) in patients with end stage renal disease (ESRD) provides a unique opportunity to study blood vessel response mechanisms to extreme hemodynamic conditions in relatively short timeframes. After BCF creation, the flow rate in the vein increases by an order of magnitu...
Article
Randall's plaque, an attachment site over which calcium oxalate stones form, begins in the basement membranes of the thin limbs of the loop of Henle. The mechanism of its formation is unknown. Possibly, enhanced delivery of calcium out of proximal tubule, found in many stone formers, increases reabsorption of calcium from thick ascending limb into...
Article
Full-text available
Background: Hypophosphatemia (HYP) is common among calcium stone formers (SFs) and in rare cases is associated with mutations in sodium-phosphate cotransporters or in Na+/H+ exchanger regulatory factor 1 (NHERF1), but the majority of cases are unexplained. We hypothesized that reduced sodium-phosphate cotransporter activity mediated via NHERF1 or...
Article
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Purpose: Mechanisms of early stone retention within the kidney are understudied and poorly understood. To date, attachment via Randall's plaque is the only widely accepted theory in this regard, best described in idiopathic calcium oxalate stone formers. Brushite stone formers are known to have distinct papillary morphology relative to calcium oxa...
Article
The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient’s upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to exc...
Article
The most common presentation of nephrolithiasis is idiopathic calcium stones in patients without systemic disease. Most stones are primarily composed of calcium oxalate and form on a base of interstitial apatite deposits, known as Randall's plaque. By contrast some stones are composed largely of calcium phosphate, as either hydroxyapatite or brushi...
Article
Full-text available
Background: Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research. Design: A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and...
Article
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Background: An autogenous arteriovenous fistula is the optimal vascular access for hemodialysis. In the case of brachiocephalic fistula, cephalic arch stenosis commonly develops leading to access failure. We have hypothesized that a contribution to fistula failure is low wall shear stress resulting from post-fistula creation hemodynamic changes th...
Data
Study Protocol for "A Clinical and Computational Study to Improve Brachiocephalic Fistula Outcomes". (PDF)
Article
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Background: Kidney stone matrix protein composition is an important yet poorly understood aspect of nephrolithiasis. We hypothesized that this proteome is considerably more complex than previous reports have indicated and that comprehensive proteomic profiling of the kidney stone matrix may demonstrate relevant constitutive differences between sto...
Article
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Background: Guidelines exist for chronic kidney disease (CKD) but are not well implemented in clinical practice. We evaluated the impact of a guideline-based clinical decision support system (CDSS) on laboratory monitoring and achievement of laboratory targets in stage 3-4 CKD patients. Methods: We performed a matched cohort study of 12,353 stag...
Article
Nephrolithiasis is a highly prevalent disorder affecting approximately one in eleven people and is associated with multiple complications including hypertension, cardiovascular disease, and chronic kidney disease. Significant epidemiologic associations with chronic kidney disease and ESRD have been noted and are reviewed herein, but debate persists...
Article
Introduction: An overlooked finding at the time of renal endoscopy for patients with nephrolithiasis is the appearance of the renal papillae. Recent work has demonstrated that it is possible to distinguish specific stone-forming phenotypes by endoscopic patterns of papillary appearance alone.1-4 These variable expressions are likely to have clinica...
Article
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and Objective: Nephrocalcinosis (NC) is commonly present in primary hyperparathyroidism (HPT), distal renal tubular acidosis (dRTA), and medullary sponge kidney disease (MSKD) but has not been studied in patients with CaP stones who do not have systemic disease. We studied patients undergoing percutaneous nephrolithotomy (PNL) who had CaP or CaOx s...
Article
Idiopathic hypercalciuria (IH) is a common familial trait among patients with calcium nephrolithiasis. We have previously demonstrated that the hypercalciuria is primarily due to reduced renal proximal and distal tubule calcium reabsorption. Here, using measurements of the clearances of sodium, calcium, and endogenous lithium in the General Clinica...
Article
It is uncertain whether increasing 25-hydroxyvitamin D (25-D) levels in chronic kidney disease (CKD) patients above those recommended by current guidelines result in progressive amelioration of secondary hyperparathyroidism. Our objective was to identify a potential therapeutic 25-D target which optimally lowers plasma parathyroid hormone (PTH) wit...
Article
Human stone calcium phosphate (CaP) content correlates with higher urine CaP supersaturation (SS) and urine pH as well as with the number of shock wave lithotripsy (SWL) treatments. SWL does damage medullary collecting ducts and vasa recta, sites for urine pH regulation. We tested the hypothesis that SWL raises urine pH and therefore Cap SS resulti...
Article
Medullary sponge kidney (MSK) is associated with recurrent stone formation, but the clinical phenotype is unclear because patients with other disorders may be incorrectly labeled MSK. We studied 12 patients with histologic findings pathognomonic of MSK. All patients had an endoscopically recognizable pattern of papillary malformation, which may be...
Article
Full-text available
The precise mechanisms of kidney stone formation and growth are not completely known, even though human stone disease appears to be one of the oldest diseases known to medicine. With the advent of the new digital endoscope and detailed renal physiological studies performed on well phenotyped stone formers, substantial advances have been made in our...
Article
Micro-computed tomographic imaging (micro-CT) provides unprecedented information on stone structure and mineral composition. High-resolution micro-CT even allows visualization of the lumens of tubule and/or vessels within Randall's plaque, on stones or in papillary biopsies, thus giving a non-destructive way to study these sites of stone adhesion....
Article
Full-text available
Our previous work has shown that stone formers who form calcium phosphate (CaP) stones that contain any brushite (BRSF) have a distinctive renal histopathology and surgical anatomy when compared with idiopathic calcium oxalate stone formers (ICSF). Here we report on another group of idiopathic CaP stone formers, those forming stone containing prima...
Article
The sequence of events by which primary hyperoxaluria type 1 (PH1) causes renal failure is unclear. We hypothesize that proximal tubule (PT) is vulnerable because oxalate secretion raises calcium oxalate (CaOx) supersaturation (SS) there, leading to crystal formation and cellular injury. We studied cortical and papillary biopsies from 2 PH1 patient...
Article
Patients with idiopathic hypercalciuria (IH) have decreased renal calcium reabsorption, most marked in the post-prandial state, but mechanisms are unknown. We compared 29 subjects with IH and 17 normal subjects (N) each fed identical meals. Urine and blood samples were collected fasting and after meals. Levels of 3 candidate signallers - serum calc...
Article
Full-text available
The most common metabolic abnormality found in calcium (Ca) kidney stone formers is idiopathic hypercalciuria (IH). Using endogenous lithium (Li) clearance, we previously showed that in IH there is decreased proximal tubule (PT) sodium absorption, and increased delivery of Ca into the distal nephron. Distal Ca reabsorption may facilitate the format...
Article
Introduction: Kidney stones are a common problem worldwide with substantial morbidities and economic costs. Medical therapy reduces stone recurrence significantly. Much progress has been made in the last several decades in improving therapy of stone disease. Areas covered: This review discusses i) the effect of medical expulsive therapy on spont...
Article
Parathyroid hormone (PTH) levels in African-American (AA) chronic kidney disease (CKD) patients exceed those in patients of other races; mechanisms are unknown. We performed a cross-sectional analysis of initial laboratory data collected on 2028 CKD patients (505 AA) from US practices using a laboratory CKD service. Serum calcium (Ca), phosphorus (...
Article
Full-text available
Calcium nephrolithiasis in children is increasing in prevalence and tends to be recurrent. Although children have a lower incidence of nephrolithiasis than adults, its etiology in children is less well understood; hence, treatments targeted for adults may not be optimal in children. To better understand metabolic abnormalities in stone-forming chil...
Article
Idiopathic calcium oxalate (CaOx) stone-formers (ICSFs) differ from patients who make idiopathic calcium phosphate (CaP) stones (IPSFs). ICSFs, but not IPSFs, form their stones as overgrowths on interstitial apatite plaque; the amount of plaque covering papillary surface is positively correlated with urine calcium excretion and inversely with urine...
Article
The evaluation and management of the geriatric stone former poses unique challenges to the practitioner. Treatment can be complicated by the presence of multiple comorbidities such as chronic kidney disease, which can limit therapeutic options and is linked to poorer treatment outcomes. The coexistence of diseases such as osteoporosis, which can co...
Article
Full-text available
Little is known about the renal handling of oxalate in patients with idiopathic hypercalciuria (IH). To explore the role of tubular oxalate handling in IH and to evaluate whether differences exist between IH and normal controls, we studied 19 IH subjects, 8 normal subjects, and 2 bariatric stone formers (BSF) during a 1-day General Clinical Researc...
Chapter
Idiopathic hypercalciuria is characterized by normocalcemia in the absence of known systemic causes of hypercalciuria. Intestinal calcium (Ca) absorption is almost always increased, and serum 1,25(OH)2D levels are elevated in some but not all patients. Idiopathic hypercalciuria (IH) affects 5 to 7% of adults and children and is the single most comm...
Article
The editor has collected poems from people who have cared for loved ones with Alzheimer's disease. The writers range from prize-winning poets to amateurs, but all share in common a passion, an experience that evokes from them emotions they long to rest in the crystal of poetry. Their poems illuminate the dark terrors of this most disabling and dehu...
Article
Nephrocalcinosis generally refers to the presence of calcium salts within renal tissue, but this term is also used radiologically in diagnostic imaging in disease states that also produce renal stones, so that it is not always clear whether it is tissue calcifications or urinary calculi that give rise to the characteristic appearance of the kidney...
Article
Full-text available
Extensive evidence now supports the role of papillary interstitial deposits-Randall's plaques-in the formation of stones in the idiopathic, calcium oxalate stone former. These plaques begin as deposits of apatite in the basement membranes of the thin limbs of Henle's loop, but can grow to become extensive deposits beneath the epithelium covering th...
Article
Compounds that prevent the crystallization of an amino acid may represent a new class of therapeutic agent for kidney stones.
Article
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A 43-year-old man presents for evaluation of recurrent kidney stones. He passed his first stone 9 years earlier and has had two additional symptomatic stones. Analysis of the first and the last stones showed that they contained 80% calcium oxalate and 20% calcium phosphate. Analysis of a 24-hour urine collection while the patient was not receiving...
Article
Once again the question of one versus two 24 h urine collections for diagnosis in kidney stone prevention has been raised. As in all previous studies, no difference is seen in the mean levels of analytes between first and second collections. However, variation within patients is so marked that at least two collections are needed for confidence.
Article
Full-text available
We present here the anatomy and histopathology of kidneys from 11 patients with renal stones following small bowel resection, including 10 with Crohn's disease and 1 resection in infancy for unknown cause. They presented predominantly with calcium oxalate stones. Risks of formation included hyperoxaluria (urine oxalate excretion greater than 45 mg...
Article
Full-text available
Data concerning nine forms of human stone disease, along with observations on normal people give new insights into formation of interstitial apatite plaque and intra-tubular crystal deposits. In general, across multiple disease states, one can reproduce the same relationships between plaque abundance as is seen among patients within individual dise...
Article
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Patients who form calcium kidney stones often have metabolic disorders such as idiopathic hypercalciuria (IH) that reflect abnormalities in mineral handling in the kidney. Renal handling of calcium is altered by ingestion of nutrients such as carbohydrates, protein, and sodium, and patients with IH appear to be more sensitive to these stimuli. Stud...
Article
Full-text available
No single theory of pathogenesis can properly account for human kidney stones, they are too various and their formation is too complex for simple understanding. Using human tissue biopsies, intraoperative imaging and such physiology data from ten different stone forming groups, we have identified at least three pathways that lead to stones. The fir...
Article
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Patients with ileostomy typically have recurrent renal stones and produce scanty, acidic, sodium-poor urine because of abnormally large enteric losses of water and sodium bicarbonate. Here we used a combination of intra-operative digital photography and biopsy of the renal papilla and cortex to measure changes associated with stone formation in sev...
Article
"NxStage System One()" is increasingly used for daily home hemodialysis. The ultrapure dialysate volumes are typically between 15 L and 30 L per dialysis, substantially smaller than the volumes used in conventional dialysis. In this study, the impact of the use of low dialysate volumes on the removal rates of solutes of different molecular weights...
Article
Full-text available
The process of kidney stone formation depends on an imbalance between excretion of water and insoluble stone-forming salts, leading to high concentrations that supersaturate urine and inner medullary collecting duct (IMCD) fluid. For common calcium-containing stones, a critical mechanism that has been proposed for integrating water and calcium salt...
Article
To analyse the structure and composition of unattached stones in idiopathic calcium oxalate (CaOx) stone-formers (ICSF) and compare them to attached stones from the same cohort, to investigate whether there is more than one pathogenic mechanism for stone formation in ICSF. ICSF undergoing percutaneous nephrolithotomy or ureteroscopy for the treatme...