GeoBioMed — a new transdisciplinary approach that integrates the fields of geology, biology and medicine — reveals that kidney stones composed of calcium-rich minerals precipitate from a continuum of repeated events of crystallization, dissolution and recrystallization that result from the same fundamental natural processes that have governed billions of years of biomineralization on Earth. This contextual change in our understanding of renal stone formation opens fundamentally new avenues of human kidney stone investigation that include analyses of crystalline structure and stratigraphy, diagenetic phase transitions, and paragenetic sequences across broad length scales from hundreds of nanometres to centimetres (five Powers of 10). This paradigm shift has also enabled the development of a new kidney stone classification scheme according to thermodynamic energetics and crystalline architecture. Evidence suggests that ≥50% of the total volume of individual stones have undergone repeated in vivo dissolution and recrystallization. Amorphous calcium phosphate and hydroxyapatite spherules coalesce to form planar concentric zoning and sector zones that indicate disequilibrium precipitation. In addition, calcium oxalate dihydrate and calcium oxalate monohydrate crystal aggregates exhibit high-frequency organic-matter-rich and mineral-rich nanolayering that is orders of magnitude higher than layering observed in analogous coral reef, Roman aqueduct, cave, deep subsurface and hot-spring deposits. This higher frequency nanolayering represents the unique microenvironment of the kidney in which potent crystallization promoters and inhibitors are working in opposition. These GeoBioMed insights identify previously unexplored strategies for development and testing of new clinical therapies for the prevention and treatment of kidney stones.

GeoBioMed——一种整合了地质学、生物学和医学领域的新的跨学科方法——揭示了由富含钙的矿物质组成的肾结石是从一系列重复的结晶、溶解和再结晶事件中沉淀出来的，这些事件是由相同的基本自然过程引起的控制着地球上数十亿年的生物矿化。我们对肾结石形成理解的这种背景变化从根本上开辟了人类肾结石研究的新途径，包括晶体结构和地层学分析、成岩相变以及从数百纳米到厘米（10 的 5 次方）的广泛长度尺度的共生序列). 这种范式转变还促成了根据热力学能量学和晶体结构开发新的肾结石分类方案。有证据表明，≥50% 的单个结石总体积经历了反复的体内溶解和再结晶。无定形磷酸钙和羟基磷灰石小球结合形成平面同心环带和扇区，表明不平衡沉淀。此外，草酸钙二水合物和草酸钙一水合物晶体聚集体表现出高频富含有机质和富含矿物质的纳米分层，比在类似的珊瑚礁、罗马渡槽、洞穴、深层地下和热-中观察到的分层高几个数量级。春季存款。这种更高频率的纳米分层代表了肾脏独特的微环境，其中有效的结晶促进剂和抑制剂相互对抗。这些 GeoBioMed 见解确定了以前未探索的策略，用于开发和测试用于预防和治疗肾结石的新临床疗法。