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Nat. Rev. Nephrol. doi:10.1038/nrneph.2016.101 Figure 5 Renal papilla of patients who formed idiopathic apatite stones Figure 5 | Renal papilla of patients who formed idiopathic apatite stones. Patients who form apatite stones can be categorized into two groups on the basis of endoscopy images: those with a | normal appearing compound papillum and those with b | severe changes that resemble those of patients with distal renal acidosis and stones. Panel a | shows a papilla with three separate attached stones (double arrowheads) and no yellow plaque or Bellini duct (BD) plugs, whereas panel b | shows a papilla with numerous regions of yellow plaque (arrows) and a large BD plug (asterisk). Light microscopy images showing c | novel interstitial plaque structures (arrows) — a form of plaque that is unique to patients who form apatite stones — characterized by irregular, large and randomly distributed laminar structures of hydroxyapatite crystal and matrix, and d | numerous plugged inner medullary collecting ducts surrounding an area of extensive interstitial fibrosis in a papilla with severe changes. Micro-CT images of tubular deposits in biopsy samples from e | a normal appearing papilla with no deposits and f | a severely damaged papilla with numerous small deposits. Coe, F. L. et al. (2016) Idiopathic hypercalciuria and formation of calcium renal stones Nat. Rev. Nephrol. doi:10.1038/nrneph.2016.101