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crystal retention and accumulation in the kidney

Urinary lithiasis is a multifactorial urological disorder that generally occurs as a result of an imbalance between inhibitors and promoters for renal stone formation . The human kidney stones predominantly comprised of calcium oxalate, and few studies have examined the effect of the sodium thiosulfate on calcium oxalate crystallization as well. However, the conclusions from those studies were not consistent as few studies claim the beneficial effect of STS and while others, its negative result . In the present study, we investigated the effect of sodium thiosulfate on renal stone formation in both in vivo and in vitro models and evaluated its mechanism of action. Our study results were in agreement with previous reports that suggested anti-urolithiatic property of STS but provides a new direction for its mode of action where STS may modulate mitochondrial KATPchannel in rendering renal protection.

Evidence in the literature showed that sodium thiosulfate reduces calcium phosphate stone formation in the genetic hypercalciuric rat However, very little data on the use of sodium thiosulfate for calcium oxalate nephrolithiasis has been published. Adherence of calcium oxalate to renal tubules is associated with free radical mediated injury and the resultant oxidative stress due to hyperoxaluria, which favors crystal adherence Administration of STS to rats for 21 days not only reduced the stress mediated by ethylene glycol, but also prevented the renal dysfunction measured by biochemical parameters like urea and creatinine in urine and serum. Elevated serum alkaline phosphatase activity is considered to be an indicator of renal damage . The increased serum ALP activity may be derived from the injury to the brush border membrane of the renal tubular cells . The near-normal activity of ALP in the present study was in agreement with the other group that showed a significant decline of ALP activity after STS administration in uremic rats . Further evidence for STS protection was confirmed through histological results where papillary crystalline deposits and calcium parenchyma deposits were absent. The direct interaction of STS on calcium oxalate formation was confirmed by using in vitro gel technique and found around 18% inhibition in calcium oxalate formation with 200mM STS, suggesting indirect action of STS in preventing renal stone formation.