Kidney Week

Abstract: TH-PO1084

Enhanced Release of Protease-Enriched Urinary Extracellular Vesicles in Hypertensive Kidney Stone Formers

Session Information

• Pathology and Lab Medicine
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

• 1700 Pathology and Lab Medicine

Authors

• Bala, Niharika, University of Florida, Gainesville, Florida, United States

Niharika Bala, MS

• Shahzad, Zenab, University of Florida, Gainesville, Florida, United States

Zenab Shahzad, MBBS

• Sattari, Maryam, University of Florida, Gainesville, Florida, United States

Maryam Sattari, MD

• Zhou, Christopher, University of Florida, Gainesville, Florida, United States

Christopher Zhou, MD

• Smith, Jordan M., University of Florida, Gainesville, Florida, United States

Jordan M. Smith, MD

• Kazory, Amir, University of Florida, Gainesville, Florida, United States

Amir Kazory, MD, FASN

• Ruchi, Rupam, University of Florida, Gainesville, Florida, United States

Rupam Ruchi, MD, FASN

• Bird, Vincent G., University of Florida, Gainesville, Florida, United States

Vincent G. Bird, MD

• Alli, Abdel A., University of Florida, Gainesville, Florida, United States

Abdel A. Alli, PhD, MPH

Background

Recurrent kidney stone (KS) formation represents a major public health issue, affecting over 500,000 people per year in the United States alone. The increase in prevalence in recent years and high recurrence rates in some patients have raised interest in developing adjunctive measures and assays to stratify the risk of recurrence. Urinary extracellular vesicles (uEVs) have been shown to trigger cell death in the renal tubules potentially contributing to Randall’s plaque and stone formation. We hypothesize that renal inflammation associated with hypertension (HTN), a common comorbidity in patients with KS, enhances the release of EVs enriched in bioactive cargo into the urine of KS patients with HTN.

Methods

uEVs were isolated by the filtration and ultracentrifugation method, and each EV preparation was characterized by first probing for CD9, CD63, CD681, cytochrome C, syntenin-1, and VLA4 via multiplex ELISA. To assess purity, EV preparations were visualized by transmission electron microscopy, while EV concentration was measured by nano-flow cytometry (NanoFCM). Cathepsin B and S activity was measured by ELISA. A one-way ANOVA was performed for group comparisons.

Results

NanoFCM analysis showed KS patients with HTN excrete more EVs into the urine compared to the non-KS control group, with a statistical significance of p= 0.01. The activity of cathepsin B and S proteases were found to be enriched in the urinary EVs from the KS HTN patient group compared to the control group.

Conclusion

To date, no reliable biomarker assay exists to assess an individual’s risk of kidney stone formation. Analysis of uEV cargo may help bridge this gap. In particular, cathepsin B and S proteases represent a novel class of uEV-derived biomarkers with potential utility for identifying high-risk patients and monitoring disease progression in individuals with KS and hypertension.

Funding

• NIDDK Support