Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.

AUA AWARD WINNERS How Do Kidney Stones Form? My Big Question

By: Kymora Scotland, MD, PhD, University of California, Los Angeles | Posted on: 18 Mar 2024

I remember walking into my college lab, looking at my bench, and freezing in place—after months of failed experiments, I had crystals! That was the day that I decided that somehow, I had to find a way to do both bench research and patient care for my career. Several years later, I froze again after firing up the scanning electron microscope and seeing the most unexpected calcium oxalate crystals. That finding supported my fledgling hypothesis and triggered a series of developments that have led me to the AUA Rising Star Award.

My career thus far has been a series of unexpected developments and fortuitous meetings with excellent mentors who have influenced my field of work and have inspired me to persevere to this point. From my PhD thesis mentor, who taught me how to be a mentor myself, and the urology residents, who encouraged me to check out the field during their research years in that lab, to my residency mentor, who convinced me that there were many questions to be asked in endourology and an unending stream of patients depending on us to figure out the answers, and my fellowship mentors, who helped me clarify my research niche. Research is a team sport, and I would absolutely not have gotten to this point without serious assists from urologists and scientists dedicated to improving patient care.

A urologist once told me that if I were going to do research, then it needed to be focused on answering a big question in urology. Answering small questions would not be enough to justify the challenges inherent in the life of a surgeon-scientist. That advice stuck with me through the years of training and on securing my first staff position. I decided to tackle a big question: I want to know why and how kidney stones form. We urologists know that the prevalence of kidney stone disease has been rapidly increasing, with the increase in patient suffering reflected in rising direct and indirect costs. Beyond the theories—some of which have held up better than others—I hope that my career will help shed some light on kidney stone pathogenesis.

Receiving this year’s Rising Star Award has been a tremendous honor for me and a real boon to my research team. It is more than just a moment of recognition of the promise of our research; it is the AUA’s promise to support this work in the critical years between receipt of a career development award and the hopeful progression to independent funding. It means that I am able to take care of my patients while also having the protected time to chip away at my big question. This initial study focuses on elucidating what role bacteria may play in the formation and propagation of calcium oxalate stones. Our central hypothesis is that, even in the absence of infection, bacteria interact with calcium stones and directly promote their propagation via the formation of biofilm. It is an absolute joy to pursue this work with collaborators ranging from microbiologists to mineralogists. I look forward to sharing our progress in the coming years.