If a patient with chronic kidney disease experiences increased calcium oxalate supersaturation despite increased fluid intake, which mechanism best explains why crystallization continues?

💡 Explanation

Decreased Tamm-Horsfall protein (THP) hinders crystal growth inhibition because THP normally binds to calcium oxalate crystals, preventing their aggregation and growth. Therefore, reduced THP allows crystallization despite increased fluid, rather than increased filtration, citrate, or pH preventing it.

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