Calcium oxalate monohydrate (COM) is a major constituent of kidneys stones. Current therapeutics block solute (Ca~(2+) and C2O_4~(2-)) attachment to crystals through either complexation in solution or binding to specific sites on crystal surfaces. Despite advancements in drug design, the incidence rate of stones is on the rise, thus emphasizing the need for alternative therapies. When designing new modifiers as drugs, it is important to consider the underlying fundamental physical interactions of modifiers (ions or molecules) with COM crystal surfaces. These interactions may be elucidated through a combination of experimental and theoretical studies. In this talk, we will describe systematic studies of bulk crystallization and in situ characterization of surface growth in the presence and absence of modifiers. We have explored the effect of metal ions (both monovalent and divalent), small organics, and native proteins that are commonly observed in human urine and kidney stone matrix. The majority of modifiers act as growth inhibitors with varying efficacy. Interestingly, we have identified modifiers that function as COM growth promoters.
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