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Nat Rev Dis Primers. 2016 Feb 25;2:16008. doi: 10.1038/nrdp.2016.8.

Kidney stones.

Author information

1
Department of Urology, University of Florida, 1600 SW Archer Road, Gainesville, Florida 32610, USA.
2
Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA.
3
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
4
Stone Biochemist, Lithoscreen Service, London, UK.
5
Division of Nephrology and Dialysis, Columbus-Gemelli University Hospital Catholic University, School of Medicine, Rome, Italy.
6
Department of Urology, Tenon Hospital, Hôpitaux Universitaires Paris-EST, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie Paris 6, Paris, France.
7
Division of Urology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Abstract

Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall's plaques, which are present on the renal papillary surface. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Obesity, diabetes, hypertension and metabolic syndrome are considered risk factors for stone formation, which, in turn, can lead to hypertension, chronic kidney disease and end-stage renal disease. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs.

Comment in

PMID:
27188687
PMCID:
PMC5685519
DOI:
10.1038/nrdp.2016.8
[Indexed for MEDLINE]
Free PMC Article

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