The formation of stones in the urinary tract stems from a wide range of underlying disorders. That clinicians look for the underlying causes for nephrolithiasis is imperative to direct management. There are many advances in genetics, pathophysiology, diagnostic imaging, medical treatment, medical prevention, and surgical intervention of nephrolithiasis. Here, I provide
a brief general background and focus mainly on pathophysiology and medical treatment of kidney stones. Although important advances have been made in understanding nephrolithiasis from single gene defects, the understanding of polygenetic causes of kidney stones is still largely elusive. A substantial proportion of data that resulted in new methods of treatment and prevention, which can be empirical or definitive, has focused on urinary luminal chemical composition of the precipitating solutes.
Manipulation of inhibitors and epithelial factors is important and needs further investigation. Advances in the management of nephrolithiasis depend on combined efforts of clinicians and scientists to understand the pathophysiology. To read this article in full you will need to make a payment Kidney stones. Nephrolithiasis. Prehistoric or predynastic
Egyptian calculus. Urolithiasis in childhood. Factors
influencing bladder stone formation in patients with spinal cord injury. Time trends in reported prevalence of kidney stones in the United States: 1976–1994. A prospective study of recurrence rate and risk factors for recurrence after a first renal stone. Recurrence after a
single renal stone in a community practice. Factors that predict relapse of calcium nephrolithiasis during treatment: a prospective study. The natural history of renal and ureteric calculi. Renal stone epidemiology: a 25-year study in Rochester,
Minnesota. Demographic and geographic variability of kidney stones in the United States. Etiological role of estrogen status on renal stone formation. Similarity of urinary risk factors among stone-forming patients in five regions of the United States. Observations on the analysis of ten thousand urinary calculi. Sex- and age-related composition of 10 617 calculi analyzed by infrared
spectroscopy. Urinary tract stone disease in the United States veterans population. I. Geographic frequency of occurrence. Urinary
tract stone disease in the United States veteran population. II. Geographic analysis of variations in composition. Predictive value of kidney stone composition in the detection of metabolic abnormalities. Diagnosis of acute flank pain: value of unenhanced helical CT. Retrospective study of 95 patients with staghorn
calculus disease. Decreased renal function among adults with a history of nephrolithiasis: a study of NHANES III. Helical CT for nephrolithiasis and ureterolithiasis: comparison of conventional and reduced radiation-dose techniques. Spiral computed
tomography: role in determination of chemical compositions of pure and mixed urinary stones—an in vitro study. Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Nephrolithiasis. Clinical implications of physicochemistry of stone formation. The origin and growth of renal calculi. Randall's plaque of patients with nephrolithiasis begins in basement membranes of thin loops of henle. Urine calcium and volume predict coverage of renal papilla by Randall's plaque. Stone
formation is proportional to papillary surface coverage by Randall's plaque. The primary stone event: a new hypothesis involving a vascular etiology. A simple test for the diagnosis of absorptive, resportive and renal hypercalciurias. Increased monocyte interleukin-1 activity and decreased vertebral
bone density in patients with fasting idiopathic hypercalciuria.Summary
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Published: 28 January 2006
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DOI: //doi.org/10.1016/S0140-6736(06)68071-9
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