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Nephrolithiasis/nephrocalcinosis

MedGen UID:
1241262
Concept ID:
CN580796
Disease or Syndrome

Definition

Kidney stones (also called renal stones or urinary stones) are small, hard deposits that form in one or both kidneys; the stones are made up of minerals or other compounds found in urine. Kidney stones vary in size, shape, and color. To be cleared from the body (or "passed"), the stones need to travel through ducts that carry urine from the kidneys to the bladder (ureters) and be excreted. Depending on their size, kidney stones generally take days to weeks to pass out of the body.

Kidney stones can cause abdominal or back pain (known as renal colic). Renal colic usually begins sporadically but then becomes constant and can lead to nausea and vomiting. The site of pain can change as the stone moves through the urinary tract. Some small stones pass through the kidney and urinary tract with little discomfort, while larger ones can block the flow of urine and impair kidney function. Kidney stones can also result in blood in the urine (hematuria) or kidney or urinary tract infections. Unusually large stones or stones that are difficult to pass can be medically removed.

Although there are many types of kidney stones, four main types are classified by the material they are made of. Up to 75 percent of all kidney stones are composed primarily of calcium. Stones can also be made up of uric acid (a normal waste product), cystine (a protein building block), or struvite (a phosphate mineral). Stones form when there is more of the compound in the urine than can be dissolved. This imbalance can occur when there is an increased amount of the material in the urine, a reduced amount of liquid urine, or a combination of both.

People are most likely to develop kidney stones between ages 40 and 60, though the stones can appear at any age. Research shows that 35 to 50 percent of people who have one kidney stone will develop additional stones, usually within 10 years of the first stone. [from MedlinePlus Genetics]

Professional guidelines

PubMed

Khan AA, Bilezikian JP, Brandi ML, Clarke BL, Gittoes NJ, Pasieka JL, Rejnmark L, Shoback DM, Potts JT, Guyatt GH, Mannstadt M
J Bone Miner Res 2022 Dec;37(12):2568-2585. Epub 2022 Nov 14 doi: 10.1002/jbmr.4691. PMID: 36054621
Sas DJ, Harris PC, Milliner DS
Urolithiasis 2019 Feb;47(1):79-89. Epub 2018 Dec 10 doi: 10.1007/s00240-018-1093-3. PMID: 30535828
Tebben PJ, Singh RJ, Kumar R
Endocr Rev 2016 Oct;37(5):521-547. Epub 2016 Sep 2 doi: 10.1210/er.2016-1070. PMID: 27588937Free PMC Article

Recent clinical studies

Etiology

Reis FS, Lazaretti-Castro M
Arch Endocrinol Metab 2023 May 25;67(5):e000626. doi: 10.20945/2359-3997000000626. PMID: 37249457Free PMC Article
Sas DJ, Harris PC, Milliner DS
Urolithiasis 2019 Feb;47(1):79-89. Epub 2018 Dec 10 doi: 10.1007/s00240-018-1093-3. PMID: 30535828
Bitzan M, Goodyer PR
Pediatr Clin North Am 2019 Feb;66(1):179-207. doi: 10.1016/j.pcl.2018.09.004. PMID: 30454743
Halbritter J, Baum M, Hynes AM, Rice SJ, Thwaites DT, Gucev ZS, Fisher B, Spaneas L, Porath JD, Braun DA, Wassner AJ, Nelson CP, Tasic V, Sayer JA, Hildebrandt F
J Am Soc Nephrol 2015 Mar;26(3):543-51. Epub 2014 Oct 8 doi: 10.1681/ASN.2014040388. PMID: 25296721Free PMC Article
Rothstein M, Obialo C, Hruska KA
Endocrinol Metab Clin North Am 1990 Dec;19(4):869-87. PMID: 2081516

Diagnosis

Sell J, Ramirez S, Partin M
Am Fam Physician 2022 Mar 1;105(3):289-298. PMID: 35289573
Bitzan M, Goodyer PR
Pediatr Clin North Am 2019 Feb;66(1):179-207. doi: 10.1016/j.pcl.2018.09.004. PMID: 30454743
Tasic V, Gucev Z
Pediatr Endocrinol Rev 2015 Sep;13(1):468-76. PMID: 26540764
Halbritter J, Baum M, Hynes AM, Rice SJ, Thwaites DT, Gucev ZS, Fisher B, Spaneas L, Porath JD, Braun DA, Wassner AJ, Nelson CP, Tasic V, Sayer JA, Hildebrandt F
J Am Soc Nephrol 2015 Mar;26(3):543-51. Epub 2014 Oct 8 doi: 10.1681/ASN.2014040388. PMID: 25296721Free PMC Article
Devuyst O, Thakker RV
Orphanet J Rare Dis 2010 Oct 14;5:28. doi: 10.1186/1750-1172-5-28. PMID: 20946626Free PMC Article

Therapy

Marques JVO, Moreira CA, Borba VZC
Arch Endocrinol Metab 2022 Nov 11;66(5):658-665. doi: 10.20945/2359-3997000000555. PMID: 36382755Free PMC Article
Sell J, Ramirez S, Partin M
Am Fam Physician 2022 Mar 1;105(3):289-298. PMID: 35289573
Shee K, Stoller ML
Nat Rev Urol 2022 Mar;19(3):137-146. Epub 2021 Dec 8 doi: 10.1038/s41585-021-00543-4. PMID: 34880452Free PMC Article
Sas DJ, Harris PC, Milliner DS
Urolithiasis 2019 Feb;47(1):79-89. Epub 2018 Dec 10 doi: 10.1007/s00240-018-1093-3. PMID: 30535828
Bitzan M, Goodyer PR
Pediatr Clin North Am 2019 Feb;66(1):179-207. doi: 10.1016/j.pcl.2018.09.004. PMID: 30454743

Prognosis

Reis FS, Lazaretti-Castro M
Arch Endocrinol Metab 2023 May 25;67(5):e000626. doi: 10.20945/2359-3997000000626. PMID: 37249457Free PMC Article
Gefen AM, Sethna CB, Cil O, Perwad F, Schoettler M, Michael M, Angelo JR, Safdar A, Amlie-Wolf L, Hunley TE, Ellison JS, Feig D, Zaritsky J
Pediatr Nephrol 2023 Aug;38(8):2615-2622. Epub 2023 Jan 23 doi: 10.1007/s00467-023-05879-0. PMID: 36688940Free PMC Article
De Sanctis V, Soliman AT, Di Maio S, Kattamis C
Pediatr Endocrinol Rev 2018 Sep;16(1):194-202. doi: 10.17458/per.vol16.2018.stsm.hypoparathyroidism. PMID: 30371038
Daga A, Majmundar AJ, Braun DA, Gee HY, Lawson JA, Shril S, Jobst-Schwan T, Vivante A, Schapiro D, Tan W, Warejko JK, Widmeier E, Nelson CP, Fathy HM, Gucev Z, Soliman NA, Hashmi S, Halbritter J, Halty M, Kari JA, El-Desoky S, Ferguson MA, Somers MJG, Traum AZ, Stein DR, Daouk GH, Rodig NM, Katz A, Hanna C, Schwaderer AL, Sayer JA, Wassner AJ, Mane S, Lifton RP, Milosevic D, Tasic V, Baum MA, Hildebrandt F
Kidney Int 2018 Jan;93(1):204-213. Epub 2017 Oct 12 doi: 10.1016/j.kint.2017.06.025. PMID: 28893421Free PMC Article
Devuyst O, Thakker RV
Orphanet J Rare Dis 2010 Oct 14;5:28. doi: 10.1186/1750-1172-5-28. PMID: 20946626Free PMC Article

Clinical prediction guides

Gefen AM, Sethna CB, Cil O, Perwad F, Schoettler M, Michael M, Angelo JR, Safdar A, Amlie-Wolf L, Hunley TE, Ellison JS, Feig D, Zaritsky J
Pediatr Nephrol 2023 Aug;38(8):2615-2622. Epub 2023 Jan 23 doi: 10.1007/s00467-023-05879-0. PMID: 36688940Free PMC Article
Marques JVO, Moreira CA, Borba VZC
Arch Endocrinol Metab 2022 Nov 11;66(5):658-665. doi: 10.20945/2359-3997000000555. PMID: 36382755Free PMC Article
Lemoine S, Figueres L, Bacchetta J, Frey S, Dubourg L
Ann Endocrinol (Paris) 2022 Aug;83(4):237-243. Epub 2022 May 19 doi: 10.1016/j.ando.2022.05.003. PMID: 35598638
Anglani F, Gianesello L, Beara-Lasic L, Lieske J
J Cell Mol Med 2019 Nov;23(11):7132-7142. Epub 2019 Aug 31 doi: 10.1111/jcmm.14590. PMID: 31472005Free PMC Article
Bobkova IN, Gussaova SS, Stavrovskaya EV, Struve AV
Ter Arkh 2018 Jun 20;90(6):98-104. doi: 10.26442/terarkh201890698-104. PMID: 30701912

Recent systematic reviews

Gosmanova EO, Houillier P, Rejnmark L, Marelli C, Bilezikian JP
Rev Endocr Metab Disord 2021 Jun;22(2):297-316. Epub 2021 Feb 18 doi: 10.1007/s11154-020-09613-1. PMID: 33599907Free PMC Article

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