JOURNAL READING

“KIDNEY STONE DISEASE:

AN UPDATE ON CURRENT
CONCEPTS”
INTRODUCTION
 Kidney Stone is the most common disease of the
urinary tract.
 Kidney stones have been associated with an
increased risk of chronic kidney diseases, end-
stage renal failure, cardiovascular diseases,
diabetes, and hypertension.
 Urolithiasis affects about 12% of the world
population.

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 EPIDEMIOLOGY OF KIDNEY
STONE
 Urolithiasis occurs more frequently in men than in women within the age

of 20–49 years.
 The prevalence of urolithiasis has been increasing in the past decades in
both
developed and developing countries
 In the United States, kidney stone affects 1 in 11 people and it is estimated

that 600,000 Americans suffer from urinary stones every year.

 In Indian population, about 12% of them are expected to have urinary
stones and out of which 50% may end up with loss of kidney function.

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ANATOMY OF THE KIDNEY 4
ETIOLGY OF KIDNEY STONES

INTRINSIC FACTORS

EXTRINSIC FACTORS

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KIDNEY STONES
 Initially, stone formation does not
cause any symptom.
 Signs and symptoms of the stone
disease :
1. Renal colic (intense cramping
pain)
2. Flank pain (pain in the back
side)
3. Hematuria (bloody urine)
4. Obstructive uropathy (urinary
tract disease)
5. Urinary tract infections,
blockage of urine flow
6. Hydronephrosis (dilation of the 6
kidney).
 Kidney stones are commonly
classiIed into Five types as
follows:
1. Calcium Stones

2. Struviteor Magnesium
Ammonium Phosphate
Stones
3. Uric Acid Stones or Urate.

4. Cystine Stones.

5. Drug-Induced Stones

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 MECHANISMS OF RENAL
STONE FORMATION
 Crystal Nucleation
 Crystal Growth
 Crystal Aggregation
 Crystal-Cell Interaction
 Endocytosis of CaOx Crystals

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 Urinary Supersaturation
(promotors such as hyperoxaluria)

Oxidative Stress

Cell injury and cell membrane rupture

Nucleation (Heterogenous)
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 Crystal Growth

Crystal aggregation

Crystal cell interaction

Crystal retention/adhesion

Stone formation
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 PREVENTIVE OPTIONS FOR
UROLITHIASIS
 Dietary intervention
 Nutritional management : The best preventive strategy against urolithiasis
 Increase their water intake
 Restriction of animal proteins
 High protein intake

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 CONCLUTION
 The incidence of urolithiasis is increasing worldwide.
 Understanding the underlying pathophysiology, pathogenesis, and genetic
basis of kidney stone formation will hopefully lead to discover novel drugs
andstrategies to manage urolithiasis in the near future.

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THANK YOU