Pathophysiological aspects of renal stone formation and stone types

Abstract

Urinary stone formation is one of the oldest and most widespread diseases known to man. The disease has a multifactorial etiology that includes anatomic, environmental, genetic, infectious, metabolic, nutritional, and most importantly socio-economic factors. It is caused by a biochemical imbalance in urine between stone-forming inhibitors and promotors in a process known as lithogenesis. The mechanisms underlying the formation and development of urinary stones are not fully understood, but it can be said that they generally begin by increased urinary supersaturation of lithiasis promoters in the urine, followed by nucleation and aggregation. Subsequently, the crystals combine with other crystals in solution to form agglomerates that accumulate in the kidney. Free radical-mediated oxalate-induced renal membrane damage promotes crystal retention at the surface of the renal papilla, as well as crystal nucleation at lower supersaturation levels. In addition, stone type identification is of great interest in guiding the physician to an effective diagnosis, which allows to determine the causes in order to treat the disease and prevent recurrence. In this context, this present study reviews current knowledge on the pathophysiological aspects of kidney stone formation as well as the type of stones.

The Anti-urolithiatic effect of the roots of Saussurea costus (falc) Lipsch agonist ethylene glycol and magnesium oxide induced urolithiasis in rats

“…This model was carried out on nine groups of six male Wistar rats randomly selected to receive different treatments. The animals were exposed to a solution containing 0.75 % (v/v) ethylene glycol (EG) and 1 % (w/v) ammonium chloride for 3 days ( Kachkoul et al, 2023 ). Then, on day 4, they were subjected to ethylene glycol only, without ammonium chloride, for a period of 11 days.…”

“…This disease arises from an imbalance in urinary biochemicals, between substances that inhibit (e.g., citrate, aspartate, calprotectin) and those that promote the formation of stones (e.g., calcium, urate, cystine.) ( Basavaraj et al, 2007 , Freitas et al, 2002 , Kachkoul et al, 2023b ). Stone formation, known as lithogenesis ( Słojewski, 2011 ), encompasses all the biological and physic-chemical processes that occur when urine becomes concentrated, leading to the formation of mineral deposits inside the kidneys ( Aggarwal et al, 2013 ), where minerals can crystallize and agglomerate.…”