Epidemiology, Pathogenesis, and Pathophysiology of Urolithiasis

Abstract Context Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence. The pathogenesis of calcium oxalate (CaOx) UL, which accounts for >80% of all urinary stones, is only incompletely understood. Objective Our aim was to review trends in epidemiology and current concepts for the pathogenesis and pathophysiology of urinary stone disease. Evidence acquisition We reviewed data from the literature and our own series. Evidence synthesis Urinary stone formation is a result of different mechanisms. Completely different pathomechanisms lead to CaOx stone formation, with Randall plaques playing a key role in the pathogenesis. Conclusions The lithogenesis of key stones is multifactorial. Lifestyle and dietary choices are important contributing factors. The pathogenesis and pathophysiology of CaOx stones is still incompletely understood. Recent evidence suggests a primary interstitial apatite crystal formation that secondarily leads to CaOx stone formation.