Theories on the formation of urinary stones
Abstract
Introduction: Kidney diseases affect hundreds of millions of people globally and the number of patients suffering from a kidney condition increases every year. Within these conditions, urinary lithiasis is one of the most frequent diseases of the urinary tract, since in recent decades it has shown an increase in incidence, prevalence and recurrence rates. Lithogenesis is the set of physicochemical and biological processes that occur from the supersaturation of urine to the formation of a urinary stone.
Objective: To describe the theories or theoretical perspectives that explain the formation of urinary stones.
Methods: A bibliographic review was carried out in the SciELO, ClinicalKey, RedALyC, Scopus, PubMed/Medline, and Cochrane databases, using the Google Academic search engine, between the years 2019 and 2024, in Spanish and English languages. The analytical-synthetic, historical-logical, and inductive-deductive theoretical methods were used.
Results: The different theories or theoretical perspectives on the formation of urinary stones are presented. The theory of crystal nucleation, their agglomeration and growth, as well as the inhibition of crystallization, are the most accepted in the genesis of urinary stones. According to the chemical composition, calcium, uric acid, struvite and cystine stones are the most common.
Conclusions: The understanding of the different theories that explain the genesis of urinary stones and the knowledge of their chemical composition are essential for an adequate diagnosis, and specific treatment according to the type of lithiasis.
DeCS:KIDNEY DISEASES; UROLITHIASIS/diagnosis; THERAPEUTICS; URINARY TRACT; REVIEW.
Downloads
References
1. Martínez-López JM, Sierra-del Rio A, Gálvez- Luque MP. Tratamiento farmacológico de la litiasis renal. Arch Esp Urol [Internet]. 2021 [citado 3 May 2024];74(1);63-70. Disponible en: https://www.aeurologia.com/EN/Y2021/V74/I1/63
2. Stamatelou K, Goldfar DS. Epidemiology of Kidney Stones. Healthcare [Internet]. 2023[citado 23 May 2024];11:424. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914194/pdf/healthcare-1100424.pdf
3. Gonzalo-Rodríguez V, Pérez- Albacete M, Pérez-Castro Ellen TE. El mal de la piedra. Arch Esp Urol [Internet]. 2009 [citado 23 May 2024]; 62(8): 623-629. Disponible en: https://scielo.isciii.es/pdf/urol/v62n8/03.pdf
4. Brito V, Rojas de Gas B, Mago JM, Velásquez W, Lezama J. Cálculos Urinarios: Importancia de los métodos de identificación química en la litogénesis, constitución y clasificación. Acta Microscópica [Internet]. 2022 [citado 23 May 2024];31(1):39-47. Disponible en: https://www.researchgate.net/profile/Blanca-Gascue/publication/360461308_Calculos_Urinarios_Importancia_de_los_metodos_de_identificacion_quimica_en_la_litogenesis_constitucion_y_clasificacion/links/627863f02f9ccf58eb38aa43/Calculos-Urinarios-Importancia-de-los-metodos-de-identificacion-quimica-en-la-litogenesis-constitucion-y-clasificacion.pdf
5. Herrera-Muñoz AA, Morelli-Martínez IE, Álvarez-Cedeño NA, Ruiz-Salgado ED, Jiménez-Salazar R, Salazar-Cedeño V; et al. Nefrolitiasis: Una revisión actualizada. Rev Clín Escuela Med UCR-HSJD [Internet]. 2020 [citado 23 May 2024];10(3):11-18. Disponible en: https://www.medigraphic.com/pdfs/revcliescmed/ucr-2020/ucr203b.pdf
6. Wang Z, Zhang Y, Zhang J, Deng Q, Liang H. Recent advances on the mechanisms of kidney stone formation (Review). Internat J Molecular Med [Internet]. 2021 [citado 14 May 2024]; 48:149. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208620/pdf/ijmm-48-02-04982.pdf
7. Grasas F, Costa-Bauza A. Diagnóstico de la litiasis renal a través del cálculo. Estudio morfocomposicional. Arch Esp Urol [Internet]. 2021 [citado 23 May 2024];74(1):35-48. Disponible en: https://www.aeurologia.com/EN/Y2021/V74/I1/35
8. Letavernier E, Vandermeersch S, Traxer O, Tligui M, Baud L, Ronco P; et al. Demographics and Characterization of 10,282 Randall Plaque-Related Kidney Stones A New Epidemic. Med [Internet]. 2015 [citado 23 May 2024]; 94(10): e566. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602465/pdf/medi-94-e566.pdf
9. Khan SR, Canales BK. A Unified Theory on the Pathogenesis of Randall’s Plaques and Plugs. Urolithiasis [Internet]. 2015 [citado 23 May 2024]; 43(01): 109–123. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373525/pdf/nihms673112.pdf
10. Sandí-Ovares N, Salazar-Campos N, Mejía-Arens C. Nefrolitiasis: evaluación metabólica. Rev Ciencia Salud [Internet]. 2021 [citado 23 May 2024]; 5(1): 69-79. Disponible en: https://revistacienciaysalud.ac.cr/ojs/index.php/cienciaysalud/article/view/262/345
11. Shringi S, Raker Ch, Tang J. Dietary Magnesium Intake and Kidney Stone: The National Health and Nutrition Examination Survey 2011–2018:FR-PO832. J Am Soc Nephrol [Internet]. 2023 [citado 23 May 2024];34(11S): 635-636. Disponible en: http://rimed.org/rimedicaljournal/2023/12/2023-12-20-kidney-stone-shringi.pdf
12. Luis-Negri A, Spivacow FR. Kidney stone matrix proteins: Role in stone formation. World J Nephrol [Internet]. 2023 [citado 23 May 2024]; 12(2):21-28. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075018/pdf/WJN-12-21.pdf
13. Bargagli M, Moochhala S, Robertson WG, Gambaro G, Lombardi G, Unwin RJ; et al. Urinary metabolic profile and stone composition in kidney stone formers with and without heart disease. J Nephrol [Internet]. 2022 [citado 15 May 2024]; 35:851–857. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995244/pdf/40620_2021_Article_1096.pdf
14. Rojas-Salazar YL, Gómez-Montañez E. Litiasis renal: una entidad cada vez más común. Expresiones Médicas [Internet]. 2021 [citado 15 May 2024]; 9(1): 30-36. Disponible en: https://erevistas.uacj.mx/ojs/index.php/expemed/article/view/4556/5042
15. Ware EB, Smith JA, Zhao W, Ganesvoort RT, Curhan GC, Pollak M; et al. Genome-wide Association Study of 24-Hour Urinary Excretion of Calcium, Magnesium, and Uric Acid. Mayo Clin Proc Inn Qual Out [Internet]. 2019 [citado 15 May 2024];3(4):448-460. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978610/pdf/main.pdf
16. Williams JM, Al-Awadi H, Muthenini M, Bledsoe SB, El-Achkar T, Evan AP; et al. Stone Morphology Distinguishes Two Pathways of Idiopathic Calcium Oxalate Stone Pathogenesis. J Endourol [Internet]. 2022 [citado 15 May 2024]; 36(5): 694–702. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145590/pdf/end.2021.0685.pdf
17. Song L, Maalouf NM. Nephrolithiasis. [Actualizado 2020 Mar 9]. En: Feingold KR, Ahmed SF, Anawalt B, et al., editores. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. 2000-. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK279069/
18. Adomako E, Moe OW. Uric acid and Urate in Urolithiasis: The Innocent Bystander, Instigator, and Perpetrator. Semin Nephrol [Internet]. 2020 [citado 15 May 2024]; 40(6): 564–573. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8127876/pdf/nihms-1671473.pdf
19. Karki N, Leslie SW. Struvite and Triple Phosphate Renal Calculi. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK568783/
20. Torricelli F, Monga M. Staghorn renal stones: what the urologist needs to know. IBJU [Internet]. 2020 [citado 15 May 2024];46(6): 927-933. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527092/pdf/1677-6119-ibju-46-06-0927.pdf
21. Alsawi M, Amer T, Mariappan M, Nalagatla S, Ramsay A, Aboumarzouk O. Conservative management of staghorn stones. Ann R CollSurgEngl [Internet]. 2020 [citado 15 May 2024];102: 243–247. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099166/pdf/rcsann.2019.0176.pdf
22. Terry RS, Preminger GM. Metabolic evaluation and medical management of staghorn calculi. Asian J Urol [Internet]. 2020 [citado 15 May 2024];7,122-129. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096691/pdf/main.pdf
23. Leslie SW, Sajjad H, Nazzal L. Cystinuria. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK470527/
Published
How to Cite
Issue
Section
License
Copyright: Camagüey Medical Archive Magazine, offers immediately after being indexed in the SciELO Project; Open access to the full text of the articles under the principle of making available and free the research to promote the exchange of global knowledge and contribute to a greater extension, publication, evaluation and extensive use of the articles that can be used without purpose As long as reference is made to the primary source.
Conflicts of interest: authors must declare in a mandatory manner the presence or not of conflicts of interest in relation to the investigation presented.
(Download Statement of potential conflicts of interest)
The Revista Archivo Médico de Camagüey is under a License Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 International (CC BY 4.0).
This license allows others to distribute, to mix, to adjust and to build from its work, even for commercial purposes, as long as it is recognized the authorship of the original creation. This is the most helpful license offered. Recommended for maximum dissemination and use of licensed materials. The full license can be found at: https://creativecommons.org/licenses/
22 julio 2025