How does a kidney stone form and how is it treated?

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1. 1

   Kidney stone disease (Wikipedia)

   WikipediaPublished Oct 15, 2026Checked Oct 17, 2026

   “Kidney stone disease or urinary stone disease is a crystallopathy that occurs when there is an excess of minerals in the urine and not enough liquid or hydration. This imbalance causes tiny crystals to aggregate and form hard masses, or calculi (stones), in the upper urinary tract. Because renal calculi typically form in the kidney, if small enough they may pass out of the urinary tract through the urine stream. A small calculus may pass without causing any symptoms. However, if a stone grows to more than 5 millimeters (0.2 inches), it can cause blockage of the ureter, resulting in extremely sharp and severe pain (renal colic) in the lower back that often radiates to the groin. A calculus may also result in blood in the urine, vomiting (owing to severe pain), swelling of the kidney, or painful urination. About half of all people who have had a kidney stone are likely to develop another within ten years. Renal is Latin for "kidney", while nephro is the Greek equivalent. Lithiasis (Greek) and calculus (Latin; plural calculi) both mean stone. Hence, kidney stones are sometimes known as renal calculi or nephroliths, and the condition may be known as nephrolithiasis.”

2. 2

   Evaluation of outcomes in kidney stone management: stone-free rate vs. cost vs. quality of life: a systematic review from EAU endourology.

   World journal of urology (Terro et al.)Published Apr 19, 2026Checked Oct 17, 2026

   “Forty six studies were included in this systematic review. PCNL achieved the highest SFR, followed by URS, and ESWL demonstrated the lowest (RR = 1.13 for PCNL vs. URS, p < 0.0001). Moreover, ESWL was the cheapest, while PCNL was the most expensive. Hospital stay and transfusion rates increased proportionally with procedural invasiveness. URS had the lowest complication and retreatment rates, while ESWL and PCNL had the highest retreatment rates and complication rates respectively. No statistically significant differences were found in QoL outcomes among the treatment modalities. PCNL remains the most effective but most invasive treatment, URS offers a balanced compromise of efficacy, safety, and cost, while ESWL is the least invasive and most economical option but carries the highest risk of retreatment. Future studies should standardize reporting of SFR, cost-effectiveness, quality-of-life measures, and procedural variations.”

3. 3

   Adherence to medical management of kidney stones: A systematic review.

   Urolithiasis (Salka et al.)Published Sep 28, 2026Checked Oct 17, 2026

   “Dual-reviewer screening and standardized data extraction were performed. No protocol was prospectively registered. Of 909 identified studies, 35 met inclusion criteria, comprising 57,970 patients. Across studies, greater adherence consistently correlated with decreased subsequent stone related events. Increased fluid intake demonstrated the highest lifestyle adherence (~ 65-85%), while thiazide diuretics showed the greatest pharmacologic adherence (43-87%), exceeding citrate therapy and dietary modification. Adherence to metabolic evaluation and longitudinal follow-up testing was relatively low. Predictors of improved adherence included older age, higher education and socioeconomic status, prior stone events, and greater disease severity. Traditional physician counseling has a positive relationship on adherence to medical management. Adherence to guideline-based kidney stone prevention strongly influences clinical outcomes. Tailored counseling and prevention plans informed by patient and disease characteristics are critical to improve effectiveness of stone prevention therapy.”

4. 4

   Personalised prevention and management of kidney stones: a narrative review on the importance of integrating environmental, social and genetic factors.

   Public health reviews (Leonova et al.)Published Jul 10, 2026Checked Oct 17, 2026

   “Kidney stone disease (KSD) is a prevalent, multifactorial, and common disorder influenced by environmental and genetic factors, with increasing global incidence and high recurrence rates. Despite advances, understanding the interplay between urinary biochemistry, lifestyle, climate, and genetic predispositions remains essential for effective management. In this review, we evaluate current concepts on KSD pathophysiology, epidemiology, stone composition, and formation mechanisms, alongside recent diagnostic and therapeutic developments. We emphasize integrating genetic, environmental, and clinical data to inform personalized prevention and treatment strategies. These insights support tailored approaches that may improve patient outcomes and reduce recurrence, highlighting the potential of personalized medicine in addressing the complex etiology of KSD.”

5. 5

   Gut microbiome modulation by diet and lifestyle in kidney stone disease and autism spectrum disorder: emerging mechanisms and translational prospects.

   Frontiers in microbiomes (Mahajan)Published Sep 22, 2026Checked Oct 17, 2026

   “ease pathogenesis in urolithiasis and ASD, with emphasis on dietary compounds, fermented foods, probiotics, and lifestyle behaviors as modulatory factors.ResultsIn urolithiasis, evidence implicates reduced abundance of oxalate-degrading taxa (notably Oxalobacter formigenes), dysbiotic short-chain fatty acid (SCFA) profiles, and urinary microbiome perturbations in stone formation and recurrence. In ASD, microbial alterations in gastrointestinal-symptomatic individuals converge on reduced butyrate-producing taxa, elevated pro-inflammatory species, and altered serotonin and gamma-aminobutyric acid (GABA) biosynthetic pathways.ConclusionDietary interventions-particularly high-fiber regimens, polyphenol-rich foods, fermented products, and targeted probiotic formulations-show mechanistic plausibility for microbiome restoration in both conditions. However, clinical translation is constrained by methodological heterogeneity, confounding lifestyle variables, and a paucity of longitudinal, mechanistically anchored trials. We outline a research agenda prioritizing standardized multi-omics, paired gut-urine sampling protocols, and rigorously controlled dietary interventions to bridge this gap.”

6. 6

   Association between the Zhejiang University index and kidney stone risks in US adults: evidence from NHANES 2007-2018.

   American journal of clinical and experimental urology (Cao et al.)Published Aug 15, 2026Checked Oct 17, 2026

   “We applied survey-weighted logistic regression models to examine the relationship between the ZJU index and kidney stone history. Non-linearity was assessed using flexible spline and segmented regression. Discrimination was evaluated using receiver operating characteristic analysis.ResultsAmong the 25,605 participants analyzed, 2,484 (9.7%) reported a history of kidney stones. Prevalence increased across ZJU index quartiles, from 4.09% in quartile 1 to 16.90% in quartile 4. In fully adjusted models, higher ZJU index was associated with higher odds of kidney stones (odds ratio 1.210, 95% CI: 1.186-1.234), with evidence of non-linearity and a turning point at 38.1. The ZJU index showed favorable discrimination (area under the curve 0.819) and an empirically derived threshold of 36.78 (sensitivity 76.2%, specificity 71.5%).ConclusionHigher ZJU index was positively associated with kidney stone history in a nationally representative US sample, supporting its potential application in population-level risk stratification and prevention-oriented public health planning.”