review · Advances in Urology
Kidney stone disease is a widespread urological condition, affecting approximately 12% of the global population and linked to an increased risk of end-stage renal failure. These crystal concretions, commonly calcium oxalate, form in the kidneys through a complex process involving supersaturation, nucleation, growth, aggregation, and retention of urinary components. This process is modulated by an imbalance between factors that either promote or inhibit crystallisation. Cellular injury, such as renal epithelial cells exposed to oxalate, can trigger a signalling cascade leading to cell death, which further promotes particle retention on renal surfaces. Currently, effective drugs to cure or prevent kidney stone recurrence are lacking. This review compiles up-to-date information on the disease's causes, development, and prevention strategies, highlighting the need for new therapeutic approaches.
Kidney stone disease is a common and painful condition affecting many people globally, with potential links to serious kidney problems. Current treatments are not fully effective at preventing recurrence. This review highlights the complex mechanisms behind stone formation and the urgent need for new therapeutic drugs, which could significantly improve patient outcomes and reduce the burden of this widespread health issue.
This review identifies a critical unmet medical need for new drugs to cure or prevent the recurrence of kidney stones. The compiled information on aetiology and pathogenesis provides foundational knowledge for early-stage pharmaceutical research and development. This could inform drug discovery programmes aimed at targeting specific mechanisms of stone formation, ultimately benefiting patients and healthcare providers.
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Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall's plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase pathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding of the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs. Therefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and prevention approaches.
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DOI: 10.1155/2018/3068365
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