Metabolic syndrome and nephrolithiasis

PROBLEM This review focuses on the association between the metabolic syndrome (MS) and nephrolithiasis. FINDINGS Associations between nephrolithiasis and systemic diseases are recognized, including atherosclerosis, cardiovascular (CV) disease, hypertension (HNT), diabetes mellitus (DM)-composite risk factors grouped as the MS. Kidney stones incidence is increasing in this particularly high risk group. Those with stones are prone to the disease and those with the systemic disease are at risk for stone formation, with the highest incidence in persons with multiple traits of the MS. Pathophysiologic explanations for the increased stone risk related to MS are likely complex and dynamic. CONCLUSIONS Kidney stones disproportionately affect persons with some or all traits of MS. One unifying theory may be of a common systemic malfunction of inflammation and tissue damage as an underlying mechanism, but it is unlikely to be the only mechanistic explanation. Further research is needed to investigate this and other hypotheses that go beyond population based and urine physiochemical studies in order to elucidate the mechanisms behind the individual disease states themselves.