Epidemiology, Pathogenesis, and Pathophysiology of Urolithiasis

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. # 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.