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Progress in the medical treatment and management of nephrolithiasis has been limited to date and continues to depend on urinary metabolic screening to assess excretion of the main stone constituents, factors determining stone solubility and precipitation, and on dietary and lifestyle recommendations. In this review, we try to highlight some of the broader aspects of kidney stone disease in relation to recent epidemiological and pathophysiological findings, and emerging new treatments. Specifically, this review will cover recent evidence on the association between metabolic risk factors and kidney stone disease, dietary risk factors, and dietary interventions to prevent kidney stones, and how genomics, metabolomics, and proteomics may improve diagnosis and treatment of this troublesome, if rarely fatal, condition. PubMed was used to identify the most suitable references according to our search strategy; only full manuscripts were included. What is emerging is that kidney stone disease is not an isolated disorder but is systemic in nature with links to important and common comorbidities such as diabetes, hypertension, cardiovascular disease, and chronic kidney disease. These associations support the need to take nephrolithiasis seriously as a medical condition and to adopt a more holistic approach to its investigation and treatment.

expert review of clinical pharmacology

Why is diagnosis, investigation, and improved management of kidney stone disease important? Non-pharmacological and pharmacological treatments for nephrolithiasis