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An update and practical guide to renal stone management.
[cystinuria]
Renal
stone
disease
covers
kidney
and
lower
urinary
tract
stones
caused
by
a
variety
of
conditions
,
including
metabolic
and
inherited
disorders
,
and
anatomical
defects
with
or
without
chronic
urinary
infection
.
Most
cases
are
idiopathic
,
in
which
there
is
undoubtedly
a
genetic
predisposition
,
but
where
environmental
and
lifestyle
factors
play
an
important
role
.
Indeed
,
it
is
becoming
apparent
that
renal
stone
disease
is
often
part
of
a
larger
'
metabolic
picture
'
commonly
associated
with
type
2
diabetes
,
obesity
,
dyslipidaemia
,
and
hypertension
.
Renal
stone
disease
is
a
growing
problem
in
the
UK
(
and
other
developed
and
developing
populations
)
with
a
cross-sectional
prevalence
of
∼
1
.
2
%
.
This
means
that
there
are
currently
∼
720
,
000
individuals
with
a
history
of
kidney
stones
in
the
UK
.
Almost
40
%
of
first
-time
stone
formers
will
form
a
second
stone
within
3
years
of
the
first
episode
if
no
prophylactic
measures
are
instituted
to
prevent
stone
recurrence
,
since
removal
or
disintegration
of
the
first
stone
does
not
treat
the
underlying
cause
of
stones
in
the
majority
of
patients
.
The
age
of
onset
is
getting
younger
and
the
sex
ratio
(
until
recently
more
men
than
women
)
is
becoming
almost
even
.
Metabolic
screening
remains
an
important
part
of
investigating
renal
stone
disease
,
but
to
the
disappointment
and
frustration
of
many
doctors
,
medical
treatment
is
still
essentially
pragmatic
,
except
perhaps
in
cystinuria
,
and
to
a
limited
extent
in
primary
hyperoxaluria
(
if
pyridoxine-sensitive
)
;
although
newer
treatments
may
be
emerging
.
This
review
summarizes
current
thinking
and
provides
a
practical
basis
for
the
management
of
renal
stone
disease
.
Diseases
Validation
Diseases presenting
"obesity"
symptom
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
carcinoma of the gallbladder
cohen syndrome
congenital adrenal hyperplasia
cushing syndrome
cystinuria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
heparin-induced thrombocytopenia
kabuki syndrome
monosomy 21
phenylketonuria
primary hyperoxaluria type 1
sneddon syndrome
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated