![]() Gastrointestinal diseases (i.e., jejuno-ileal bypass, intestinal resection, Crohn’s disease, malabsorptive conditions, enteric hyperoxaluria after urinary diversion, exocrine pancreatic insufficiency) and bariatric surgeryĭrug-induced stone formation (see Table 4.11)Īnatomical abnormalities associated with stone formation Solitary kidney (the kidney itself does not particularly increase the risk of stone formation, but prevention of stone recurrence is of crucial importance to avoid acute renal failure) Table 3.3: High-risk stone formers Įarly onset of urolithiasis (especially children and teenagers)īrushite-containing stones (CaHPO 4.2H 2O) Stone type and disease severity determine low- or high-risk stone formers (Table 3.3). ![]() Highly recurrent disease is observed in slightly more than 10% of patients. A recent review of first-time stone formers calculated a recurrence rate of 26% in five years’ time. About 50% of recurrent stone formers have just one lifetime recurrence. The risk status of stone formers should be determined in a holistic way taking into consideration not only the probability of stone recurrence or regrowth, but also the risk of CKD and mineral and bone disorder (MBD), and is imperative for pharmacological treatment. Table 3.2 lists the most clinically relevant substances and their mineral components. Stones are often formed from a mixture of substances. Stone composition is the basis for further diagnostic and management decisions. *In children in developing countries in patients with anorexia or laxative-abuse. Table 3.1: Stones classified by aetiology Stones can be stratified into those caused by: infections, non-infectious causes, genetic defects or adverse drug effects (drug stones) (Table 3.1). There is emerging evidence linking nephrolithiasis to the risk of chronic Kidney disease (CKD). For some areas, an increase of more than 37% over the last 20 years has been reported. In countries with a high standard of life such as Sweden, Canada or the USA, renal stone prevalence is notably high (> 10%). Accordingly, the prevalence rates for urinary stones vary from 1% to 20%. The recurrence risk is basically determined by the disease or disorder causing the stone formation. Stone incidence depends on geographical, climatic, ethnic, dietary, and genetic factors. Prevalence, aetiology, risk of recurrence 3.1.1. ![]()
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