The origin of urinary stones

Urinary stone disease has historically been viewed as a disorder of mineral metabolism leading to precipitation of minerals out of the urine. Therefore, the medical management of urinary stones has focused on improving the urinary milieu. A growing body of evidence suggests that both cardiovascular risk factors and cardiovascular disease itself are associated with the development of urinary stones. Although disorders of mineral metabolism and cardiovascular diseases are both systemic conditions, patients frequently present with asymmetric renal calculus disease, suggesting that as yet uncharacterized local mechanisms must contribute to the formation of renal calculi. In this review, we examine the links between cardiovascular disease and nephrolithiasis, and discuss the evidence for potential local factors that contribute to stone disease.