Risk Factor and Pathophysiology of Nephrolithiasis: A Review Article

Abstract

Introduction: Nephrolithiasis is a urinary tract stone disease that can be found in the kidneys, ureters, bladder, and urethra. This disease is the three most common diseases in the field of urology besides urinary tract infections and benign prostate enlargement. Kidney stones are the most common, with an estimated lifetime prevalence as high as 15%. Bladder stones have significant morbidity but occur much less frequently than kidney stones. Many factors cause reduced urine flow and cause obstruction, one of which is urine static and decreased urine volume due to dehydration and inadequate fluid intake, this can increase the risk of nephrolithiasis. Low urine flow is a common abnormal symptom. In addition, various conditions that trigger nephrolithiasis such as the composition of various stones are the main factors in identifying the cause of nephrolithiasis. Aims of this article is to review risk factors and pathophysiology of nephrolithiasis. Discussion: Symptoms associated with urinary tract stones depend on the location of the stone, the size of the stone, and any complications that have occurred. Usually, stones in the kidney calyx are asymptomatic. When the stone falls off and descends into the narrow ureter, it becomes symptomatic. Stones generally get stuck in the narrowest part of the ureter, such as the uretero-pelvic junction, when the ureter crosses the iliac vasa, and the uretero-vesical junction. The main symptom of ureteric stones is often an acute onset of pain in the back. This pain can be colicky or not. Colic pain occurs because the peristaltic activity of the smooth muscle of the calical system or ureter increases in an attempt to remove stones from the urinary tract. The increase in peristalsis causes the intraluminal pressure to increase so that there is stretching of the nerve terminals that provide a sensation of pain. The pain can radiate from the pelvis and to the ipsilateral groin. Other symptoms include nausea, vomiting and hematuria. Hematuria can occur macros or microscopy from urinalysis. Hematuria occurs as a result of trauma to the urinary tract mucosa caused by stones. Conclusion: Nephrolithiasis is rock-forming salt reaches a urine concentration that exceeds the equilibrium point between the dissolved component and crystallization occurs. There are several risk factors that nephrolithiasis occurs due to various causes. Therapy and lifestyle changes are interventions that can change risk factors, but there are also risk factors that cannot be changed.