Materiały źródłowe

• #1 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs.

• #1 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. […] The prevalence of nephrolithiasis (kidney stones) is increasing in the United States, from one in 20 adults in 1994 to one in 11 adults in 2010. […] All patients with kidney stones should be screened for risk of stone recurrence with medical history, basic laboratory evaluation, and imaging. […] Patients at high risk of stone recurrence should be referred for additional metabolic assessment, which can serve as a basis for tailored preventive measures. […] Approximately 86% of kidney stones pass spontaneously; this proportion is lower for stones larger than 6 mm (59% vs. 90% for smaller stones). […] Medical expulsive therapy with alpha blockers (e.g., tamsulosin [Flomax], 0.4 mg per day; doxazosin [Cardura], 4 mg per day) hastens and increases the likelihood of stone passage, reduces pain, and prevents surgical interventions and hospital admissions.

• #1 The Factors That Affecting Shockwave Lithotripsy Treatment Outcome of Kidney Stones – Journal of Urological Surgery

  https://jurolsurgery.org/articles/the-factors-that-affecting-shockwave-lithotripsy-treatment-outcome-of-kidney-stones/doi/jus.galenos.2023.2022.0018

  Significant markers that determine SWL effectiveness are stone size, stone burden, stone density and stone type. […] Stone size and stone burden had a significant association with treatment success (p=0.0001), and the cut-off values determined for stone size and stone burden were 12.95 mm (p=0.0006) and 121.38 mm2 (p=0.004) respectively. Stone density also had a significant association with treatment success (p=0.0001), and the cut-off value determined for stone density was 739 Hounsfield Unit (p=0.001). Treatment success was significantly lower in cystine and calcium oxalate monohydrate stones compared to other stone types (p=0.019). […] However, the predicted factors for the SWL result should be defined and the proper treatment option should be chosen for patients with upper urinary tract stones. […] In the study, it was determined that stone size, stone burden, and stone density were the essential factors in the success of SWL and the type of stone is an essential marker determining SWL activity. By defining these parameters before treatment, SWL treatment success can become more predictable.

• #1 Predictive value of scoring systems for stone free status and complications before percutaneous nephrolithotomy in children | Scientific Reports

  https://www.nature.com/articles/s41598-025-91760-z

  PCNL, a minimally invasive surgical technique for kidney stone removal, relies on achieving stone-free status, which various scoring systems aim to predict. This study assesses the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES) and Guys Stone Score (GSS) systems in determining stone-free rates following percutaneous nephrolithotomy (PCNL) in pediatric patients. […] The study showed that 83.7% of patients achieved a stone-free condition postoperatively. […] CROES had high accuracy for predicting stone-free outcomes, while GSS was also effective in predicting both stone-free rates and complications. […] Both CROES and GSS are valuable for predicting PCNL outcomes in pediatric patients. While CROES is more reliable for stone-free rates, GSS better predicts complications.

• #1 An internally validated prognostic nomogram model predicts the stone-free rate following endoscopic combined intrarenal surgery for renal stones | BMC Urology | Full Text

  https://bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01668-5

  Here, we aim to develop and validate a viable prognostic nomogram model for predicting a stone-free rate of kidney stones patients based on retrospective cohort analysis. […] Hydronephrosis, Renal Infundibular Length (RIL), Renal Infundibular Width (RIW), stone burden, and number of calyces involved were revealed to be significant factors in the prediction of stone-free rate after ECIRS. […] Hydronephrosis, renal infundibular length, renal infundibular width, stone burden, and number of involved calyces were all significantly linked with residual stone after ECIRS. A nomogram created with these five factors showed good calibration, differentiation, and clinical usefulness. […] Hydronephrosis, renal infundibular length, renal infundibular width, stone burden, and number of calyces involved were significantly associated with residual stone after ECIRS. A nomogram created using these five factors demonstrated good calibration, differentiation, and clinical usefulness.

• #1 Interactive Journal of Medical Research – A Machine Learning Approach to Predict the Outcome of Urinary Calculi Treatment Using Shock Wave Lithotripsy: Model Development and Validation Study

  https://www.i-jmr.org/2022/1/e33357

  Our goal was to evaluate the ability of machine learning techniques to assist in effective decision-making for the treatment of urolithiasis with SWL by accurately predicting the SWL results. We have shown that AdaBoost provided superior prediction ability compared to 5 other classification techniques. […] The model had high sensitivity and medium specificity. Given that we are interested in identifying the patients for whom SWL has a low chance of success to plan for alternative procedures, the NPV of 0.839 demonstrated that the model can predict with high probability if a subject will fail the treatment. Considering how scarce and expensive health care resources are, it is important to allocate those limited resources appropriately; our model allows for appropriate allocation by informing physicians about patients who are not likely to benefit from SWL. […] We built a machine learning model to assist physicians and decision-makers to choose the best treatment option for SWL candidates based on their demographics and stone characteristics, which can result in improved prognoses.

• #1

  https://link.springer.com/article/10.1007/s00240-023-01457-z

  Preoperative diagnosis of urinary infection stones is difficult, and accurate detection of stone composition can only be performed ex vivo. […] We developed a predictive model through machine learning that can quickly identify infection stones in vivo with good predictive performance. It can be used for risk assessment and decision support of infection stones, optimize the disease management of urinary calculi and improve the prognosis of patients. […] In conclusion, we developed a preoperative prediction model using machine learning to identify urinary infection stones in vivo. The model is easy to use for both clinicians and patients and may allow clinicians to predict stone types more precisely before surgery, to optimize the disease management of urolithiasis and improve the prognosis of patients.

• #1 Development of a personalized diagnostic model for kidney stone disease tailored to acute care by integrating large clinical, demographics and laboratory data: the diagnostic acute care algorithm – kidney stones (DACA-KS) | BMC Medical Informatics and Dec

  https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-018-0652-4

  DACA-KS could be integrated into electronic health systems; the algorithm has the potential used as an effective tool to help nurses and healthcare personnel during triage or clinicians making a diagnosis, streamlining patients management in acute care. […] In this large sample of individuals admitted to acute care between 2000 and 2012, we aimed to infer a multi-domain, personalized, diagnostic algorithm risk assessment for KS disease. With a robust model collection and selection framework, under cross-validation settings, we demonstrated that the integrated model improves both specificity and sensitivity as compared to a single domain model. Also, it includes more extensive parameters compared to the STONE score. […] Despite these limitations, our study provided a compact and high-performance diagnostic model for diagnosis of KS.

• #1 Kidney stones and kidney function loss: a cohort study | The BMJ

  https://www.bmj.com/content/345/bmj.e5287

  Objective To investigate whether the presence of kidney stones increase the risk of end stage renal disease (ESRD) or other adverse renal outcomes. […] Results 23706 (0.8%) patients had at least one kidney stone, 5333 (0.2%) developed ESRD, 68525 (4%) developed stage 3b5 chronic kidney disease, and 6581 (0.3%) experienced sustained doubling of serum creatinine. Overall, one or more stone episodes during follow-up was associated with increased risk of ESRD (adjusted hazard ratio 2.16 (95% CI 1.79 to 2.62)), new stage 3b5 chronic kidney disease (hazard ratio 1.74 (1.61 to 1.88)), and doubling of serum creatinine (hazard ratio 1.94 (1.56 to 2.43)), all compared with those without kidney stones during follow-up. […] Conclusion Even a single kidney stone episode during follow-up was associated with a significant increase in the likelihood of adverse renal outcomes including ESRD. However, the increases were small in absolute terms.

• #1

  https://link.springer.com/article/10.1007/s00240-024-01653-5

  24U parameters play an important role in prevention of USR, and therefore, patients with a history of stones are recommended to closely monitor for future recurrence by regularly conducting 24U tests. […] The joint recurrent with mixture cure component, Model 3, revealed key insights into the dynamic relationships between 24U parameters and recurrent events. […] Model 3 demonstrated superior performance compared to conventional Cox regression and PWP models. It achieves better predictive accuracy and identifies significant associations between 24-hour urine parameters and stone recurrences.

• #2 Kidney stones – Symptoms, causes, types, and treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/kidney-stones

  Each year, more than half a million people go to emergency rooms for kidney stone problems. […] The prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. The prevalence of kidney stones was 10% during 20132014. […] Kidney stones increase the risk of developing chronic kidney disease. lf you have had one stone, you are at increased risk of having another stone. Those who have developed one stone are at approximately 50% risk for developing another within 5 to 7 years. […] Drinking enough fluid will help keep your urine less concentrated with waste products. […] If you would like more information, please contact us.

• #2 Kidney Stones: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15604-kidney-stones

  Around 90% of small kidney stones (smaller than 6 mm) and 60% of large stones (larger than 6 mm) pass on their own. If you have a large kidney stone or one that’s blocking the flow of pee, you’ll need to have a procedure to break up and/or remove it. Sometimes, smaller stones that were expected to pass on their own can grow or move to create a blockage. […] If you’ve had kidney stones, you’re likely to get more in the future. You’ll likely need to work on preventing them with changes to the foods you eat and, sometimes, medication. […] If you’ve had kidney stones, you’re at a higher risk for more kidney stones and chronic kidney disease.

• #2 The Factors That Affecting Shockwave Lithotripsy Treatment Outcome of Kidney Stones – Journal of Urological Surgery

  https://jurolsurgery.org/articles/the-factors-that-affecting-shockwave-lithotripsy-treatment-outcome-of-kidney-stones/doi/jus.galenos.2023.2022.0018

  Significant markers that determine SWL effectiveness are stone size, stone burden, stone density and stone type. […] Stone size and stone burden had a significant association with treatment success (p=0.0001), and the cut-off values determined for stone size and stone burden were 12.95 mm (p=0.0006) and 121.38 mm2 (p=0.004) respectively. Stone density also had a significant association with treatment success (p=0.0001), and the cut-off value determined for stone density was 739 Hounsfield Unit (p=0.001). Treatment success was significantly lower in cystine and calcium oxalate monohydrate stones compared to other stone types (p=0.019). […] However, the predicted factors for the SWL result should be defined and the proper treatment option should be chosen for patients with upper urinary tract stones. […] In the study, it was determined that stone size, stone burden, and stone density were the essential factors in the success of SWL and the type of stone is an essential marker determining SWL activity. By defining these parameters before treatment, SWL treatment success can become more predictable.

• #2 Predictive value of scoring systems for stone free status and complications before percutaneous nephrolithotomy in children | Scientific Reports

  https://www.nature.com/articles/s41598-025-91760-z

  PCNL, a minimally invasive surgical technique for kidney stone removal, relies on achieving stone-free status, which various scoring systems aim to predict. This study assesses the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES) and Guys Stone Score (GSS) systems in determining stone-free rates following percutaneous nephrolithotomy (PCNL) in pediatric patients. […] The study showed that 83.7% of patients achieved a stone-free condition postoperatively. […] CROES had high accuracy for predicting stone-free outcomes, while GSS was also effective in predicting both stone-free rates and complications. […] Both CROES and GSS are valuable for predicting PCNL outcomes in pediatric patients. While CROES is more reliable for stone-free rates, GSS better predicts complications.

• #2 An internally validated prognostic nomogram model predicts the stone-free rate following endoscopic combined intrarenal surgery for renal stones | BMC Urology | Full Text

  https://bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01668-5

  Here, we aim to develop and validate a viable prognostic nomogram model for predicting a stone-free rate of kidney stones patients based on retrospective cohort analysis. […] Hydronephrosis, Renal Infundibular Length (RIL), Renal Infundibular Width (RIW), stone burden, and number of calyces involved were revealed to be significant factors in the prediction of stone-free rate after ECIRS. […] Hydronephrosis, renal infundibular length, renal infundibular width, stone burden, and number of involved calyces were all significantly linked with residual stone after ECIRS. A nomogram created with these five factors showed good calibration, differentiation, and clinical usefulness. […] Hydronephrosis, renal infundibular length, renal infundibular width, stone burden, and number of calyces involved were significantly associated with residual stone after ECIRS. A nomogram created using these five factors demonstrated good calibration, differentiation, and clinical usefulness.

• #2 Interactive Journal of Medical Research – A Machine Learning Approach to Predict the Outcome of Urinary Calculi Treatment Using Shock Wave Lithotripsy: Model Development and Validation Study

  https://www.i-jmr.org/2022/1/e33357

  Our goal was to evaluate the ability of machine learning techniques to assist in effective decision-making for the treatment of urolithiasis with SWL by accurately predicting the SWL results. We have shown that AdaBoost provided superior prediction ability compared to 5 other classification techniques. […] The model had high sensitivity and medium specificity. Given that we are interested in identifying the patients for whom SWL has a low chance of success to plan for alternative procedures, the NPV of 0.839 demonstrated that the model can predict with high probability if a subject will fail the treatment. Considering how scarce and expensive health care resources are, it is important to allocate those limited resources appropriately; our model allows for appropriate allocation by informing physicians about patients who are not likely to benefit from SWL. […] We built a machine learning model to assist physicians and decision-makers to choose the best treatment option for SWL candidates based on their demographics and stone characteristics, which can result in improved prognoses.

• #2 Radiomics in Urolithiasis: Systematic Review of Current Applications, Limitations, and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9457189/

  Radiomics is increasingly applied to the diagnosis, management, and outcome prediction of various urological conditions. […] More importantly, it has also been utilized to predict outcomes and complications after endourological procedures. […] The aim of the scoping review is to evaluate if radiomics-based applications can help endourologist overcome some confounders in stone management such as preoperative identification of stone composition, identifying phleboliths, and predicting stone free rate after medical expulsion therapy. […] Radiomics has been also applied in the field of urolithiasis to predict the complications and outcomes of endourological procedures. […] Summary: This adds a significant research potential wherein using the radiomics signatures comparisons can be made between the efficacy of single emission CT scans (SECT) vis a vis dual emission CT scans to accurately determine stone composition.

• #2 Optimizing Kidney Stone Prediction through Urinary Analysis with Improved Binary Particle Swarm Optimization and eXtreme Gradient Boosting

  https://www.mdpi.com/2227-7390/11/7/1717

  Globally, the incidence of kidney stones (urolithiasis) has increased over time. Without better treatment, stones in the kidneys could result in blockage of the ureters, repetitive infections in the urinary tract, painful urination, and permanent deterioration of the kidneys. Hence, detecting kidney stones is crucial to improving an individual’s life. […] The overall proposed system is assessed by internal comparison with DT (Decision Tree) and NB (Naïve Bayes), which reveals the efficient performance of the proposed system in kidney stone prognostication. […] The proposed method is undertaken in an IoT-fog environment that uses a real-time dataset. In the present study, the proposed method is Improved MBPSO for feature selection and Modified XGBoost algorithm for classification. […] The proposed system demands expertise in XGBoost and PSO. This indicates that it might not be available to non-experts, which might restrict its acceptance in certain settings. Overall, though the proposed algorithm possesses various merits for prognosticating kidney stone, it also possesses certain limitations in terms of restricted applicability and requirement for expertise, which have to be considered for effective usage.

• #2 Kidney stones and kidney function loss: a cohort study | The BMJ

  https://www.bmj.com/content/345/bmj.e5287

  Objective To investigate whether the presence of kidney stones increase the risk of end stage renal disease (ESRD) or other adverse renal outcomes. […] Results 23706 (0.8%) patients had at least one kidney stone, 5333 (0.2%) developed ESRD, 68525 (4%) developed stage 3b5 chronic kidney disease, and 6581 (0.3%) experienced sustained doubling of serum creatinine. Overall, one or more stone episodes during follow-up was associated with increased risk of ESRD (adjusted hazard ratio 2.16 (95% CI 1.79 to 2.62)), new stage 3b5 chronic kidney disease (hazard ratio 1.74 (1.61 to 1.88)), and doubling of serum creatinine (hazard ratio 1.94 (1.56 to 2.43)), all compared with those without kidney stones during follow-up. […] Conclusion Even a single kidney stone episode during follow-up was associated with a significant increase in the likelihood of adverse renal outcomes including ESRD. However, the increases were small in absolute terms.

• #2 Kidney stones in adults: Evaluation of the patient with established stone disease – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-evaluation-of-the-patient-with-established-stone-disease

  Given the variability in reporting of mixed stones by commercial laboratories, it is important to keep in mind the clinical setting and other available information and to question the reliability of the stone composition report if it seems inconsistent with the patient’s history. […] Monitoring should be performed initially at one year and, if negative, every two to four years thereafter depending upon the severity of the stone disease and the 24-hour urine values.

• #3 Kidney stones – Symptoms, causes, types, and treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/kidney-stones

  Each year, more than half a million people go to emergency rooms for kidney stone problems. […] The prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. The prevalence of kidney stones was 10% during 20132014. […] Kidney stones increase the risk of developing chronic kidney disease. lf you have had one stone, you are at increased risk of having another stone. Those who have developed one stone are at approximately 50% risk for developing another within 5 to 7 years. […] Drinking enough fluid will help keep your urine less concentrated with waste products. […] If you would like more information, please contact us.

• #3 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. […] The prevalence of nephrolithiasis (kidney stones) is increasing in the United States, from one in 20 adults in 1994 to one in 11 adults in 2010. […] All patients with kidney stones should be screened for risk of stone recurrence with medical history, basic laboratory evaluation, and imaging. […] Patients at high risk of stone recurrence should be referred for additional metabolic assessment, which can serve as a basis for tailored preventive measures. […] Approximately 86% of kidney stones pass spontaneously; this proportion is lower for stones larger than 6 mm (59% vs. 90% for smaller stones). […] Medical expulsive therapy with alpha blockers (e.g., tamsulosin [Flomax], 0.4 mg per day; doxazosin [Cardura], 4 mg per day) hastens and increases the likelihood of stone passage, reduces pain, and prevents surgical interventions and hospital admissions.

• #3 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  The aim of preventive strategies should also focus on CKD, MBD and ESRD. […] Although prevention of new calcium stones is possible, there is no pharmacological treatment that can dissolve existing calcium stones. […] Drug treatment could be considered if stones continue to recur despite the above measures, or if the CKD and/or MBD risks are considerable, or in certain groups of people (for example, flying airline personnel) and in those who have severe urine metabolic abnormalities. […] The success of SWL is typically determined 1-3 months after the procedure by plain abdominal X-ray with or without renal ultrasonography. […] Overall, most of the SWL shortcomings are surmounted by the excellent quality-of-life (QOL) measures and low morbidity associated with the procedure. […] The development of sepsis following SWL is low in absolute terms (1% of patients), but is considerably higher in the presence of staghorn or colonized stones (up to 10% of patients). […] It cannot be too strongly emphasized that the optimal care of patients with stone disease is not only surgical, in its widest sense, but also medical.

• #3 Predictive value of scoring systems for stone free status and complications before percutaneous nephrolithotomy in children | Scientific Reports

  https://www.nature.com/articles/s41598-025-91760-z

  The objective of this study is to compare the efficiency of CROES and GSS scoring systems in predicting post-PCNL stone-free rate in pediatric patients and to evaluate the accuracy of these systems. […] The average CROES score was measured as 203.58 in group 1 and as 151.08 in group 2, showing a statistically significant condition. […] Residual stone rate was detected to increase with increasing degree in GSS groups, which was regarded to be statistically significant. […] In conclusion, although fever was the most frequently observed complication in both groups, the incidence of severe complications (Clavien-Dindo Grade IIIb and IV) was higher in Group 2. […] This study compared the effectiveness of the CROES and Guys Stone Score (GSS) scoring systems in predicting percutaneous nephrolithotomy (PCNL) outcomes in pediatric patients. The findings indicate that while the CROES scoring system demonstrates high accuracy in predicting stone-free rates, it is less effective in forecasting postoperative complications. In contrast, the GSS score was found to be a reliable predictor of both stone-free rates and complication risks. […] The results of this study provide valuable insights into the applicability of the CROES and GSS scoring systems in optimizing PCNL outcomes in pediatric patients. However, the limitations of these scoring systems in the pediatric population should be acknowledged.

• #3 An internally validated prognostic nomogram model predicts the stone-free rate following endoscopic combined intrarenal surgery for renal stones | BMC Urology | Full Text

  https://bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01668-5

  The results showed hydronephrosis, RIL, RIW, stone burden, and number of calyces involved as the main factors affecting the stone-free rate. […] The number of calyces involved as a prognostic factor was significantly associated with the stone-free rate after ECIRS in our study. Additionally, the predictive ability of the variable number of calyces involved showed high accuracy (AUC=0.751, CI=0.7030.798).

• #3 Radiomics in Urolithiasis: Systematic Review of Current Applications, Limitations, and Future Directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9457189/

  Our review shows that radiomics in urolithiasis is still in infancy. Its best potential lies in identifying infectious stones preoperatively; whether this application can extend to all stone types remains undetermined. Future applications in ESWL and predicting stone free rates for different compositions are the next frontiers for research and development. It is hoped that with further correlation of radiomics with conventional established sources of diagnostic subsets such as clinical, molecular, and imaging can optimize disease management in urolithiasis and improve patient prognosis.

• #3 Optimizing Kidney Stone Prediction through Urinary Analysis with Improved Binary Particle Swarm Optimization and eXtreme Gradient Boosting

  https://www.mdpi.com/2227-7390/11/7/1717

  The efficiency of the proposed system was assessed by performing an internal comparison with the DT and NB classifiers, which showed the effectiveness of the proposed model. From the internal comparison, the DT classifier showed an accuracy rate of 0.75, while the NB classifier attained an accuracy of 0.74. However, the proposed system revealed a high accuracy rate of 0.97. […] The results revealed that the proposed method attained a high accuracy value with feature selection at a rate of 97%, whereas without feature selection, it was 85.269%.

• #3 Kidney stones and kidney function loss: a cohort study | The BMJ

  https://www.bmj.com/content/345/bmj.e5287

  The adjusted risk of incident ESRD, our primary outcome, was significantly higher in patients with one or more episodes of kidney stones (hazard ratio 2.16 (95% confidence interval 1.79 to 2.62), table 2, fig 2). […] The risk of adverse renal outcomes associated with kidney stones seemed to increase with the number of stone episodes, since the adjusted risk of ESRD and doubling of serum creatinine were both greater in patients with multiple episodes of stones as compared with those with a single episode or no stones (table 2). […] In conclusion, we found a graded association between episodes of kidney stones and the risk of adverse renal outcomes, including ESRD.

• #3 Kidney stones in adults: Evaluation of the patient with established stone disease – UpToDate

  https://www.uptodate.com/contents/kidney-stones-in-adults-evaluation-of-the-patient-with-established-stone-disease

  Kidney stone disease (nephrolithiasis) is a common problem in primary care practice. […] In patients with established kidney stone disease, the goal of a diagnostic evaluation is to identify, as efficiently and economically as possible, the particular behavioral and physiologic differences present in a given patient so that effective therapy to prevent recurrent stones can be established and the prognosis can be better defined. […] The presence of certain stone types may indicate the existence of an underlying predisposing condition. […] In asymptomatic patients with a single stone who do not warrant a complete metabolic evaluation, active surveillance with repeat imaging within one to two years is a reasonable approach. […] Approximately one-third of such patients will develop symptoms related to their kidney stones within three years, and as many as one-half of these symptomatic patients may require surgical treatment for their stones.

• #4 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  The aim of preventive strategies should also focus on CKD, MBD and ESRD. […] Although prevention of new calcium stones is possible, there is no pharmacological treatment that can dissolve existing calcium stones. […] Drug treatment could be considered if stones continue to recur despite the above measures, or if the CKD and/or MBD risks are considerable, or in certain groups of people (for example, flying airline personnel) and in those who have severe urine metabolic abnormalities. […] The success of SWL is typically determined 1-3 months after the procedure by plain abdominal X-ray with or without renal ultrasonography. […] Overall, most of the SWL shortcomings are surmounted by the excellent quality-of-life (QOL) measures and low morbidity associated with the procedure. […] The development of sepsis following SWL is low in absolute terms (1% of patients), but is considerably higher in the presence of staghorn or colonized stones (up to 10% of patients). […] It cannot be too strongly emphasized that the optimal care of patients with stone disease is not only surgical, in its widest sense, but also medical.

• #4 Predictive value of scoring systems for stone free status and complications before percutaneous nephrolithotomy in children | Scientific Reports

  https://www.nature.com/articles/s41598-025-91760-z

  The objective of this study is to compare the efficiency of CROES and GSS scoring systems in predicting post-PCNL stone-free rate in pediatric patients and to evaluate the accuracy of these systems. […] The average CROES score was measured as 203.58 in group 1 and as 151.08 in group 2, showing a statistically significant condition. […] Residual stone rate was detected to increase with increasing degree in GSS groups, which was regarded to be statistically significant. […] In conclusion, although fever was the most frequently observed complication in both groups, the incidence of severe complications (Clavien-Dindo Grade IIIb and IV) was higher in Group 2. […] This study compared the effectiveness of the CROES and Guys Stone Score (GSS) scoring systems in predicting percutaneous nephrolithotomy (PCNL) outcomes in pediatric patients. The findings indicate that while the CROES scoring system demonstrates high accuracy in predicting stone-free rates, it is less effective in forecasting postoperative complications. In contrast, the GSS score was found to be a reliable predictor of both stone-free rates and complication risks. […] The results of this study provide valuable insights into the applicability of the CROES and GSS scoring systems in optimizing PCNL outcomes in pediatric patients. However, the limitations of these scoring systems in the pediatric population should be acknowledged.

• #4 An internally validated prognostic nomogram model predicts the stone-free rate following endoscopic combined intrarenal surgery for renal stones | BMC Urology | Full Text

  https://bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01668-5

  The results showed hydronephrosis, RIL, RIW, stone burden, and number of calyces involved as the main factors affecting the stone-free rate. […] The number of calyces involved as a prognostic factor was significantly associated with the stone-free rate after ECIRS in our study. Additionally, the predictive ability of the variable number of calyces involved showed high accuracy (AUC=0.751, CI=0.7030.798).

• #4

  https://link.springer.com/article/10.1007/s00240-024-01653-5

  To address the limitations in existing urinary stone recurrence (USR) models, including failure to account for changes in 24-hour urine (24U) parameters over time and ignoring multiplicity of stone recurrences, we presented a novel statistical method to jointly model temporal trends in 24U parameters and multiple recurrent stone events. […] The joint recurrent model with a mixture cure component identified significant associations between 24U parameters – including urine pH (adjusted HR=1.991; 95% CI 1.4902.660; p0.001), total volume (adjusted HR=0.700; 95% CI 0.5010.977; p=0.036), potassium (adjusted HR=0.983; 95% CI 0.9740.991; p0.001), uric acid (adjusted HR=1.528; 95% CI 1.1052.113, p=0.010), calcium (adjusted HR=1.164; 95% CI 1.0521.289; p=0.003), and citrate (adjusted HR=0.796; 95% CI 0.7060.897; p0.001), and USR, achieving better predictive performance compared to existing methods.

• #4 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  Racial and ethnic differences in stone prevalence have long been recognized. […] Numerous systemic diseases and factors have been associated with an increased risk of kidney stones. […] Finally, risk of cardiovascular disease has been associated with a history of kidney stones, although a cause and effect relationship has not been definitively established. […] The rate of crystal growth of a particular mineral is mainly dependent on its RSS level in the urine but might also be influenced by certain modifiers of crystallization. […] Several analyses have suggested a link between vascular calcification and the formation of idiopathic kidney stones. […] CKD can also result from whatever has caused stones to precipitate, renal damage from stone complications (pyelonephritis and obstructive nephropathy) or can be the result of urological treatment.

• #4 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. […] The prevalence of nephrolithiasis (kidney stones) is increasing in the United States, from one in 20 adults in 1994 to one in 11 adults in 2010. […] All patients with kidney stones should be screened for risk of stone recurrence with medical history, basic laboratory evaluation, and imaging. […] Patients at high risk of stone recurrence should be referred for additional metabolic assessment, which can serve as a basis for tailored preventive measures. […] Approximately 86% of kidney stones pass spontaneously; this proportion is lower for stones larger than 6 mm (59% vs. 90% for smaller stones). […] Medical expulsive therapy with alpha blockers (e.g., tamsulosin [Flomax], 0.4 mg per day; doxazosin [Cardura], 4 mg per day) hastens and increases the likelihood of stone passage, reduces pain, and prevents surgical interventions and hospital admissions.

• #5 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  Racial and ethnic differences in stone prevalence have long been recognized. […] Numerous systemic diseases and factors have been associated with an increased risk of kidney stones. […] Finally, risk of cardiovascular disease has been associated with a history of kidney stones, although a cause and effect relationship has not been definitively established. […] The rate of crystal growth of a particular mineral is mainly dependent on its RSS level in the urine but might also be influenced by certain modifiers of crystallization. […] Several analyses have suggested a link between vascular calcification and the formation of idiopathic kidney stones. […] CKD can also result from whatever has caused stones to precipitate, renal damage from stone complications (pyelonephritis and obstructive nephropathy) or can be the result of urological treatment.

• #5 Kidney Stones: Treatment and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p490.html

  Patients at risk of stone recurrence should be referred for additional metabolic testing (e.g., 24-hour urine collection for total volume, pH, and calcium oxalate, uric acid, citrate, sodium, potassium, and creatinine levels) and individualized preventive measures. […] Measures to prevent recurrence of kidney stones include lifestyle modifications, citrate supplementation, and medications. […] Patients at high risk of stone recurrence should receive preventive measures tailored to the results of the metabolic assessment.

• #5 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  The aim of preventive strategies should also focus on CKD, MBD and ESRD. […] Although prevention of new calcium stones is possible, there is no pharmacological treatment that can dissolve existing calcium stones. […] Drug treatment could be considered if stones continue to recur despite the above measures, or if the CKD and/or MBD risks are considerable, or in certain groups of people (for example, flying airline personnel) and in those who have severe urine metabolic abnormalities. […] The success of SWL is typically determined 1-3 months after the procedure by plain abdominal X-ray with or without renal ultrasonography. […] Overall, most of the SWL shortcomings are surmounted by the excellent quality-of-life (QOL) measures and low morbidity associated with the procedure. […] The development of sepsis following SWL is low in absolute terms (1% of patients), but is considerably higher in the presence of staghorn or colonized stones (up to 10% of patients). […] It cannot be too strongly emphasized that the optimal care of patients with stone disease is not only surgical, in its widest sense, but also medical.

• #6 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  The aim of preventive strategies should also focus on CKD, MBD and ESRD. […] Although prevention of new calcium stones is possible, there is no pharmacological treatment that can dissolve existing calcium stones. […] Drug treatment could be considered if stones continue to recur despite the above measures, or if the CKD and/or MBD risks are considerable, or in certain groups of people (for example, flying airline personnel) and in those who have severe urine metabolic abnormalities. […] The success of SWL is typically determined 1-3 months after the procedure by plain abdominal X-ray with or without renal ultrasonography. […] Overall, most of the SWL shortcomings are surmounted by the excellent quality-of-life (QOL) measures and low morbidity associated with the procedure. […] The development of sepsis following SWL is low in absolute terms (1% of patients), but is considerably higher in the presence of staghorn or colonized stones (up to 10% of patients). […] It cannot be too strongly emphasized that the optimal care of patients with stone disease is not only surgical, in its widest sense, but also medical.

• #6 Kidney stones – Symptoms, causes, types, and treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/kidney-stones

  Each year, more than half a million people go to emergency rooms for kidney stone problems. […] The prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. The prevalence of kidney stones was 10% during 20132014. […] Kidney stones increase the risk of developing chronic kidney disease. lf you have had one stone, you are at increased risk of having another stone. Those who have developed one stone are at approximately 50% risk for developing another within 5 to 7 years. […] Drinking enough fluid will help keep your urine less concentrated with waste products. […] If you would like more information, please contact us.

• #7 Kidney stones

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5685519/

  The aim of preventive strategies should also focus on CKD, MBD and ESRD. […] Although prevention of new calcium stones is possible, there is no pharmacological treatment that can dissolve existing calcium stones. […] Drug treatment could be considered if stones continue to recur despite the above measures, or if the CKD and/or MBD risks are considerable, or in certain groups of people (for example, flying airline personnel) and in those who have severe urine metabolic abnormalities. […] The success of SWL is typically determined 1-3 months after the procedure by plain abdominal X-ray with or without renal ultrasonography. […] Overall, most of the SWL shortcomings are surmounted by the excellent quality-of-life (QOL) measures and low morbidity associated with the procedure. […] The development of sepsis following SWL is low in absolute terms (1% of patients), but is considerably higher in the presence of staghorn or colonized stones (up to 10% of patients). […] It cannot be too strongly emphasized that the optimal care of patients with stone disease is not only surgical, in its widest sense, but also medical.

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