A BIOCHEMICAL APPROACH TO RENAL STONE FORMATION

This chapter a biochemical approach to renal stone formation. The chapter focuses on the three main theories concerning stone formation in the urinary tract—namely, the precipitation theory, the theory of the lack of inhibitors, and the matrix theory. The chapter considers all of them to be applicable in this multifactorial disease. However, the chapter focuses only on the matrix theory as it appears to form the basis of urolithiasis. Urinary stones are the final product and chief symptom of a many-faceted disease of multifactorial etiology. From the mineralogist's viewpoint, a stone is a solid aggregate of complex composition precipitated from a supersaturated solution. The pathogenesis of kidney stones may be attributed to a number of different causes, but the first step in urolithiasis is probably the precipitation of glycoproteins. The cause of this precipitation is still unclear and open to speculation. Nevertheless, whatever is the answer to this complex multifactorial disease, the activity and concentration of urinary enzymes play an important role in the supplementation of traditional risk factors and new investigations. © 1992 Academic Press Inc.