Management of urinary stones: state of the art and future perspectives by experts in stone disease

Published: June 27, 2024
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Aim: To present state of the art on the management of urinary stones from a panel of globally recognized urolithiasis experts who met during the Experts in Stone Disease Congress in Valencia in January 2024.
Options of treatment: The surgical treatment modalities of renal and ureteral stones are well defined by the guidelines of international societies, although for some index cases more alternative options are possible. For 1.5 cm renal stones, both m-PCNL and RIRS have proven to be valid treatment alternatives with comparable stone-free rates. The m-PCNL has proven to be more cost effective and requires a shorter operative time, while the RIRS has demonstrated lower morbidity in terms of blood loss and shorter recovery times. SWL has proven to be less effective at least for lower calyceal stones but has the highest safety profile. For a 6mm obstructing stone of the pelviureteric junction (PUJ) stone, SWL should be the first choice for a stone less than 1 cm, due to less invasiveness and lower risk of complications although it has a lower stone free-rate. RIRS has advantages in certain conditions such as anticoagulant treatment, obesity, or body deformity.
Technical issues of the surgical procedures for stone removal: In patients receiving antithrombotic therapy, SWL, PCN and open surgery are at elevated risk of hemorrhage or perinephric hematoma. URS, is associated with less morbidity in these cases. An individualized combined evaluation of risks of bleeding and thromboembolism should determine the perioperative thromboprophylactic strategy. Pre-interventional urine culture and antibiotic therapy are mandatory although UTI treatment is becoming more challenging due to increasing resistance to routinely applied antibiotics. The use of an intrarenal urine culture and stone culture is recommended to adapt antibiotic therapy in case of postoperative infectious complications. Measurements of temperature and pressure during RIRS are vital for ensuring patient safety and optimizing surgical outcomes although techniques of measurements and methods for data analysis are still to be refined. Ureteral stents were improved by the development of new biomaterials, new coatings, and new stent designs. Topics of current research are the development of drug eluting and bioresorbable stents.
Complications of endoscopic treatment: PCNL is considered the most invasive surgical option. Fever and sepsis were observed in 11 and 0.5% and need for transfusion and embolization for bleeding in 7 and 0.4%. Major complications, as colonic, splenic, liver, gall bladder and bowel injuries are quite rare but are associated with significant morbidity. Ureteroscopy causes less complications, although some of them can be severe. They depend on high pressure in the urinary tract (sepsis or renal bleeding) or application of excessive force to the urinary tract (ureteral avulsion or stricture).
Diagnostic work up:  Genetic testing consents the diagnosis of monogenetic conditions causing stones. It should be carried out in children and in selected adults. In adults, monogenetic diseases can be diagnosed by systematic genetic testing in no more than 4%, when cystinuria, APRT deficiency, and xanthinuria are excluded. A reliable stone analysis by infrared spectroscopy or X-ray diffraction is mandatory and should be associated to examination of the stone under a stereomicroscope. The analysis of digital images of stones by deep convolutional neural networks in dry laboratory or during endoscopic examination could allow the classification of stones based on their color and texture. Scanning electron microscopy (SEM) in association with energy dispersive spectrometry (EDS) is another fundamental research tool for the study of kidney stones. The combination of metagenomic analysis using Next Generation Sequencing (NGS) techniques and the enhanced quantitative urine culture (EQUC) protocol can be used to evaluate the urobiome of renal stone formers. Twenty-four hour urine analysis has a place during patient evaluation together with repeated measurements of urinary pH with a digital pH meter. Urinary supersaturation is the most comprehensive physicochemical risk factor employed in urolithiasis research. Urinary macromolecules can act as both promoters or inhibitors of stone formation depending on the chemical composition of urine in which they are operating. At the moment, there are no clinical applications of macromolecules in stone management or prophylaxis. Patients should be evaluated for the association with systemic pathologies.
Prophylaxis: Personalized medicine and public health interventions are complementary to prevent stone recurrence. Personalized medicine addresses a small part of stone patients with a high risk of recurrence and systemic complications requiring specific dietary and pharmacological treatment to prevent stone recurrence and complications of associated systemic diseases. The more numerous subjects who form one or a few stones during their entire lifespan should be treated by modifications of diet and lifestyle. Primary prevention by public health interventions is advisable to reduce prevalence of stones in the general population. Renal stone formers at "high-risk" for recurrence need early diagnosis to start specific treatment. Stone analysis allows the identification of most “high-risk” patients forming non-calcium stones: infection stones (struvite), uric acid and urates, cystine and other rare stones (dihydroxyadenine, xanthine). Patients at “high-risk” forming calcium stones require a more difficult diagnosis by clinical and laboratory evaluation. Particularly, patients with cystinuria and primary hyperoxaluria should be actively searched.
Future research: Application of Artificial Intelligence are promising for automated identification of ureteral stones on CT imaging, prediction of stone composition and 24-hour urinary risk factors by demographics and clinical parameters, assessment of stone composition by evaluation of endoscopic images and prediction of outcomes of stone treatments. The synergy between urologists, nephrologists, and scientists in basic kidney stone research will enhance the depth and breadth of investigations, leading to a more comprehensive understanding of kidney stone formation.



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Assimos D, Krambeck A, Miller NL, et al. Surgical management of stones: American Urological Association/Endourological Society Guideline, part II. J Urol 2016; 196:1161. DOI:
Skolarikos A, Jung H, Neisius A, et al. EAU Guidelines 2023 on Urolithiasis. Edn. presented at the EAU Annual Congress Milan 2023. ISBN 978-94-92671-19-6. EAU Guidelines Office, Arnhem, The Netherlands.
Akram M, Jahrreiss V, Skolarikos A, et al. Urological Guidelines for Kidney Stones: Overview and Comprehensive Update. J Clin Med. 2024;13:1114. DOI:
Jackman SV, Docimo SG, Cadeddu JA, et al. The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 1998; 16:371-374 DOI:
Lahme S. Miniaturisation of PCNL. Urolithiasis 2017; 46:99-106. DOI:
Liu Y, Zhang H, Wen Z, et al. Efficacy and safety of minimally invasive percutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of upper urinary tract stones (> 1 cm): a systematic review and meta-analysis of 18 randomized controlled trials. BMC Urol. 2023; 23:171. DOI:
Rebuck DA, Macejko A, Bhalani V, et al. The natural history of renal stone fragments following ureteroscopy. Urology. 2011; 77:564-8. DOI:
Mahmood SN, Ahmed CJ, Tawfeeq H, et al. Evaluation of mini-PCNL and RIRS for renal stones 1-2 cm in an economically challenged setting: A prospective cohort study. Ann Med Surg (Lond). 2022; 81:104235. DOI:
Jiao B, Lai S, Xu X, et al. The efficacy of flexible ureteroscopy lithotripsy and miniaturized percutaneous nephrolithotomy for the treatment of renal and proximal ureteral calculi of ≤ 2 cm: A retrospective study. Medicine (Baltimore). 2019; 98:e14535. DOI:
Zheng C, Yang H, Luo J, et al. Extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery for treatment for renal stones 1-2 cm: a meta-analysis. Urolithiasis. 2015; 43:549-56. DOI:
Setthawong V, Srisubat A, Potisat S, et al. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev. 2023; 8:CD007044. DOI:
Hou J, Xu F, Du H, et al. Efficacy and safety of the surgical treatments for lower calyceal stones: a systematic review and network meta-analysis. Int J Surg. 2023; 109:383-8. DOI:
Güler Y. Non-contrast computed tomography-based factors in predicting ESWL success: A systematic review and meta-analysis. Progr Urol. 2023; 33:27-47. DOI:
Geraghty RM, Davis NF, Tzelves L, et al. Best practice in interventional management of urolithiasis: an update from the European Association of Urology Guidelines Panel for Urolithiasis 2022. Eur Urol Focus. 2023; 9:199-208. DOI:
Peng L, Wen J, Zhong W, Zeng G. Is physical therapy effective following extracorporeal shockwave lithotripsy and retrograde intrarenal surgery: a meta-analysis and systematic review. BMC Urology. 2020;20:1-11. DOI:
Sarica K, Kafkasli A, Yazici Ö, et al. Ureteral wall thickness at the impacted ureteral stone site: a critical predictor for success rates after SWL. Urolithiasis. 2015; 43:83-8. DOI:
Bucci S, Umari P, Rizzo M, et al. Emergency extracorporeal shockwave lithotripsy (eSWL) as opposed to delayed SWL (dSWL) for the treatment of acute renal colic due to obstructive ureteral stone: a prospective randomized trial. Minerva Urol Nefrol 2018; 70:526-33. DOI:
Peng C-X, Lou Y-K, Xu L, et al. Efficacy of emergency extracorporeal shock wave lithotripsy in the treatment of ureteral stones: a meta-analysis. BMC Urology. 2023; 23:56. DOI:
Cornelius J, Zumbühl D, Afferi L, et al. Immediate shockwave lithotripsy vs delayed shockwave lithotripsy after urgent ureteral stenting in patients with ureteral or pyeloureteral urolithiasis: a matched-pair analysis. J Endourol. 2021; 35:721-7. DOI:
Bourdoumis A, Stasinou T, Kachrilas S, et al. Thromboprophylaxis and bleeding diathesis in minimally invasive stone surgery. Nat Rev Urol. 2014; 11:51-8. DOI:
Walker E, Lyman A, Gupta K, et al. Clinical management of an increasing threat: outpatient urinary tract infections due to multidrug-resistant pathogens.Clin Infect Dis. 2016; 63:960-965. DOI:
Tenney J, Hudson N, Alnifaidy H, et al. Risk factors for aquiring multidrug- resistant organisms in urinary tract infections: A systematic literature review. Saudi Pharm J. 2018; 26:678-684. DOI:
Wagenlehner FM, Vahlensieck W, Bauer HW, et al. Prevention of recurrent urinary tract infections. Minerva Urol Nefrol 2013; 65:9-20.
Cek M, Tandogdu Z, Wagenlehner F, et al. Healthcare-associated urinary tract infections in hospitalized urological patients - a global perspective: results from the GPIU studies 2003-2010. World J Urol. 2014;32:1587-1594. DOI:
Gauhar V, Traxer O, García Rojo E, et al. Complications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: a systematic review and meta-analysis of randomized clinical trials. Urolithiasis. 2022; 50:511-522. DOI:
Chen ZJ, Yan YJ, Zhou JJ. Comparison of tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: A meta-analysis of randomized trials. Asian J Surg. 2020; 43:60-68. DOI:
Li Q, Gao L, Li J, et al. Total tubeless versus standard percutaneous nephrolithotomy: a meta-analysis. Minim Invasive Ther Allied Technol 2019; 29:61-69. DOI:
Xun Y, Wang Q, Hu H, et al. Tubeless versus standard percutaneous nephrolithotomy: an update meta-analysis. BMC Urol 2017;17:102. DOI:
Kim HJ, Ghani KR. Which Is the Best Laser for Lithotripsy? Holmium Laser. Eur Urol Open Sci. 2022; 44:27-29. DOI:
Emiliani E, Kanashiro A, Angerri O. Lasers for stone lithotripsy: advantages/disadvantages of each laser source. Curr Opin Urol. 2023;33:302-307. DOI:
Ortner G, Somani BK, Güven S, et al. Experts' recommendations in laser use for the treatment of urolithiasis: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training-Research in Urological Surgery and Technology (T.R.U.S.T.)-Group. World J Urol. 2024; 42:33. DOI:
Panthier F, Pauchard F, Traxer O. Retrograde intra renal surgery and safety: pressure and temperature. A systematic review. Curr Opin Urol. 2023; 33:308-317. DOI:
Yao Q, Zhang J, Pan G, Chen B. Mussel-Inspired Clickable Antibacterial Peptide Coating on Ureteral Stents for Encrustation Prevention. ACS Appl Mater Interfaces. 2022; 14:36473-36486. DOI:
Ho DR, Su SH, Chang PJ, et al. Biodegradable Stent with mTOR Inhibitor-Eluting Reduces Progression of Ureteral Stricture. Int J Mol Sci. 2021; 22:5664. DOI:
Hu J, Wang Z, Hu H, et al. In vitro and in vivo assessment of a bilayered degradable rapamycin-eluting stent for ureteral stricture caused by holmium: YAG laser lithotripsy. Acta Biomater. 2023; 172:321-329. DOI:
Soria F, Delacruz JE, Aznar-Cervantes SD, et al. Animal model assessment of a new design for a coated mitomycin-eluting biodegradable ureteral stent for intracavitary instillation as an adjuvant therapy in upper urothelial carcinoma. Minerva Urol Nephrol. 2023; 75:194-202. DOI:
Soria F, de la Cruz JE, Budia A, et al. Experimental Assessment of New Generation of Ureteral Stents: Biodegradable and Antireflux Properties. J Endourol. 2020; 34:359-365. DOI:
de la Cruz JE, Soto M, Martínez-Plá L, et al. Biodegradable ureteral stents: in vitro assessment of the degradation rates of braided synthetic polymers and copolymers. Am J Clin Exp Urol. 2022; 10:1-12.
Soria F, de La Cruz JE, Budia A, et al. Iatrogenic Ureteral Injury Treatment with Biodegradable Antireflux Heparin-Coated Ureteral Stent-Animal Model Comparative Study. J Endourol. 2021; 35:1244-1249. DOI:
Seitz C, Desai M, Häcker A, et al. Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol. 2012; 61:146-58. DOI:
de la Rosette JJ, Opondo D, Daels FP, et al. CROES PCNL Study Group. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012; 62:246-55. DOI:
Öztürk H. Gastrointestinal system complications in percutaneous nephrolithotomy: a systematic review. J Endourol. 2014; 28:1256-67. DOI:
Lorenzo-Soriano L, Ordaz-Jurado DG, Pérez Ardavín J, et al. Predictive factors of infectious complications in the postoperative of percutaneous nephrolithotomy. Actas Urol Esp 2019; 43:131-136. DOI:
Perez Castro E, Osther PJ, Jinga V, et al. CROES Ureteroscopy Global Study Group. Differences in ureteroscopic stone treatment and outcomes for distal, mid-, proximal, or multiple ureteral locations: the Clinical Research Office of the Endourological Society ureteroscopy global study. Eur Urol. 2014; 66:102-9. DOI:
Ma YC, Jian ZY, Yuan C, et al. Risk Factors of Infectious Complications after Ureteroscopy: A Systematic Review and Meta-Analysis Based on Adjusted Effect Estimate. Surg Infect (Larchmt). 2020; 21:811-822. DOI:
Gaizauskas A, Markevicius M, Gaizauskas S, Zelvys A. Possible complications of ureteroscopy in modern endourological era: two point or "scabbard" avulsion. Case Rep Urol. 2014; 2014:308093. DOI:
Taie K, Jasemi M, Khazaeli D, Fatholahi A. Prevalence and management of complications of ureteroscopy: a seven-year experience with introduction of a new maneuver to prevent ureteral avulsion. Urol J. 2012; 9:356-60.
Estrade V, Meria P, Almeras C; Lithiasis Committee of the French Association of Urology (CLAFU). 2022 Recommendations of the AFU Lithiasis Committee: Combined approach for the management of kidney and ureteral stones (Endoscopic Combined IntraRenal Surgery, ECIRS). Prog Urol. 2023; 33:871-874. DOI:
Ibarluzea G, Scoffone CM, Cracco CM, et al. Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int. 2007; 100:233-236. DOI:
Oguz U, Resorlu B, Ozyuvali E, et al. Categorizing intraoperative complications of retrograde intrarenal surgery. Urol Int. 2014; 92:164-168. DOI:
Liu YH, Jhou HJ, Chou MH, et al. Endoscopic Combined Intrarenal Surgery Versus Percutaneous Nephrolithotomy for Complex Renal Stones: A Systematic Review and Meta-Analysis. J Pers Med. 2022;12:532. DOI:
Widyokirono DR, Kloping YP, Hidayatullah F, et al. Endoscopic Combined Intrarenal Surgery vs Percutaneous Nephrolithotomy for Large and Complex Renal Stone: A Systematic Review and Meta-Analysis. J Endourol. 2022; 36:865-876. DOI:
Halbritter J, et al. Fourteen monogenic genes account for 15% of nephrolithiasis/nephrocalcinosis. J Am Soc Nephrol. 2015; 26:543-551. DOI:
Braun DA, et al. Prevalence of Monogenic Causes in Pediatric Patients with Nephrolithiasis or Nephrocalcinosis. Clin J Am Soc Nephrol. 2016; 11:664-72. DOI:
Daga A, et al. Whole exome sequencing frequently detects a monogenic cause in early onset nephrolithiasis and nephrocalcinosis. Kidney Int. 2018; 93:204-213. DOI:
Santoro G, et al. Association analysis of 10 candidate genes causing Mendelian calcium nephrolithiasis in the INCIPE study: a South European general population cohort. Clin Kidney J. 2023; 16:521-527. DOI:
Ferraro PM, et al. When to suspect a genetic disorder in a patient with renal stones, and why. Nephrol Dial Transplant 2013; 28:811-820. DOI:
Pearle MS, Goldfarb DS, Assimos DG, et al. American Urological Assocation. Medical management of kidney stones: AUA guideline. J Urol. 2014; 192:316-24. DOI:
Williams JC Jr, Gambaro G, Rodgers A, et al. Urine and stone analysis for the investigation of the renal stone former: a consensus conference. Urolithiasis. 2021; 49:1-16. DOI:
Siener R, Buchholz N, Daudon M, et al. EAU Section of Urolithiasis (EULIS). Quality Assessment of Urinary Stone Analysis: Results of a Multicenter Study of Laboratories in Europe. PLoS One. 2016; 11:e0156606. DOI:
Cloutier J, Villa L, Traxer O, Daudon M. Kidney stone analysis: "Give me your stone, I will tell you who you are!". World J Urol. 2015; 33:157-69. DOI:
Estrade V, De Senneville BD, Meria P, et al. Toward improved endoscopic examination of urinary stones: A concordance study between endoscopic digital pictures vs microscopy. BJU Int. 2020. DOI:
Keller EX, De Coninck V, Doizi S, et al. Thulium fiber laser: ready to dust all urinary stone composition types? World J Urol 2020; 38:1883-94. DOI:
Almeras C, Pradere B, Estrade V. Meria P. On behalf of the Lithiasis Committee of the French Urological Association Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review. J. Clin. Med. 2021; 10:2888. DOI:
Sampogna G, Basic D, Geavlete P, et al. En representación del grupo SEGUR. Endoscopic identification of urinary stone composition: A study of South Eastern Group for Urolithiasis Research (SEGUR 2). Actas Urol Esp (Engl Ed). 2021; 45:154-159. DOI:
Costa-Bauzá A, Grases F, Julià F. The power of desktop scanning electron microscopy with elemental analysis for analyzing urinary stones. Urolithiasis. 2023; 51:50. DOI:
Racek M, Racek J, Hupáková I. Scanning electron microscopy in analysis of urinary stones. Scand J Clin Lab Invest 2019; 79:208-217. DOI:
Bazin D, Bouderlique E, Daudon M, et al. Scanning electron microscopy-a powerful imaging technique for the clinician. C. R. Chimie 2022; 25:37-60. DOI:
Ticinesi A, Nouvenne A, Meschi T. Gut microbiome and kidney stone disease: not just an Oxalobacter story. Kidney Int. 2019; 96:25-27. DOI:
Lee JA, Stern JM. Understanding the Link Between Gut Microbiome and Urinary Stone Disease. Curr Urol Rep. 2019; 20:19. DOI:
Kachroo N, Lange D, Penniston KL, et al. Standardization of microbiome studies for urolithiasis: an international consensus agreement. Nat Rev Urol. 2021; 18:303-311. DOI:
Yuan T, Xia Y, Li B, et al. Gut microbiota in patients with kidney stones: a systematic review and meta-analysis. BMC Microbiol. 2023; 23:143. DOI:
Wolfe AJ, Toh E, Shibata N, et al. Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol. 2012; 50:1376-83. DOI:
Adomako EA, Li X, Sakhaee K, et al. Urine pH and Citrate as Predictors of Calcium Phosphate Stone Formation. Kidney360. 2023; 4:1123-1129. DOI:
Sromicki J, Kacl G, Föhl M, Hess B. Prospective long-term evaluation of incomplete distal renal tubular acidosis in idiopathic calcium nephrolithiasis diagnosed by low-dose NH4CL loading - gender prevalences and impact of alkali treatment. J Nephrol. 2022; 35:1619-1626. DOI:
Wiederkehr MR, Moe OW. Uric Acid Nephrolithiasis: A Systemic Metabolic Disorder. Clin Rev Bone Miner Metab. 2011; 9:207-217. DOI:
Grases F, Costa-Bauzá A, Gomila I, et al. Urinary pH and renal lithiasis. Urol Res. 2012; 40:41-6. DOI:
Julià F, Costa-Bauza A, Berga F, Grases F. Effect of theobromine on dissolution of uric acid kidney stones. World J Urol. 2022; 40:2105-2111. DOI:
Daudon M, Frochot V. "Crystalluria" Clinical Chemistry and Laboratory Medicine (CCLM)[Internet]. 2015; 53: s1479-s1487. DOI:
Siener R. Nutrition and Kidney Stone Disease. Nutrients 2021;13:1917. DOI:
Kok DJ. Metaphylaxis, diet and lifestyle in stone disease. Arab J Urol. 2012; 10:240-9.
Kok DJ, Papapoulos SE, Bijvoet OLM. Excessive crystal agglomeration with low citrate excretion in recurrent stone formers. Lancet 1986;i:1056-1058. DOI:
Kok DJ. The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease? Urolithiasis 2016; 44:83-90
Kok DJ, Boellaard W, Ridwan Y, Levchenko VA. Timelines of the “free-particle” and “fixed particle” models of stone-formation: theoretical and experimental investigations. Urolithiasis 2017; 45:33-41.
Laube N, Kleinen L. Risk indices. In Rao PN, Preminger GM, Kavanagh JP (eds.), Urinary Tract Stone Disease, Springer-Verlag, London. 2011; pp. 355-368. DOI:
Galan J. New medical device to monitor the urine pH of stone former patients. 14th Meeting of the International Urolithiasis Society in conjunction with the 5th Experts in Stone Disease Conference , June 10-11, Athens, Greece 2022.
Robertson WG, Peacock M. The cause of idiopathic calcium stone disease: hypercalciuria or hyperoxaluria?. Nephron 1980; 26:105-10. DOI:
Rimer JD, Kolbach-Mandel AM, Ward MD, Wesson JA. The role of macromolecules in the formation of kidney stones. Urolithiasis. 2017;45:57-74. DOI:
Negri AL, Spivacow FR. Kidney stone matrix proteins: Role in stone formation. World Journal of Nephrology. 2023; 12:21. DOI:
Schönauer R, Scherer L, Nemitz-Kliemchen M, et al. Systematic assessment of monogenic etiology in adult-onset kidney stone formers undergoing urological intervention-evidence for genetic pretest probability. Am J Med Genet C Semin Med Genet. 2022; 190:279-288. DOI:
Liu Y, Ge Y, Zhan R, et al. Identification of mutations in 15 nephrolithiasis-related genes leading to a molecular diagnosis in 85 Chinese pediatric patients. Pediatr Nephrol. 2023; 38:3645-3661. DOI:
Langman CB. A rational approach to the use of sophisticated genetic analyses of pediatric stone disease. Kidney Int. 2018; 93:15-18. DOI:
Prot-Bertoye C, Lebbah S, Daudon M, et al. French Cystinuria Group. CKD and Its Risk Factors among Patients with Cystinuria. Clin J Am Soc Nephrol. 2015; 10:842-51. DOI:
Sánchez Pintos P, Cocho de Juan JÁ, et al. Evaluación y perspectiva de 20 años de cribado neonatal en Galicia. Resultados del programa [Evaluation and perspective of 20 years of neonatal screening in Galicia. Program results.]. Rev Esp Salud Publica. 2020; 94:e202012161.
Piñero-Fernández JA, Vicente-Calderón C, Lorente-Sánchez MJ, et al. Phenotypic characterization of a pediatric cohort with cystinuria and usefulness of newborn screening. Pediatr Nephrol. 2023; 38:1513-1521. DOI:
Fuchs F, Rodriguez A, Mousty E, et al. Postnatal outcome of children with antenatal colonic hyperechogenicity. Prenat Diagn. 2024; 44:28-34 DOI:
Dejban P, Lieske JC. New therapeutics for primary hyperoxaluria type 1. Curr Opin Nephrol Hypertens. 2022; 31:344-350. DOI:
van Woerden CS, Groothoff JW, Wanders RJ, et al. Primary hyperoxaluria type 1 in The Netherlands: prevalence and outcome. Nephrol Dial Transplant. 2003; 18:273-9. DOI:
Chen P, Cen L, Wang Y, et al. Rapid binary visual detection of oxalate in urine samples of urolithiasis patients via competitive recognition and distance reading test strips. J Mater Chem B. 2023; 11:2530-2537. DOI:
Daudon M, Estepa L, Lacour B, Jungers P. Unusual morphology of calcium oxalate calculi in primary hyperoxaluria. J Nephrol. 1998; 11(Suppl 1):51-5.
Ganesan C, et al. Prevalence of twenty-four hour urine testing in Veterans with urinary stone disease. PLoS One 2019; 14:e0220768. DOI:
Ferraro PM, et al. Practice patterns of kidney stone management across European and non European centers: an in-depth investigation from the European Renal Stone Network (ERSN). J Nephrol 2021; 34:1337-1346. DOI:
Goldfarb DS. Empiric therapy for kidney stones. Urolithiasis 2019; 47:107-113. DOI:
Lombardi GM, et al. The optimal length of pharmacological prophylaxis in calcium kidney stone formers. KIDNEY360. 2023; 4:1318- 1321. DOI:
Stamatelou K, Goldfarb DS. Epidemiology of Kidney Stones. Healthcare (Basel). 2023; 11:424. DOI:
Fakheri RJ, Goldfarb DS. Ambient temperature as a contributor to kidney stone formation: implications of global warming. Kidney Int. 2011; 79:1178-85. DOI:
Maline GE, Goldfarb DS. Climate change and kidney stones. Curr Opin Nephrol Hypertens. 2024; 33:89-96. DOI:
Trinchieri A, Maletta A, Simonelli G, et al. Time changes in the spectrum of urinary stone composition: a role for climate variations? BMC Nephrol. 2020; 21:535. DOI:
Rendina D, De Filippo G, De Pascale F, et al. The changing profile of patients with calcium nephrolithiasis and the ascendancy of overweight and obesity: a comparison of two patient series observed 25 years apart. Nephrol Dial Transplant. 2013; 28(Suppl 4):iv146-51. DOI:
Nouvenne A, Ticinesi A, Allegri F, et al. Twenty-five years of idiopathic calcium nephrolithiasis: has anything changed? Clin Chem Lab Med. 2014; 52:337-44. DOI:
Kok DJ, Khan SR. Calcium oxalate Nephrolithiasis, a free or fixed particle disease. Kidney International. 1994; 46:847-854. DOI:
Mathoera RB, Kok DJ, Verduin K, Nijman RJM. Pathological and therapeutical significance of cellular invasion by Proteus Mirabilis in an enterocystoplasty infection stone model. Infect Immun. 2002; 70:7022-7032. DOI:
Salahuddin S, Hsu YS, Buchholz NP, et al. Is Indinavir crystalluria an indicator for indinavir stone formation? AIDS. 2001; 15:1079-1080. DOI:
Dieleman JP, Salahuddin S, Hsu YS, et al. Indinavir crystallisation under loop of Henle conditions: experimental evidence. J Acq Immun Def Synd. 2001; 28:9-13. DOI:
Kok DJ, Boellaard W, Ridwan Y, Levchenko VA. Timelines of the “free-particle” and “fixed particle” models of stone-formation: theoretical and experimental investigations. Urolithiasis. 2017; 45:33-41. DOI:
Kok DJ. The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease? Urolithiasis. 2016; 44:83-90.
Kok DJ. Metaphylaxis, diet and lifestyle in stone disease. Arab J Urol. 2012; 10:240-9. DOI:
Kok DJ. The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease? Urolithiasis. 2016; 44:83-90. DOI:
Hameed BMZ, Shah M, Naik N, et al. The Ascent of Artificial Intelligence in Endourology: a Systematic Review Over the Last 2 Decades. Curr Urol Rep. 2021; 22:53. DOI:
El Beze J, Mazeaud C, Daul C, et al. Evaluation and understanding of automated urinary stone recognition methods. BJU Int. 2022; 130:786-798. DOI:
Onal EG, Tekgul H. Assessing kidney stone composition using smartphone microscopy and deep neural networks. BJUI Compass. 2022; 3:310-315. DOI:
Rodgers A, Trinchieri A. Fifty years of basic and clinical renal stone research: have we achieved major breakthroughs? A debate. Curr Opin Nephrol Hypertens. 2023; 32:177-182. DOI:
Jungers P, Joly D, Blanchard A, et al. Lithiases rénales héréditaires monogéniques : récents acquis diagnostiques et thérapeutiques [Inherited monogenic kidney stone diseases: recent diagnostic and therapeutic advances]. Nephrol Ther. 2008; 4:231-55. DOI:
Tiselius HG, Daudon M, Thomas K, Seitz C. Metabolic Work-up of Patients with Urolithiasis: Indications and Diagnostic Algorithm. Eur Urol Focus. 2017; 3:62-71. DOI:

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Papatsoris, A., Alba, A. B., Galán Llopis, J. A., Musafer, M. A., Alameedee, M., Ather, H., Caballero-Romeu, J. P., Costa-Bauzá, A., Dellis, A., El Howairis, M., Gambaro, G., Geavlete, B., Halinski, A., Hess, B., Jaffry, S., Kok, D., Kouicem, H., Llanes, L., Lopez Martinez, J. M., Popov, E., Rodgers, A., Soria, F., Stamatelou, K., Trinchieri, A., & Tuerk, C. (2024). Management of urinary stones: state of the art and future perspectives by experts in stone disease. Archivio Italiano Di Urologia E Andrologia, 96(2).