Kidney stones form as a result of the accumulation of mineral deposits on an organic matrix. They are more common in patients with metabolic and/or anatomical abnormalities that lead to urine supersaturation, have a prevalence of ~10% and recur in ~50% of patients at 5–10 years of follow-up. Known risk factors for kidney stones are obesity and metabolic syndrome, anatomical abnormalities leading to urinary stasis, dietary habits and genetic factors leading to potential dysregulation of urinary calcium, uric acid, oxalate and cystine concentrations. Kidney stones are diagnosed based on imaging, including ultrasonography, radiography and CT. Minimally invasive treatments, including shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotripsy, have largely replaced open surgery in kidney stone management. These modalities can achieve stone clearance, while minimizing complication rates, improving health-related quality of life and enabling a quicker return to daily activities compared to open surgery. Technological advances, such as advanced laser fibres and devices and suction technology, which are used during minimally invasive treatments, are further improving clinical outcomes. Kidney stone disease is a common and often recurrent disorder arising from complex interactions between genetic, metabolic, environmental and dietary factors. In this Primer, Tzelves et al. summarize the epidemiology and pathophysiology of this disease, discuss its diagnosis and management, and highlight patient quality of life and future research areas.
