What are the leading causes of nephrolithiasis?
- The most common causes of nephrolithiasis are the various types of polygenic idiopathic hypercalciuria (IH): absorptive hypercalciuria (AH) types AH-I to AH-III (renal phosphate leak) and renal hypercalciuria (RH).
- Other causes are primary hyperparathyroidism, hyperoxaluria, hyperuricosuria, hyperphosphaturia, hypocitraturia, hypomagnesuria, infection stones, gouty diathesis, renal tubular acidosis, cystinuria, calcifying nanoparticles, and alterations in the microbiome.
- Rarely, kidney stones may form from xanthine, triamterene, monosodium urate, ephedrine, guaifenesin, ciprofloxacin, and sulfonamides, and more commonly from protease inhibitors indinavir, atazanavir, and darunavir.
- Patients with idiopathic nephrolithiasis make up 10% to 20% of “stone formers” in whom routine workup yields no identifiable cause.
