Published online Jul 24, 2017. doi: 10.5410/wjcu.v6.i2.40
Peer-review started: November 10, 2016
First decision: February 16, 2017
Revised: February 26, 2017
Accepted: March 13, 2017
Article in press: March 13, 2017
Published online: July 24, 2017
Core tip: The supersaturation of urinary compounds has been considered during long time as a key risk factor for renal lithiasis. Nevertheless, theoretical studies demonstrate that the rate of spontaneous (homogeneous) nucleation of calcium oxalate monohydrate and brushite only occurs at urinary supersaturations much higher than conceivable in any individual. This demonstrates the necessity of presence of efficient substances or foreign solid particles for induced nucleation (heterogeneous) of lithiatic compounds. Consequently, urinary supersaturation per se is necessary but not sufficient condition for stone development. Fundamental condition of renal stone formation and development is presence of heteronuclei and significantly reduced content of crystal growth inhibitors. Identification of nucleation promoters and absence of crystal growth inhibitors is very important as a diagnostic aspect to avoid urolithiasis.