thesis
Hyaluronan Biology and Regulation in Renal Tubular
Epithelial Cells and its Role in Kidney Stone Disease
- Publication date
- 3 September 2008
- Publisher
- Renal stone disease is a widespread problem afflicting more and more people throughout the
world. Epidemiological studies show an increase in incidence and prevalence rates. In North
America and Europe the yearly incidence is estimated to be about 0.5% 1, 2. The prevalence
of kidney stones in the USA has risen in two decades from 3.2% to 5.2% 3. The lifetime risk
is about 10-15% in the developed world, but can be as high as 20-25% in the middle east 1,
2. Kidney stone disease often presents as an episode of acute renal colic with characteristic
severe intermittent pain in the flank or lower abdomen, vomiting and haematuria caused by
a calculus obstructing the ureter 4. Renal stone disease has a substantial impact on the health
care system. For example, the total annual cost for urolithiasis in the United States in 1995
was estimated to be $1.83 billion 5. Nephrolithiasis is likely to recur and recurrence rates are
reported to be 50% in 10 years and 75% in 20 years 1. Apparently the development of minimal
invasive techniques for stone removal, such as extracorporal shock-wave lithotripsy (ESWL),
ureterorenoscopy (URS) and percutaneous nephrolitholapaxy (PCNL) together with current
standards to avoid stone recurrence such as general measures and metabolic therapy have
not resolved the increasing problem of (recurrent) stone formation 4, 6, 7. Therefore scientific
research is warranted to better understand the etiology of stone disease aimed at preventing
kidney stone formation in healthy people or stone recurrence in patients.