Environmental determinants in the development of kidney stone.

The increase with years of kidney stone prevalence has become a serious public health problem worldwide. The geographical distribution pattern of kidney stone (known as "stone belt") clearly indicates the critical role of environmental exposure in its formation, which has long been an underestimated risk factor in studying the development of kidney stone. Based on our previous studies and bibliometric analysis, we discerned four environmental determinants and elaborated their impacts on human internal exposure related to kidney stone formation. The importance of climatic factor lies in that the relatively high temperature and low humidity environment may contribute greater prevalence of kidney stone, since it promotes elevating the concentration of relatively insoluble stone-forming salts. Geological factors including water quality, hydrogeology, and soil environment is involved in kidney stone formation via the food chain. Additionally, air pollution and heavy metal pollutants also act as potential risk factors by directly or indirectly affecting the normal renal function and urinary metabolism. This review thus provides insights into the specific mechanisms affecting metabolic changes in the human body which result in kidney stone formation under environmental exposure, and shed light on the pathogenesis of nephrolithiasis from an interdisciplinary perspective.