Mechanisms of stone formation: role of promoters and inhibitors.

This paper represents a review on the role played by promoters and inhibitors in the formation of urinary stones. It appears that both mechanisms are, together with the degree of supersaturation, important in the development of urolithiasis. For the promoting activity emphasis has shifted towards the role of crystals of one salt inducing epitactically the precipitation of another salt. For the inhibitors it is important to distinguish the effect on crystal growth and aggregation. While citrate, pyrophosphate and magnesium are probably the most relevant for crystal formation, glycosaminoglycans play the primary role for aggregation. This field is still at its beginnings, and it might be rewarding to focus future investigations both in the laboratory and clinically along these directions.