A holistic approach to urinary calculi: crystal formation, analysis, diagnosis and management

Urinary calculi, i.e. popularly known as urinary stones, are found in urinary/renal areas, which are mineral crystalline depositions. It is globally observed human suffering and leads to costly medical managements. Generally, in the urinary calculi, the crystalline depositions of calcium oxalate, calcium phosphate, struvite, uric acid and cystine are found either in a pure phase or mixed phase. The formation of calculi leads to often severe painful urinary disease, which is found in not only humans but animals and birds also. In this article, we review the mechanism of crystal formation of calculi, factors affecting crystal formation, calculi chemical composition, characterization, health risk due to urinary calculi, diagnosis methods, and method of treatment or management. Also the in vivo and in vitro models are discussed. Presently the in vitro gel-based model for the growth inhibition studies of urinary type crystals is discussed in detail through the approach of reverse pharmacology to rapidly screen pre-clinically the potential herbal formulations. The importance of alternate medicine, mathematical and computer modelling and artificial intelligence in management of urinary calculi is briefly discussed. The authors emphasize the holistic approach to deal with urinary calculi through all sciences, technologies and traditional knowledges available presently.