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The natural history of urolithiasis includes the risk of recurrence and of the development of chronic kidney and/or bone disease, which is why a thorough clinical and metabolic evaluation of these patients is of the utmost importance at disease onset. This paper is aimed at identifying the type of urolithiasis, the related risk factors, and the corresponding treatment options. The diagnostic and therapeutic approach described here includes 1) accurate history taking to detect secondary nephrolithiasis and screen for the main risk factors for kidney and bone disease; 2) metabolic evaluation graded according to different complexity levels based on the severity of the disease and the presence of risk factors; 3) carrying out appropriate imaging procedures. The resulting information allows to plan treatment based either on general rules of lifestyle and diet, or on selected medical intervention, if necessary. This report, which is based on current guidelines, was produced by the Gruppo Italiano di Studio Multidisciplinare per la Calcolosi Renale. It is addressed to all professionals involved in the management of patients suffering from nephrolithiasis, first of all general practitioners, who often become involved immediately at the onset of the disease.

Paget's disease of bone is a focal skeletal disorder characterized by the formation of structurally abnormal bone, deformity and other complications leading to significant disability and bone pain. Recently, the availability of newer, more potent nitrogen-containing bisphosphonates has improved treatment outcomes, allowing a more effective and convenient management of this disorder.

Metabolic syndrome and nephrolithiasis are quite common disorders presenting similar epidemiological characteristics. Belonging to genetic, environmental and hormonal interaction, they have high incidence and prevalence in the adult population of industrialised countries and are characterised by a high level of morbidity and mortality if not adequately identified and treated. Despite metabolic syndrome is considered a fundamental risk factor for chronic kidney diseases, is not actually known whether it is associated with nephrolithiasis beyond the effect of its individual components, in particular obesity, glucose intolerance, and hypertension. In this paper, the possible pathogenetic links between metabolic syndrome and nephrolithiasis will be presented and discussed.