It is time to look at stone disease in a holistic way

This issue of the AJU deals with stone disease, but perhaps not in the way you know it. Currently stone disease is recognised as a systemic and recurrent disease linked to many other socalled ‘civilisation’ diseases. Therefore the traditional surgical approach of ‘break it’, ‘forget it’ and ‘wait until it comes back’ is slightly outdated. Of course, surgical advances in minimally invasive technologies for stone removal are rapid, fascinating and important. No special issue on stones would be complete without them. However, it is time to look at stone disease in a holistic way. It starts from understanding the mechanisms of stone disease on a tubular and crystalline level, understanding eventual genetic predispositions, and understanding causes and interactions between metabolism, diet and other chronic diseases, and stone disease. Then comes the increasingly sophisticated and minimalistic treatments. Finally, once the stone is removed the task of the stone doctor is not finished. Metaphylaxis and prophylaxis are undoubtedly necessary and called for in health economic terms, and the patient must be convinced of an often life-long therapy. We have tried to cover all of these aspects and more in this issue, and I hope we will be able to raise awareness that a stone is much more than just a nuisance to get rid of for the moment.