A comprehensive review of renal calculi (Ḥaṣā al-Kulya): Unani and modern understanding

Abstract

Nephrolithiasis, commonly termed urolithiasis, is characterized by the development of calculi anywhere within the urinary tract. The occurrence of this condition varies across different regions and is influenced by multiple factors, including climate, age, gender, dietary patterns, and genetic predisposition. The highest incidence is typically reported during the second and third decades of life, with males being affected more frequently than females in an approximate ratio of 2:1. Stone formation results from supersaturation of urinary solutes such as calcium, oxalate, and uric acid, along with low levels of citrate. This physicochemical imbalance promotes crystal aggregation and subsequent calculus formation. From the perspective of Unani medicine, calculi (Ḥaṣā) are believed to develop due to the retention and accumulation of dense, morbid matter (Mādda Ghalīẓ) within the organs, coupled with impaired expulsion. Progressive deposition of this material eventually leads to stone formation. The concept of Hararat (heat) contributes to the evaporation of Ratubat (moisture), resulting in desiccation (Tajfīf), condensation, and hardening of the retained matter into calculi.