From stones to system: integrating kidney stones disease into the cardiovascular-kidney-metabolic continuum

Embedding kidney stone disease prevention within a cardiovascular-kidney-metabolic program supports value-based outcomes. A hybrid "Care, Remote Monitoring, Medication optimization, Nudges pathway" links early risk identification to telemonitoring and titration. Integrating urinary lithogenic profiling into cardiovascular-kidney-metabolic screening flags asymptomatic patients with lithogenic profiles before a first stone, enabling prevention of stones and chronic kidney disease progression. Priorities consist in validation of digital urinary biomarkers (time-in-target volume/pH) and deployment of hybrid care. This patient-centred hybrid model can shift current episodic procedures to anticipatory, measurable, and scalable prevention within routine cardiovascular-kidney-metabolic care.