Evidence Report: Risk of Renal Stone Formation

Kidney stone formation and passage has the potential to greatly impact mission success and crewmember health, especially for long-duration missions. Alterations in hydration state (relative dehydration), spaceflight-induced changes in urine biochemistry (urine super-saturation), and bone metabolism (increased calcium excretion) during exposure to microgravity may increase the risk of kidney stone formation. There are possible countermeasures and treatments available that are used terrestrially that may then be applied to spaceflight.

Directed Acyclic Graphs (DAGs) are used throughout this document to communicate spaceflight conditions that may lead to renal stone formation, the countermeasures that may be used to prevent their formation, and possible treatment modalities. The DAGs are sorted by strength of evidence, according to Table 6. Additionally, for the full Renal Stone Evidence Report Content: Directed Acyclic Graphs and Evidence Report, please see Appendix A, Expanded Directed Acyclic Graphs (DAGs) and Evidence.

Additionally, a proposed Concept of Operations for the Prevention, Diagnosis, and Treatment of Renal Stones for a Mars Mission was created in conjunction with and to complement this Evidence Report update. Please see Appendix B, Proposed Expanded Concept of Operations for the Prevention, Diagnosis and Treatment of Renal Stones for Mars Missions, for the full report. Areas in the following Evidence Report will be cross-linked to scenarios from the Concept of Operations.