INS and obesity due to melanocortin 4 receptor deficiency: MS is known to cause more uric acid stone formation, but studies in recent years indicate it increases the risk for calcium stones.8,15 The relationship of components of MS, diabetes, hypertension and obesity, to formation of kidney stones has been shown by previous studies.7,12,14,16-19 The insufficient response of peripheral tissues to insulin in circulation, known as insulin resistance, was held responsible for the pathophysiology of stone formation in these diseases.