| |
Title: |
 |
Urolithiasis: Update on Metabolic Evaluation of Stone Formers |
| |
Authors: |
|
Pearle, Margaret S.; Park, Sangtae |
|
| |
Journal: |
|
TheScientificWorldJOURNAL |
|
| |
Year: |
|
2005 |
|
| |
Volume: |
|
5 |
|
| |
Page Range: |
|
902-914 |
|
| |
Article Type: |
|
Review Article |
|
| |
Handling Editor: |
|
Anthony Atala |
|
| |
Domains: |
|
Urology
|
|
| |
DOI: |
|
10.1100/tsw.2005.118 |
|
 ?
|
Article clouds not enabled. Press the image to enable for this session.
|
| |
Synopsis: |
|
Urolithiasis is a common malady that affects a large proportion of the adult population at some time in their lives. The causes of urolithiasis have been well studied and treatment regimens consisting of dietary measures and medication have been largely successful in reducing stone recurrence rates. However, because of the ease of treatment of upper urinary tract stones with minimally or noninvasive means, metabolic evaluation and medical treatment are often overlooked. We review the simplified and comprehensive approaches to metabolic evaluation of stone formers. |
|
| |
Keywords: |
|
nephrolithiasis, metabolic evaluation, mineral metabolism |
|
| |
|
|
|
|
| |
|
|
[Related TSW Articles]
[Export to EndNote]
[Open Choice]
|
|
| |
|
|
|
|
| |
|
|
Abstract |
|
| |
|
|
Metabolic abnormalities are identified in over 90% of stone formers and the institution of preventative dietary and medical measures has resulted in substantial reduction in stone recurrence rates. We review the contemporary approach to metabolic evaluation of urolithiasis.
A careful medical and dietary history, stone analysis, serologic tests, and urinalysis constitute the initial screening regimen in patients who have been diagnosed with stones. Risk stratification of patients, based on the outcome of the initial screening tests, determines the need for and extent of urinary evaluation in individual stone formers. Conservative dietary measures or a simple metabolic evaluation and treatment has been described for first-time or low-risk stone formers, although the number of 24-h urine collections needed is debatable. A more extensive metabolic evaluation is recommended for recurrent or high-risk stone formers or for those in whom empiric treatment or medical therapy based on simplified evaluation is unsuccessful.
Regardless of etiology, all stone formers should be counseled on dietary measures for stone prevention. The need for medication is determined by the results of 24-h urine analysis and the risk level of the patient. Cost effectiveness of the metabolic evaluation and treatment is strongly influenced by recurrence rate and efficacy of therapy.
Metabolic evaluation and treatment has clearly been shown in randomized trials to reduce stone recurrence rates. Further study will determine the extent of evaluation necessary and the need for selective vs. empiric medical therapy for first-time and recurrent stone formers. |
|
| |
|
|
Related articles in:
|
|
| |
|
|
|
|
| |
|
|
| |
Post Your Comment |
 |
|
|
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|