Defining metabolic activity of nephrolithiasis - Appropriate evaluation and follow-up of stone formers.

Abstract

Considering the variation in metabolic evaluation and medical management of kidney stone disease, this consensus review was created to discuss the metabolic activity of nephrolithiasis, define the difference between single and recurrent stone formers, and develop a schema for metabolic and radiologic follow-up. A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis. Both single and recurrent stone formers share many similarities in metabolic profiles. The study group determined that based on an assessment of risk for stone recurrence and metabolic activity, single and recurrent stone formers should be evaluated comprehensively, including two 24 h urine studies on a random diet. Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence. Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient, the risk of chronic kidney disease and the risk of osteoporosis/osteopenia. A standard scheme includes a baseline metabolic profile, a repeat study 3-6 months after initiation of treatment, and then yearly when stable, with abdominal imaging obtained every 1-2 years.

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Published Version (Please cite this version)

10.1016/j.ajur.2018.06.007

Publication Info

Wollin, Daniel A, Adam G Kaplan, Glenn M Preminger, Pietro Manuel Ferraro, Antonio Nouvenne, Andrea Tasca, Emanuele Croppi, Giovanni Gambaro, et al. (2018). Defining metabolic activity of nephrolithiasis - Appropriate evaluation and follow-up of stone formers. Asian journal of urology, 5(4). pp. 235–242. 10.1016/j.ajur.2018.06.007 Retrieved from https://hdl.handle.net/10161/25545.

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Scholars@Duke

Preminger

Glenn Michael Preminger

James F. Glenn, M.D. Distinguished Professor of Urology
  1. Minimally invasive management of urologic diseases
    2. Minimally invasive management of renal and ureteral stones
    3. Medical management of nephrolithiasis
    4. Bioeffects of shock wave lithotripsy
    5. Basic physics of shock wave lithotripsy
    6. Intracorporeal lithotripsy for stone fragmentation
    7. Minimally invasive management of urinary tract obstruction, including ureteropelvic junction obstruction and ureteral strictures
    8. Enhanced imaging modalities for minimally invasive surgery
    9. Digital video imaging during endoscopic surgery
    10. 3-D imaging modalities for minimally invasive surgery
    11. Holmium laser applications in urology

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