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Metabolic risk-evaluation and prevention of recurrence in stone disease: does it make sense?

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Abstract

In this review, aspects on the importance of information on urine composition and selection of the most appropriate regimen for prevention of recurrence are discussed. For patients with urolithiasis the treatment is facilitated by urine analysis with estimates of supersaturation levels. Despite lack of strong scientific evidence for the benefit of selective versus non-selective prevention of recurrence in patients with calcium stone disease, there is currently both convincing and logical information in support of tailored/selective treatment regimens aiming at correction of abnormal target variables. Such an approach is also recommended in the EAU and AUA guidelines. It is important, however, that every preventive regimen is balanced between the effects on urine composition and patients’ tolerance to the treatment in order to achieve satisfactory compliance. It is possible that future improved understanding of the causes of calcium stone formation might provide a different therapeutic approach.

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  1. Division of Urology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden

    Hans-Göran Tiselius

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Correspondence to Hans-Göran Tiselius.

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Tiselius, HG. Metabolic risk-evaluation and prevention of recurrence in stone disease: does it make sense?. Urolithiasis 44, 91–100 (2016). https://doi.org/10.1007/s00240-015-0840-y

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