Metabolic Evaluation and Recurrence Prevention for Urinary Stone Patients: An EAU Guidelines Update.

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  • Additional Information
    • Source:
      Publisher: Elsevier Science Country of Publication: Switzerland NLM ID: 7512719 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-7560 (Electronic) Linking ISSN: 03022838 NLM ISO Abbreviation: Eur Urol Subsets: MEDLINE
    • Publication Information:
      Publication: 2002- : Amsterdam : Elsevier Science
      Original Publication: Basel, New York, Karger.
    • Subject Terms:
      Recurrence* ; Secondary Prevention*/methods ; Urinary Calculi*/prevention & control ; Urinary Calculi*/therapy; Humans ; Practice Guidelines as Topic ; Risk Assessment ; Risk Factors
    • Abstract:
      Background and Objective: The aim of this review was to define patients who are at high risk of recurrence of urolithiasis, to delineate diagnostic and therapeutic algorithms for each type of stone, and to clarify general guidelines and recommendations for prevention of recurrence.
      Methods: A professional research librarian carried out literature searches for all sections of the urolithiasis guidelines, covering the timeframe between 1976 and June 2023.
      Key Findings and Limitations: For every patient with urolithiasis, an attempt should be made to analyse the stone. Patients should be given general instructions on how to prevent recurrence, including adequate fluid and calcium intake, and low consumption of sodium and protein. Identifying and correcting the causative factors is a cornerstone in preventing the recurrence of urolithiasis. Diagnostic and therapeutic algorithms by stone composition are available. Every patient should undergo baseline metabolic screening, while patients with calcium stones, who are at high risk of relapse and complications, should undergo extensive metabolic screening with two 24-h urine collections and should receive targeted therapy. Patients with uric acid, infection, or cystine stones are at high risk of relapse. All patients at high risk of recurrence should be closely monitored, especially those not complying with therapy in the long term.
      Conclusions and Clinical Implications: Metabolic stone evaluation and patient follow-up are highly recommended to prevent urolithiasis recurrence.
      (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Follow-up; Metabolic evaluation; Prevention; Treatment; Urolithiasis
    • Publication Date:
      Date Created: 20240728 Date Completed: 20240921 Latest Revision: 20241013
    • Publication Date:
      20241014
    • Accession Number:
      10.1016/j.eururo.2024.05.029
    • Accession Number:
      39069389