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2017 ; 8
(ä): 67
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Preventive Kidney Stones: Continue Medical Education
#MMPMID28966756
Assadi F
; Moghtaderi M
Int J Prev Med
2017[]; 8
(ä): 67
PMID28966756
show ga
Nephrolithiasis is a common health problem across the globe with a prevalence of
15%-20%. Idiopathic hypercalciuria is the most common cause of nephrolithiasis,
and calcium oxalate stones are the most common type of stones in idiopathic
hypercalciuric patients. Calcium phosphate stones are frequently associated with
other diseases such as renal tubular acidosis type 1, urinary tract infections,
and hyperparathyroidism. Compared with flat abdominal film and renal sonography,
a noncontrast helical computed tomography scan of the abdomen is the diagnostic
procedure of choice for detection of small and radiolucent kidney stones with
sensitivity and specificity of nearly 100%. Stones smaller than 5 mm in diameter
often pass the urinary tract system and rarely require surgical interventions.
The main risk factors for stone formation are low urine output, high urinary
concentrations of calcium, oxalate, phosphate, and uric acid compounded by a
lower excretion of magnesium and citrate. A complete metabolic workup to identify
the risk factors is highly recommended in patients who have passed multiple
kidney stones or those with recurrent disease. Calcium oxalate and calcium
phosphate stones are treated by the use of thiazide diuretics, allopurinol, and
potassium citrate. Strategies to prevent kidney stone recurrence should include
the elimination of the identified risk factors and a dietary regimen low in salt
and protein, rich in calcium and magnesium which is coupled with adequate fluid
intake.
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