Medical management of renal stones

Abstract

The prevalence of kidney stones is increasing in industrialized nations, resulting in a corresponding rise in economic burden. Nephrolithiasis is now recognized as both a chronic and systemic condition, which further underscores the impact of the disease. Diet and environment play an important role in stone disease, presumably by modulating urine composition. Dietary modification as a preventive treatment to decrease lithogenic risk factors and prevent stone recurrence has gained interest because of its potential to be safer and more economical than drug treatment. However, not all abnormalities are likely to be amenable to dietary therapy, and in some cases drugs are necessary to reduce the risk of stone formation. Unfortunately, no new drugs have been developed for stone prevention since the 1980s when potassium citrate was introduced, perhaps because the long observation period needed to demonstrate efficacy discourages investigators from embarking on clinical trials. Nonetheless, effective established treatment regimens are currently available for stone prevention.

Administration of calcium and vitamin D supplementation in kidney stone formers

“…It has been demonstrated that intake of calcium supplements both with and without meal increases urine calcium, but because of binding of dietary oxalate with calcium when it is taken with meal, the amount of intestinal oxalate absorption and its urine secretion declines and the rate of stone formation would not increase (13). Of note, apart from calcium intake in high amounts, several other dietary habits including low fluid intake, small intake of fruits and vegetable, large sodium intake, excessive consumption of diet rich in oxalate, and high meat intake are involved in stone formation (14). Therefore, patients who are taking calcium and vitamin D supplements should be advised to consider the foregoing predisposing factors of stone formation.…”

Dietary Habits among Patients with Kidney Stones: A Retrospective Study

“…A high prevalence of disease is commonly seen in countries such as Egypt, Saudi Arabia and Pakistan. It is suggested that a high temperature, inadequate fluid intake and low urine volume predispose to stone formation in these areas [10].…”

Applicability of percutaneous nephrolithotomy operation in a county State Hospital

“…Urinary system stone disease is encountered at a rate of 4-20 % in developed countries [1][2][3][4]. Our country is in the endemic zone for stone disease with an incidence rate of 15 percent [5,6].…”