title: Nephrolithiasis: current concepts in medical management.
abstract: Advances in renal lithiasis research have contributed to a better understanding of the many varied factors that contribute to renal calculus formation. Utilizing the newer techniques of ambulatory metabolic evaluation, we can establish a specific diagnosis in 95% of recurrent stone-formers. Since a significant percentage of initial stone-formers will never have a second episode, it is essential to establish the natural history of the patient's stone disease prior to initiating potentially life-long medical therapy. The majority of initial stone-formers can be managed with education concerning modest dietary restrictions and increased fluid intake. For the recurrent stone-former with metabolically active stone disease, it is probably best to design medical therapy to treat the specific urinary chemical abnormality or disease process.
mesh_terms: D000141:Acidosis, Renal Tubular / Q000150:complications; D001424:Bacterial Infections / Q000150:complications; D002118:Calcium / Q000378:metabolism / Q000652:urine; D003461:Crystallography; D003555:Cystinuria / Q000209:etiology; D004231:Diuresis; D005440:Fluid Therapy; D006801:Humans; D007408:Intestinal Absorption; D007668:Kidney / Q000002:abnormalities; D007669:Kidney Calculi / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008274:Magnesium / Q000378:metabolism; D017616:Magnesium Compounds; D010070:Oxalates / Q000378:metabolism; D010353:Patient Education as Topic; D010710:Phosphates / Q000378:metabolism; D012008:Recurrence; D012306:Risk; D000069877:Struvite; D014527:Uric Acid / Q000652:urine; D014567:Urography
chemical_list: D017616:Magnesium Compounds; D010070:Oxalates; D010710:Phosphates; D014527:Uric Acid; D000069877:Struvite; D008274:Magnesium; D002118:Calcium