Prevention of nephrolithiasis.
The high incidence of recurrence after an initial stone event underscores the need for an effective medical prophylactic program. Dietary modification and drug therapies have long been advocated to reduce the likelihood of stone recurrence. While the efficacy of a high fluid intake has been validated in a randomized trial, the benefit of other dietary measures is based on modulation of urinary stone risk factors and outcomes derived from observational studies. Several drug therapies have been evaluated in a limited number of prospective, randomized trials and efficacy has been demonstrated for thiazides, allopurinol and alkali citrate in some populations of recurrent stone formers. The role of selective versus nonselective therapy for stone prevention awaits further study.
Department of Urology, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA. margaret.pearle@email.SWMED.edu
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D000493:Allopurinol / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000008:administration & dosage; D001581:Benzothiadiazines; D002136:Calcium, Dietary / Q000008:administration & dosage; D019343:Citric Acid / Q000627:therapeutic use; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D004232:Diuretics; D004326:Drinking; D006801:Humans; D007669:Kidney Calculi / Q000178:diet therapy / Q000188:drug therapy / Q000517:prevention & control*; D008274:Magnesium / Q000627:therapeutic use; D019815:Oxalic Acid / Q000008:administration & dosage; D010710:Phosphates / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use; D012982:Sodium, Dietary / Q000008:administration & dosage
D001581:Benzothiadiazines; D002136:Calcium, Dietary; D004044:Dietary Proteins; D004232:Diuretics; D010710:Phosphates; D049993:Sodium Chloride Symporter Inhibitors; D012982:Sodium, Dietary; D019343:Citric Acid; D000493:Allopurinol; D019815:Oxalic Acid; D008274:Magnesium; D001205:Ascorbic Acid