Medical treatment of nephrolithiasis.
The medical treatment of nephrolithiasis is aimed in particular at the prevention of relapses, even though in some cases, such as cystine or uric acid lithiasis, the calculi also can be dissolved on site. When the diagnosis and metabolic profile have been performed correctly, medical treatment is effective in a large number of patients. The greatest difficulty is the patient's compliance with the most suitable prevention measures and the frequency of follow-up controls. This compliance can be influenced significantly by the amount of time that the doctor spends to explain the origin of the disease. This article reviews the main methods available for the medical treatment of various nephrolithiasis types, namely water intake, diet, and drugs, supplying the relevant information about the mechanism of action, metabolic consequences, indications, evidence provided from studies, dosage, efficacy, and side-effects. Finally, brief simplified guidelines are given for the medical treatment of stone disease caused by calcium oxalate or calcium phosphate, uric acid, cystine, and struvite.
Borghi
Loris
L
Department of Clinical Sciences, University of Parma, Via Gramsci 14, 43100 Parma, Italy. loris.borghi@unipr.it
Meschi
Tiziana
T
Schianchi
Tania
T
Allegri
Franca
F
Guerra
Angela
A
Maggiore
Umberto
U
Novarini
Almerico
A
D001581:Benzothiadiazines; D002136:Calcium, Dietary / Q000378:metabolism; D004040:Dietary Carbohydrates / Q000378:metabolism; D004044:Dietary Proteins / Q000378:metabolism; D004232:Diuretics; D004326:Drinking / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D006801:Humans; D007669:Kidney Calculi / Q000178:diet therapy* / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D049993:Sodium Chloride Symporter Inhibitors / Q000494:pharmacology
D001581:Benzothiadiazines; D002136:Calcium, Dietary; D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors