Medical management of urinary stone disease.
Kidney stones occur in approximately 10% of patients in their lifetimes, and > 10 crystal types have been reported in the literature. After treatment, a subset of these patients will have recurrent calculi, leading to significant morbidity and potential for serious chronic renal disease. Detailed metabolic evaluation is indicated in patients at high risk for stone recurrence, as a reversible metabolic abnormality can be identified in > 90% of them. Once the patient's underlying physicochemical and physiologic derangements are defined, targeted medical therapy can be initiated in order to prevent growth of pre-existing stones and new stone formation. In this report, the author provides a comprehensive review of the presently available selective and nonselective pharmacologic treatments for stones. Several exciting investigational pharmaceutical agents for kidney stone prevention are also discussed. Although many of these agents are effective, there remain clinical scenarios in which existing medicines are insufficient.
Park
Sangtae
S
Department of Urology, University of Washington Medical Center, 1959 NE Pacific Ave., Box 356510, Seattle, WA 98195, USA. spark1@u.washington.edu
D003460:Crystallization; D016503:Drug Delivery Systems; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008659:Metabolic Diseases; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors