title: Prevention of renal stone disease recurrence. A systematic review of contemporary pharmaceutical options.
abstract: BACKGROUND
  Renal stone disease has a high recurrence rate. Prompt metabolic evaluation followed by appropriate medical management is of paramount importance for preventing disease recurrence.
  
  
  METHODS
  A PubMed/Medline search was performed to identify randomized controlled studies evaluating medical treatments against renal stone recurrence. Due to the limited number of published randomized studies, non-randomized studies of significant importance were included and reported.
  
  
  CONCLUSIONS
  Thiazides are widely used for lowering calcium levels in urine and thus preventing calcium stone formation. Citrate supplements may increase the urine citrate level and increase pH. Allopurinol has shown significant efficacy for preventing formation of calcium stones in hyperuricosuric patients. Prevention of recurrence of infection stones and cystine stones has not been widely studied. Several agents that are used today have shown efficacy outside randomized controlled studies. However, they may produce severe adverse events, which are minimizing their use.
authors.affiliation: The Hebrew University, Hadassah University Hospital , Jerusalem 92120 , Israel +972508946695 ; sfoungaristosst@gmail.com.
authors.forename: Stavros
authors.initials: S
authors.lastname: Sfoungaristos
authors.forename: Ofer N
authors.initials: ON
authors.lastname: Gofrit
authors.forename: Vladimir
authors.initials: V
authors.lastname: Yutkin
authors.forename: Dov
authors.initials: D
authors.lastname: Pode
authors.forename: Mordechai
authors.initials: M
authors.lastname: Duvdevani
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D002951:Citrates / Q000627:therapeutic use; D006801:Humans; D007669:Kidney Calculi / Q000188:drug therapy / Q000517:prevention & control*; D007710:Klebsiella Infections / Q000517:prevention & control; D011512:Proteus Infections / Q000517:prevention & control; D011552:Pseudomonas Infections / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D055502:Secondary Prevention; D049971:Thiazides / Q000627:therapeutic use
chemical_list: D002951:Citrates; D049971:Thiazides; D000493:Allopurinol
keywords: allopurinol; citrate; prevention; recurrence; renal stone; thiazides