title: Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement.
abstract: BACKGROUND
  Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research.
  
  
  METHODS
  A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved.
  
  
  RESULTS
  Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients.
  
  
  CONCLUSIONS
  This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified.
authors.affiliation: Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gambaro
authors.affiliation: , A.S.L. 10, Florence, Italy. emcroppi@mark.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Croppi
authors.affiliation: Department of Nephrology, University of Chicago Medicine, Chicago, USA.
authors.forename: Fredric
authors.initials: F
authors.lastname: Coe
authors.affiliation: Department of Urology, Indiana University School of Medicine, Indianapolis, USA.
authors.forename: James
authors.initials: J
authors.lastname: Lingeman
authors.affiliation: Department of Internal Medicine, Southwestern Medical Center, University of Texas, Dallas, USA.
authors.forename: Orson
authors.initials: O
authors.lastname: Moe
authors.affiliation: Department of Nephrology, University of Chicago Medicine, Chicago, USA.
authors.forename: Elen
authors.initials: E
authors.lastname: Worcester
authors.affiliation: Department of Urological Surgery, Sobeh's Vascular and Medical Center, Dubai, UAE.
authors.forename: Noor
authors.initials: N
authors.lastname: Buchholz
authors.affiliation: Department of Nephrology, Medical Center, University of Rochester, Rochester, USA.
authors.forename: David
authors.initials: D
authors.lastname: Bushinsky
authors.affiliation: Renal Division, Brigham and Women's Hospital, Boston, USA.
authors.forename: Gary C
authors.initials: GC
authors.lastname: Curhan
authors.affiliation: Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Pietro Manuel
authors.initials: PM
authors.lastname: Ferraro
authors.affiliation: Department of Nephrology, University of Bern, Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fuster
authors.affiliation: Department of Nephrology, New York Harbor VA Health Care System, New York, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Goldfarb
authors.affiliation: Department of Nephrology, Sao Paulo University, Sao Paulo, Brazil.
authors.forename: Ita Pfeferman
authors.initials: IP
authors.lastname: Heilberg
authors.affiliation: Department of Internal Medicine and Nephrology, Klinik Im Park Hospital, Zurich, Switzerland.
authors.forename: Bernard
authors.initials: B
authors.lastname: Hess
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA.
authors.forename: John
authors.initials: J
authors.lastname: Lieske
authors.affiliation: Department of Nephrology, A.S.O Ordine Mauriziano Hospital, Turin, Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Marangella
authors.affiliation: Department of Nephrology, Mayo Clinic, Rochester, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Milliner
authors.affiliation: Department of Urology, Duke University Medical Center, Durham, USA.
authors.forename: Glen M
authors.initials: GM
authors.lastname: Preminger
authors.affiliation: Department of Urology, Catholic University of Portugal, Lisbon, Portugal.
authors.forename: Jose' Manuel
authors.initials: JM
authors.lastname: Reis Santos
authors.affiliation: Southwestern Medical Center, Mineral Metabolism Research, University of Texas, Dallas, USA.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Sakhaee
authors.affiliation: Department of Urology, Dr. Lutfi KIRDAR Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Sarica
authors.affiliation: Department of Urology, University of Bonn, Bonn, Germany.
authors.forename: Roswitha
authors.initials: R
authors.lastname: Siener
authors.affiliation: Department of Internal Medicine, University of Naples, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Strazzullo
authors.affiliation: Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indiana, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Williams
mesh_terms: D015415:Biomarkers / Q000652:urine; D002118:Calcium / Q000652:urine*; D032921:Consensus; D003460:Crystallization; D006801:Humans; D033183:Interdisciplinary Communication; D053040:Nephrolithiasis / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control* / Q000652:urine; D000072104:Nephrologists; D010348:Patient Care Team; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D016896:Treatment Outcome; D016482:Urinalysis; D000072178:Urologists
chemical_list: D015415:Biomarkers; D002118:Calcium
keywords: Beverages; Bone disease; CKD; Diet; Nephrolithiasis; Renal tubular acidosis