Urolithiasis: evaluation, dietary factors, and medical management: an update of the 2014 SIU-ICUD international consultation on stone disease.
OBJECTIVE
The aim of this review was to provide current best evidence for evaluation, dietary, and medical management of patients with urolithiasis.


METHODS
Literature addressing evaluation, dietary, and medical management of urolithiasis was searched. Papers were analyzed and rated according to level of evidence (LOE), whereupon a synthesis of the evidence was made. Grade of recommendation (GOR) was judged from individual clinical experience and knowledge of the evidence according to the Oxford Centre for Evidence-based Medicine.


RESULTS
It is obvious that different stone diseases influence the life of stone-forming individuals very differently, and that evaluation and medical management should be personalized according to risk of recurrence, severity of stone disease, presence of associated medical conditions, and patient's motivation. With regard to evaluation, dietary and medical management of patients with urolithiasis evidence from the literature suggest that selective metabolic evaluation may lead to rational dietary and medical management. Statements based on LOE and GOR are provided to guide clinical practice.


CONCLUSIONS
The provided evidence for evaluation of patients with urolithiasis aims at defining patients at high risk for recurrent/complicated stone disease. Based on this approach, evidence-based dietary and medical management regimes are suggested.
Urological Research Center, Lillebaelt Hospital, University of Southern Denmark, Kabbeltoft 25, 7100, Vejle, Denmark.
Helene
H
Jung
Department of Urology, McGill University, Montreal, QC, Canada.
Sero
S
Andonian
Department of Urology, U.A.B. School of Medicine, Birmingham, AL, USA.
Dean
D
Assimos
UPMC Department of Urology, Pittsburg, PA, USA.
Timothy
T
Averch
Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania.
Petrisor
P
Geavlete
Department of Urology, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Yasuo
Y
Kohjimoto
Klinik für Urologie, Universitätsmedizin Mainz, Mainz, Germany.
Andreas
A
Neisius
Bristol Urological Institute, Bristol, UK.
Joe
J
Philip
Department of Urology, Humanitas Research Hospital, Rozzano, Milan, Italy.
Alberto
A
Saita
Urolab Superspeciality Clinic, Andheri, Mumbai, India.
Hemendra
H
Shah
Urological Research Center, Lillebaelt Hospital, University of Southern Denmark, Kabbeltoft 25, 7100, Vejle, Denmark. palle.joern.osther@rsyd.dk.
Palle Jörn
PJ
Osther
D000493:Allopurinol / Q000627:therapeutic use; D004035:Diet Therapy / Q000379:methods*; D019468:Disease Management; D004232:Diuretics / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005440:Fluid Therapy / Q000379:methods*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D007259:Infrared Rays; D007669:Kidney Calculi / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy; D019357:Potassium Citrate / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use*; D013057:Spectrum Analysis; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D016482:Urinalysis; D052878:Urolithiasis / Q000175:diagnosis / Q000628:therapy*; D014961:X-Ray Diffraction
D004232:Diuretics; D006074:Gout Suppressants; D049993:Sodium Chloride Symporter Inhibitors; D000493:Allopurinol; D019357:Potassium Citrate
Diet; Follow-up; Imaging; Kidney calculi; Metabolic evaluation; Pharmacologic intervention; Prevention