title: Tailored Metabolic Workup for Urolithiasis - The Debate Continues.
abstract: Urolithiasis is one of the commonest afflictions of the urinary tract. Stones are of various chemical compositions, some share some common etiology; but most are specific to the structure and composition of stone. In view of highly recurrent nature of this condition, it is logical to have strategies for prevention. However, due to multiple factors most patients receive no or fragmented information on prevention. The current controversy is to the extent of metabolic workup in adult first time stone former. This requires longitudinal studies to show benefit in prevention strategies. Patients at high risk can have recurrence in weeks to years, depending upon the composition and attending risk factor. They should be targeted with concentric and tailored prevention protocols. The major urological guidelines (EAU and AUA) recommend basic stone workup for all patients. However, indication for detailed workup are less well documented, so one potential solution is to tailor metaphylaxis strategies for individual patient.
authors.affiliation: Department of Surgery, The Aga Khan University Hospital, Karachi.
authors.forename: M. Hammad
authors.lastname: Ather
authors.affiliation: Department of Surgery, The Aga Khan University Hospital, Karachi.
authors.forename: M. Nasir
authors.lastname: Sulaiman
authors.affiliation: Department of Pathology, The Aga Khan University Hospital, Karachi.
authors.forename: Imran
authors.initials: I
authors.lastname: Siddiqui
authors.affiliation: Department of Biochemistry, Karachi Medical and Dental College (KMDC), Karachi.
authors.forename: Tahmeena
authors.initials: T
authors.lastname: Siddiqui
mesh_terms: D002118:Calcium / Q000378:metabolism*; D019468:Disease Management; D006801:Humans; D010070:Oxalates / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention / Q000592:standards*; D052878:Urolithiasis / Q000378:metabolism / Q000517:prevention & control / Q000628:therapy
chemical_list: D010070:Oxalates; D002118:Calcium