Medical management of kidney stones: AUA guideline.


Journal Article

PURPOSE: The purpose of this guideline is to provide a clinical framework for the diagnosis, prevention and follow-up of adult patients with kidney stones based on the best available published literature. MATERIALS AND METHODS: The primary source of evidence for this guideline was the systematic review conducted by the Agency for Healthcare Research and Quality on recurrent nephrolithiasis in adults. To augment and broaden the body of evidence in the AHRQ report, the AUA conducted supplementary searches for articles published from 2007 through 2012 that were systematically reviewed using a methodology developed a priori. In total, these sources yielded 46 studies that were used to form evidence-based guideline statements. In the absence of sufficient evidence, additional statements were developed as Clinical Principles and Expert Opinions. RESULTS: Guideline statements were created to inform clinicians regarding the use of a screening evaluation for first-time and recurrent stone formers, the appropriate initiation of a metabolic evaluation in select patients and recommendations for the initiation and follow-up of medication and/or dietary measures in specific patients. CONCLUSIONS: A variety of medications and dietary measures have been evaluated with greater or less rigor for their efficacy in reducing recurrence rates in stone formers. The guideline statements offered in this document provide a simple, evidence-based approach to identify high-risk or interested stone-forming patients for whom medical and dietary therapy based on metabolic testing and close follow-up is likely to be effective in reducing stone recurrence.

Full Text

Duke Authors

Cited Authors

  • Pearle, MS; Goldfarb, DS; Assimos, DG; Curhan, G; Denu-Ciocca, CJ; Matlaga, BR; Monga, M; Penniston, KL; Preminger, GM; Turk, TMT; White, JR; American Urological Assocation,

Published Date

  • August 2014

Published In

Volume / Issue

  • 192 / 2

Start / End Page

  • 316 - 324

PubMed ID

  • 24857648

Pubmed Central ID

  • 24857648

Electronic International Standard Serial Number (EISSN)

  • 1527-3792

Digital Object Identifier (DOI)

  • 10.1016/j.juro.2014.05.006


  • eng

Conference Location

  • United States