Role of stone analysis in metabolic evaluation and medical treatment of nephrolithiasis.

Published

Journal Article

BACKGROUND AND PURPOSE: Comprehensive metabolic evaluation has become an important aspect of the management of recurrent nephrolithiasis, yet the role of stone analysis is often neglected or perhaps underestimated. The purpose of this study was to determine the role of stone analysis in medical decision making in patients with recurrent nephrolithiasis. MATERIALS AND METHODS: We evaluated 100 consecutive stone-forming patients who had undergone compositional stone analysis as well as comprehensive metabolic evaluation at our institution. An analysis of stone composition in relation to metabolic disturbances was performed. Patients were stratified into two groups: calcium and non-calcium stone formers. RESULTS: Patients having non-calcium stones were found to have a metabolic analysis reflecting specific metabolic disorders. Alternatively, patients with calcium stones were heterogeneous with regard to metabolic disorders, but there was a significant likelihood of renal tubular acidosis in those patients with calcium phosphate calculi. On the basis of these results, a simplified metabolic evaluation and nonselective medical therapy based on stone composition was formulated to facilitate assessment, management, and monitoring of stone disease. CONCLUSIONS: Compositional stone analysis should be an integral part of the metabolic evaluation of patients with nephrolithiasis. Moreover, stone analysis alone may provide guidance for therapeutic treatment and obviate a formal metabolic evaluation.

Full Text

Duke Authors

Cited Authors

  • Kourambas, J; Aslan, P; Teh, CL; Mathias, BJ; Preminger, GM

Published Date

  • March 2001

Published In

Volume / Issue

  • 15 / 2

Start / End Page

  • 181 - 186

PubMed ID

  • 11325090

Pubmed Central ID

  • 11325090

International Standard Serial Number (ISSN)

  • 0892-7790

Digital Object Identifier (DOI)

  • 10.1089/089277901750134548

Language

  • eng

Conference Location

  • United States