J Clin Outcomes Manage
Nephrolithiasis management and prevention: current perspectives
Brener Z, Bergman MO
Abstract Objective: To discuss current approaches to management and prevention of kidney stones. Methods: Review of the literature. Results: Nephrolithiasis is a major cause of morbidity involving the urinary tract. The prevalence of this disease in the United States is rising, especially in men and with increased age. About 80% of stones are composed of calcium oxalate with variable amounts of calcium phosphate. Stone formation is associated with increased rates of chronic kidney disease and hypertension. Management mainstays of acute renal colic include pain relief, fluid resuscitation, and referral to a urologist. Preventing recurrence is largely specific to the type of stone; howewer, even when the stone cannot be retrieved, urine pH and 24-hour urine assessment provide information about preventable stone-forming factors. Managing diet, medication use, and nutrient intake can help prevent the development of kidney stones. Surgery may be required in selected severe cases. Conclusion: Improved awareness and education in both the general population and among health care providers about modifiable risk factors has the potential to improve general health and decrease morbidity and mortality secondary to kidney stone disease.
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