Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers

Considering the variation in metabolic evaluation and medical management of kidney stone disease, this consensus review was created to discuss the metabolic activity of nephrolithiasis, define the difference between single and recurrent stone formers, and develop a schema for metabolic and radiologi...

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Main Authors: Daniel A. Wollin, Adam G. Kaplan, Glenn M. Preminger, Pietro Manuel Ferraro, Antonio Nouvenne, Andrea Tasca, Emanuele Croppi, Giovanni Gambaro, Ita P. Heilberg
Format: Article
Language:English
Published: Elsevier 2018-10-01
Series:Asian Journal of Urology
Online Access:http://www.sciencedirect.com/science/article/pii/S2214388218300596
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author Daniel A. Wollin
Adam G. Kaplan
Glenn M. Preminger
Pietro Manuel Ferraro
Antonio Nouvenne
Andrea Tasca
Emanuele Croppi
Giovanni Gambaro
Ita P. Heilberg
author_facet Daniel A. Wollin
Adam G. Kaplan
Glenn M. Preminger
Pietro Manuel Ferraro
Antonio Nouvenne
Andrea Tasca
Emanuele Croppi
Giovanni Gambaro
Ita P. Heilberg
author_sort Daniel A. Wollin
collection DOAJ
description Considering the variation in metabolic evaluation and medical management of kidney stone disease, this consensus review was created to discuss the metabolic activity of nephrolithiasis, define the difference between single and recurrent stone formers, and develop a schema for metabolic and radiologic follow-up. A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis. Both single and recurrent stone formers share many similarities in metabolic profiles. The study group determined that based on an assessment of risk for stone recurrence and metabolic activity, single and recurrent stone formers should be evaluated comprehensively, including two 24 h urine studies on a random diet. Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence. Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient, the risk of chronic kidney disease and the risk of osteoporosis/osteopenia. A standard scheme includes a baseline metabolic profile, a repeat study 3–6 months after initiation of treatment, and then yearly when stable, with abdominal imaging obtained every 1–2 years. Keywords: Follow-up, Medical management, Metabolic evaluation, Urolithiasis
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spelling doaj-art-778c80d11e004e8fa688c306f51c873c2025-08-20T02:07:09ZengElsevierAsian Journal of Urology2214-38822018-10-015423524210.1016/j.ajur.2018.06.007Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formersDaniel A. Wollin0Adam G. Kaplan1Glenn M. Preminger2Pietro Manuel Ferraro3Antonio Nouvenne4Andrea Tasca5Emanuele Croppi6Giovanni Gambaro7Ita P. Heilberg8Duke Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA; Corresponding author.Duke Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USADuke Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USAColumbus-Gemelli University Hospital, Division of Nephrology, Department of Medical Sciences, Rome, ItalyUniversity of Parma, Department of Clinical and Experimental Medicine, Parma, ItalyS. Bortolo Hospital, Department of Urology, Vicenza, ItalyColumbus-Gemelli University Hospital, Division of Nephrology, Department of Medical Sciences, Rome, ItalyColumbus-Gemelli University Hospital, Division of Nephrology, Department of Medical Sciences, Rome, ItalyUniversidade Federal de São Paulo, Nephrology Division, São Paulo, BrazilConsidering the variation in metabolic evaluation and medical management of kidney stone disease, this consensus review was created to discuss the metabolic activity of nephrolithiasis, define the difference between single and recurrent stone formers, and develop a schema for metabolic and radiologic follow-up. A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis. Both single and recurrent stone formers share many similarities in metabolic profiles. The study group determined that based on an assessment of risk for stone recurrence and metabolic activity, single and recurrent stone formers should be evaluated comprehensively, including two 24 h urine studies on a random diet. Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence. Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient, the risk of chronic kidney disease and the risk of osteoporosis/osteopenia. A standard scheme includes a baseline metabolic profile, a repeat study 3–6 months after initiation of treatment, and then yearly when stable, with abdominal imaging obtained every 1–2 years. Keywords: Follow-up, Medical management, Metabolic evaluation, Urolithiasishttp://www.sciencedirect.com/science/article/pii/S2214388218300596
spellingShingle Daniel A. Wollin
Adam G. Kaplan
Glenn M. Preminger
Pietro Manuel Ferraro
Antonio Nouvenne
Andrea Tasca
Emanuele Croppi
Giovanni Gambaro
Ita P. Heilberg
Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers
Asian Journal of Urology
title Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers
title_full Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers
title_fullStr Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers
title_full_unstemmed Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers
title_short Defining metabolic activity of nephrolithiasis – Appropriate evaluation and follow-up of stone formers
title_sort defining metabolic activity of nephrolithiasis appropriate evaluation and follow up of stone formers
url http://www.sciencedirect.com/science/article/pii/S2214388218300596
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