Kidney Stones:Diagnostic and Treatment Strategies

摘要

In patients with stone disease, multiple risk factors are often present, including high concentrations of crystalloids that exceed supersaturation, lack of inhibitors of stone formation, or excess promoter substances. You can best determine the type of stone by retrieving and analyzing it. If the stone cannot be recovered, consider clinical features, urinalysis results, and radiologic findings. The first line of treatment for any stone former is high fluid intake to increase urine volume. Thiazides are indicated in calcium stone formers with hypercalciuria, hypertension, or osteoporosis, but they may be beneficial in the absence of these conditions. Metabolic syndrome is associated with nephrolithiasis, and diabetes may be a factor in the development of uric acid stones. The long-term treatment goal is to prevent future stone formation and growth of existing stones. Prevention is preferable to repeated urological procedures, even though the latter are less invasive than open surgery.