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Treatment and prevention of kidney stones: an update.
Am Fam Physician. 2011 Dec 01; 84(11):1234-42.AF

Abstract

The incidence of nephrolithiasis (kidney stones) is rising worldwide, especially in women and with increasing age. Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved, urine pH and 24-hour urine assessment provide information about stone-forming factors that can guide prevention. Medications, such as protease inhibitors, antibiotics, and some diuretics, increase the risk of some types of kidney stones, and patients should be counseled about the risks of using these medications. Managing diet, medication use, and nutrient intake can help prevent the formation of kidney stones. Obesity increases the risk of kidney stones. However, weight loss could undermine prevention of kidney stones if associated with a high animal protein intake, laxative abuse, rapid loss of lean tissue, or poor hydration. For prevention of calcium oxalate, cystine, and uric acid stones, urine should be alkalinized by eating a diet high in fruits and vegetables, taking supplemental or prescription citrate, or drinking alkaline mineral waters. For prevention of calcium phosphate and struvite stones, urine should be acidified; cranberry juice or betaine can lower urine pH. Antispasmodic medications, ureteroscopy, and metabolic testing are increasingly being used to augment fluid and pain medications in the acute management of kidney stones.

Authors+Show Affiliations

University of California School of Medicine, San Francisco, 94143, USA. frassett@gcrc.ucsf.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22150656

Citation

Frassetto, Lynda, and Ingrid Kohlstadt. "Treatment and Prevention of Kidney Stones: an Update." American Family Physician, vol. 84, no. 11, 2011, pp. 1234-42.
Frassetto L, Kohlstadt I. Treatment and prevention of kidney stones: an update. Am Fam Physician. 2011;84(11):1234-42.
Frassetto, L., & Kohlstadt, I. (2011). Treatment and prevention of kidney stones: an update. American Family Physician, 84(11), 1234-42.
Frassetto L, Kohlstadt I. Treatment and Prevention of Kidney Stones: an Update. Am Fam Physician. 2011 Dec 1;84(11):1234-42. PubMed PMID: 22150656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment and prevention of kidney stones: an update. AU - Frassetto,Lynda, AU - Kohlstadt,Ingrid, PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2013/2/13/medline SP - 1234 EP - 42 JF - American family physician JO - Am Fam Physician VL - 84 IS - 11 N2 - The incidence of nephrolithiasis (kidney stones) is rising worldwide, especially in women and with increasing age. Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved, urine pH and 24-hour urine assessment provide information about stone-forming factors that can guide prevention. Medications, such as protease inhibitors, antibiotics, and some diuretics, increase the risk of some types of kidney stones, and patients should be counseled about the risks of using these medications. Managing diet, medication use, and nutrient intake can help prevent the formation of kidney stones. Obesity increases the risk of kidney stones. However, weight loss could undermine prevention of kidney stones if associated with a high animal protein intake, laxative abuse, rapid loss of lean tissue, or poor hydration. For prevention of calcium oxalate, cystine, and uric acid stones, urine should be alkalinized by eating a diet high in fruits and vegetables, taking supplemental or prescription citrate, or drinking alkaline mineral waters. For prevention of calcium phosphate and struvite stones, urine should be acidified; cranberry juice or betaine can lower urine pH. Antispasmodic medications, ureteroscopy, and metabolic testing are increasingly being used to augment fluid and pain medications in the acute management of kidney stones. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/22150656/Treatment_and_prevention_of_kidney_stones:_an_update_ L2 - https://www.aafp.org/link_out?pmid=22150656 DB - PRIME DP - Unbound Medicine ER -