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Medical management of kidney stones: AUA guideline.
J Urol 2014; 192(2):316-24JU

Abstract

PURPOSE

The purpose of this guideline is to provide a clinical framework for the diagnosis, prevention and follow-up of adult patients with kidney stones based on the best available published literature.

MATERIALS AND METHODS

The primary source of evidence for this guideline was the systematic review conducted by the Agency for Healthcare Research and Quality on recurrent nephrolithiasis in adults. To augment and broaden the body of evidence in the AHRQ report, the AUA conducted supplementary searches for articles published from 2007 through 2012 that were systematically reviewed using a methodology developed a priori. In total, these sources yielded 46 studies that were used to form evidence-based guideline statements. In the absence of sufficient evidence, additional statements were developed as Clinical Principles and Expert Opinions.

RESULTS

Guideline statements were created to inform clinicians regarding the use of a screening evaluation for first-time and recurrent stone formers, the appropriate initiation of a metabolic evaluation in select patients and recommendations for the initiation and follow-up of medication and/or dietary measures in specific patients.

CONCLUSIONS

A variety of medications and dietary measures have been evaluated with greater or less rigor for their efficacy in reducing recurrence rates in stone formers. The guideline statements offered in this document provide a simple, evidence-based approach to identify high-risk or interested stone-forming patients for whom medical and dietary therapy based on metabolic testing and close follow-up is likely to be effective in reducing stone recurrence.

Authors+Show Affiliations

American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.American Urological Assocation Education and Research, Inc., Linthicum, Maryland.No affiliation info available

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

24857648

Citation

Pearle, Margaret S., et al. "Medical Management of Kidney Stones: AUA Guideline." The Journal of Urology, vol. 192, no. 2, 2014, pp. 316-24.
Pearle MS, Goldfarb DS, Assimos DG, et al. Medical management of kidney stones: AUA guideline. J Urol. 2014;192(2):316-24.
Pearle, M. S., Goldfarb, D. S., Assimos, D. G., Curhan, G., Denu-Ciocca, C. J., Matlaga, B. R., ... White, J. R. (2014). Medical management of kidney stones: AUA guideline. The Journal of Urology, 192(2), pp. 316-24. doi:10.1016/j.juro.2014.05.006.
Pearle MS, et al. Medical Management of Kidney Stones: AUA Guideline. J Urol. 2014;192(2):316-24. PubMed PMID: 24857648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medical management of kidney stones: AUA guideline. AU - Pearle,Margaret S, AU - Goldfarb,David S, AU - Assimos,Dean G, AU - Curhan,Gary, AU - Denu-Ciocca,Cynthia J, AU - Matlaga,Brian R, AU - Monga,Manoj, AU - Penniston,Kristina L, AU - Preminger,Glenn M, AU - Turk,Thomas M T, AU - White,James R, AU - ,, Y1 - 2014/05/20/ PY - 2014/05/05/accepted PY - 2014/5/27/entrez PY - 2014/5/27/pubmed PY - 2014/9/19/medline KW - citrate KW - hypercalciuria KW - nephrolithiasis KW - oxalate KW - urolithiasis SP - 316 EP - 24 JF - The Journal of urology JO - J. Urol. VL - 192 IS - 2 N2 - PURPOSE: The purpose of this guideline is to provide a clinical framework for the diagnosis, prevention and follow-up of adult patients with kidney stones based on the best available published literature. MATERIALS AND METHODS: The primary source of evidence for this guideline was the systematic review conducted by the Agency for Healthcare Research and Quality on recurrent nephrolithiasis in adults. To augment and broaden the body of evidence in the AHRQ report, the AUA conducted supplementary searches for articles published from 2007 through 2012 that were systematically reviewed using a methodology developed a priori. In total, these sources yielded 46 studies that were used to form evidence-based guideline statements. In the absence of sufficient evidence, additional statements were developed as Clinical Principles and Expert Opinions. RESULTS: Guideline statements were created to inform clinicians regarding the use of a screening evaluation for first-time and recurrent stone formers, the appropriate initiation of a metabolic evaluation in select patients and recommendations for the initiation and follow-up of medication and/or dietary measures in specific patients. CONCLUSIONS: A variety of medications and dietary measures have been evaluated with greater or less rigor for their efficacy in reducing recurrence rates in stone formers. The guideline statements offered in this document provide a simple, evidence-based approach to identify high-risk or interested stone-forming patients for whom medical and dietary therapy based on metabolic testing and close follow-up is likely to be effective in reducing stone recurrence. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/24857648/full_citation L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2014.05.006?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -