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J Nephrol. 2016 Dec;29(6):715-734. Epub 2016 Jul 25.

Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement.

Author information

1
Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy.
2
, A.S.L. 10, Florence, Italy. emcroppi@mark.it.
3
Department of Nephrology, University of Chicago Medicine, Chicago, USA.
4
Department of Urology, Indiana University School of Medicine, Indianapolis, USA.
5
Department of Internal Medicine, Southwestern Medical Center, University of Texas, Dallas, USA.
6
Department of Urological Surgery, Sobeh's Vascular and Medical Center, Dubai, UAE.
7
Department of Nephrology, Medical Center, University of Rochester, Rochester, USA.
8
Renal Division, Brigham and Women's Hospital, Boston, USA.
9
Department of Nephrology, University of Bern, Bern, Switzerland.
10
Department of Nephrology, New York Harbor VA Health Care System, New York, USA.
11
Department of Nephrology, Sao Paulo University, Sao Paulo, Brazil.
12
Department of Internal Medicine and Nephrology, Klinik Im Park Hospital, Zurich, Switzerland.
13
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA.
14
Department of Nephrology, A.S.O Ordine Mauriziano Hospital, Turin, Italy.
15
Department of Nephrology, Mayo Clinic, Rochester, USA.
16
Department of Urology, Duke University Medical Center, Durham, USA.
17
Department of Urology, Catholic University of Portugal, Lisbon, Portugal.
18
Southwestern Medical Center, Mineral Metabolism Research, University of Texas, Dallas, USA.
19
Department of Urology, Dr. Lutfi KIRDAR Kartal Research and Training Hospital, Istanbul, Turkey.
20
Department of Urology, University of Bonn, Bonn, Germany.
21
Department of Internal Medicine, University of Naples, Naples, Italy.
22
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indiana, USA.

Abstract

BACKGROUND:

Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research.

DESIGN:

A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved.

RESULTS:

Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients.

CONCLUSIONS:

This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified.

KEYWORDS:

Beverages; Bone disease; CKD; Diet; Nephrolithiasis; Renal tubular acidosis

PMID:
27456839
PMCID:
PMC5080344
DOI:
10.1007/s40620-016-0329-y
[Indexed for MEDLINE]
Free PMC Article

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