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Available treatments to prevent recurrent nephrolithiasis
Treatments vary, depending on the type of stone and the underlying metabolic abnormality that has caused the stone to form.
The below table lists possible treatments to prevent stone recurrence.
Medical Therapy for Recurrent Nephrolithiasis
Stone Type | Metabolic Abnormality | Potential Treatment |
---|---|---|
Calcium oxalate (therapy for calcium phosphate stone focuses on hypercalciuria and hypocitraturia) | Hyperparathyroidism Hypercalciuria Dietary hyperoxaluria Enteric hyperoxaluria Primary hyperoxaluria Hypocitraturia Hyperuricosuria | Parathyroidectomy Low-sodium, low-protein diet Thiazide diuretic Low-oxalate, normal-calcium diet Low-oxalate, low-fat diet Calcium supplements with meals Pyridoxine Neutral phosphate Potassium citrate Potassium citrate Sodium bicarbonate if potassium salts not tolerated Low-purine diet Allopurinol |
Uric acid | Low urine pH Severe hyperuricosuria | Alkali salts, potassium citrate preferred Allopurinol |
Cystine | Cystinuria | Alkali salts, potassium citrate preferred Tiopronin, D-penicillamine |