Available treatments to prevent recurrent nephrolithiasis

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 TypeMetabolic AbnormalityPotential 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 acidLow urine pH
Severe hyperuricosuria
Alkali salts, potassium citrate preferred
Allopurinol
CystineCystinuriaAlkali salts, potassium citrate preferred
Tiopronin, D-penicillamine
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