Workup for a patient with a single kidney stone

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Workup for a patient with a single kidney stone

How much of a workup should a patient with a single kidney stone have?

When adults present with their initial stone episode, they should have a limited workup to identify the more serious issues related to nephrolithiasis.

Serum chemistries will reveal hypokalemia and/or acidosis that would indicate distal renal tubular acidosis (RTA), hypercalcemia to identify patients who should be evaluated for hyperparathyroidism, and serum creatinine to estimate kidney function. Stone analysis should always be performed.

Urinalysis and/or urine culture should be done to identify infection and microscopy for stone-related crystals.

Radiographic evaluation should be performed to quantify stone burden. If multiple stones are seen on CT scan or x-ray, the patient should be considered a recurrent stone former.

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