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The following is a summary of “Metabolic Evaluation and Recurrence Prevention for Urinary Stone Patients: An EAU Guidelines Update,” published in the July 2024 issue of Urology by Skolarikos et al.
This review aims to identify patients with high-risk urolithiasis, outline diagnostic and therapeutic strategies for each stone type, and provide general guidelines for recurrence prevention.
A professional research librarian conducted comprehensive literature searches for all sections of the urolithiasis guidelines, covering publications from 1976 to June 2023.
For all patients with urolithiasis, stone analysis is crucial. General preventative advice includes maintaining adequate fluid and calcium intake while minimizing sodium and protein consumption. Identifying and addressing causative factors is essential for preventing recurrence. Diagnostic and therapeutic algorithms based on stone composition are provided.
Every patient should undergo baseline metabolic screening, while those with calcium stones, who face a higher risk of relapse and complications, should receive extensive metabolic screening, including two 24-hour urine collections, followed by targeted therapy. Patients with uric acid, infection, or cystine stones also face high relapse risks. Patients on high risk require close monitoring, particularly those with long-term non-compliance with therapy.
Metabolic evaluation and regular follow-up are strongly recommended for preventing urolithiasis recurrence.
Source: sciencedirect.com/science/article/abs/pii/S0302283824024114
