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Evaluation of Patients with Nephrolithiasis (Diagnosis of Nephrolithiasis)

  • Matthew Lynch
  • Samer NasserEmail author
Chapter
Part of the Nutrition and Health book series (NH)

Abstract

Kidney stones affect 11% of men and 6% of women and incidence is on the rise. When stones pass through urinary tract, the symptoms can be debilitating, resulting in significant morbidity and cost to the medical system. Almost half of first-time stone formers have a recurrent episode. Thus, prevention of recurrence is important. Evaluation of the patient for stone-forming risk factors includes history, imaging, stone analysis, and metabolic workup. The evaluation begins with patient history focused on medications, diseases, diet, and work habits that increase the risk. Imaging with computed tomography and ultrasound helps determine the burden, size, and location of the stone(s) in the urinary tract. Stone analysis when available is important in determining the type of stone. Metabolic workup consists of targeted blood work and urinalysis as well as a 24-hour urine collection. The cornerstone of the stone evaluation is the 24-hour urine collection especially in recurrent stone formers as its components determine the risk of stone formation. The 24-hour urine values guide medical management and dietary modifications for prevention of recurrence, and follow-up collections determine the effectiveness of the therapy.

Keywords

Nephrolithiasis Kidney stones/calculi 24-hour urine collection Ultrasound Uric acid Ultrasound CT scan Supersaturation Renal colic 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Brown MedicineEast ProvidenceUSA
  2. 2.Department of NephrologyAtrius HealthQuincyUSA

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