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Evaluation and Medical Management of Kidney Stones

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Essential Urology

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Nephrolithiasis is a worldwide epidemic affecting countries of affluence. The occurrence of kidney stones represents not only a high economic burden to health systems but also results in patient suffering and morbidity. Despite the widespread incidence, the exact cellular mechanisms that mediate the formation of kidney stones remain poorly understood. Clearly, environmental, dietary, and metabolic risk factors can be identified in many stone-forming individuals that increase stone-forming risk. In addition, treatment to correct those abnormalities can reduce the subsequent stone-forming rate. Therefore, this chapter will review the driving forces of stone formation, the theories of crystallization, the cost effectiveness of medical management, dietary and environmental factors that play a role in stone formation, the evaluation of stone-forming patients, and specific metabolic risk factors and the corresponding treatment strategies for which there is strong evidence of clinical efficacy. This information will provide a background in to the understanding of nephrolithiasis that should help the clinician with the appropriate evaluation and management of the most common stone-forming patients in their practice. It will provide a deeper insight into what drives kidney stone disease and offer clinically proven recommendations to improve care and reduce the risk of future symptomatic stone episodes.

Editor’s Note:

In memory of Dr. Joseph Segura: “This chapter was originally authored by Dr. Joseph Segura, my friend and frequent international conference companion. We were all saddened by his unexpected death a few years ago, and I was again reminded of this sorrow when I was asked to prepare the second edition of this book. By coincidence, during another international conference presentation, I met one of Dr. Segura’s former residents, Mitchell Humphreys. He is not only an expert in stone disease, but is also a great admirer of Dr. Segura. It was heartwarming to receive Dr. Humphreys’ enthusiastic response to my invitation, as he agreed to update and expand this chapter as a tribute to his beloved mentor.”

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Acknowledgments

This work was supported by grants to J.C.L. from the National Institutes of Health (R01 DK 53399), the Oxalosis and Hyperoxaluria Foundation, and the Ralph Wilson Foundation. We thank Charlann Thompson for excellent secretarial assistance.

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  1. Department of Urology, Mayo Clinic Arizona, 5777 E Mayo Blvd, MCB 2 - Urology, Phoenix, AZ, 85054, USA

    Mitchell R. Humphreys

  2. Mayo Clinic, Rochester, MN, USA

    John C. Lieske (Professor of Medicine)

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    Jeannette M. Potts

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Humphreys, M.R., Lieske, J.C. (2012). Evaluation and Medical Management of Kidney Stones. In: Potts, J. (eds) Essential Urology. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-092-2_6

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