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International Alliance of Urolithiasis (IAU) guidelines on the metabolic evaluation and medical management of urolithiasis

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Abstract

The aim of this study was to construct the fourth in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis (IAU) that by providing a clinical framework for the metabolic evaluation, prevention, and follow-up of patients with urolithiasis based on the best available published literature. All recommendations were summarized following a systematic review and assessment of the literature in the PubMed database from January 1976 to June 2022. Each generated recommendation was graded using a modified GRADE methodology. Guideline recommendations were developed that addressed the following topics: initial evaluation, metabolic testing, dietary measures, medical management, and follow-up of recurrent stone formers. It was emphasized by the Panel that prevention of new stone formation is as important as the surgical removal of the stones. Although general preventive measures may be effective in reducing stone recurrence rates in some patients, specific medical and dietary management should be well considered and eventually applied in an individualized manner based on the outcomes of metabolic work-up, stone analysis and some certain patient related factors. A detailed follow-up of each case is essential depending on the metabolic activity of each individual patient.

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Author notes

  1. Guohua Zeng, Wei Zhu and William G. Robertson authors contributed equally to this work.

Authors and Affiliations

  1. Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Guohua Zeng & Wei Zhu

  2. Lithoscreen Service, Over, CB24 5NE, Cambridge, UK

    William G. Robertson

  3. Department of Urology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Kristina L. Penniston

  4. Department of Urology, Westmoreland Street Hospital, University College Hospital London, London, UK

    Daron Smith

  5. Nephrology and Dialysis Department, Kidney Stone Clinic, Hôpital Universitaire Brugmann, Brussels, Belgium

    Agnieszka Pozdzik

  6. Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Tzevat Tefik

  7. Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy

    Domenico Prezioso

  8. Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA

    Margaret S. Pearle

  9. Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada

    Ben H. Chew

  10. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria

    Julian Veser

  11. Division of Urology, Department Of Oncology, School of Medicine, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy

    Cristian Fiori

  12. Department of Urology, First Affiliated Hospital of Guangxi Medical University, Nanning, China

    Yaoliang Deng

  13. Department of Urology, Technical University Munich, Munich, Germany

    Michael Straub

  14. Sisters of Charity Hospital Vienna, Vienna, Austria

    Christian Türk

  15. Department of Urology, West Virginia University, Wheeling, WV, USA

    Michelle J. Semins

  16. Department of Urology, Institute of Urology, Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China

    Kunjie Wang

  17. Fondazione Scientifica Ospedale Mauriziano Onlus, Turin, Italy

    Martino Marangella

  18. Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Zhankui Jia

  19. Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen, China

    Liyuan Zhang

  20. Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China

    Zhangqun Ye

  21. Department of Urology, Karolinska Institutet - Huddinge Campus, Stockholm, Sweden

    Hans-Göran Tiselius

  22. Department of Urology, Medical School, Biruni University, Istanbul, Turkey

    Kemal Sarica

  23. Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium

    Agnieszka Pozdzik

Authors
  1. Guohua Zeng
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  2. Wei Zhu
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  3. William G. Robertson
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  4. Kristina L. Penniston
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  23. Kemal Sarica
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Contributions

Study concept and design: Guohua Zeng, Kemal Sarica Drafting of the manuscript: Guohua Zeng, Wei Zhu, William G Robertson, Kristina L Penniston, Daron Smith, Agnieszka Pozdzik, Tzevat Tefik, Domenico Prezioso, Margaret S Pearle, Ben H Chew, Julian Veser, Cristian Fiori, Yaoliang Deng, Michael Straub, Christian Türk, Michelle J Semins, Kunjie Wang, Martino Marangella, Zhankui Jia, Liyuan Zhang, Zhangqun Ye, Hans-Göran Tiselius, Kemal Sarica Critical revision of the manuscript for important intellectual content: William G Robertson, Margaret S Pearle, Hans-Göran Tiselius, Kemal Sarica

Corresponding authors

Correspondence to Guohua Zeng, Hans-Göran Tiselius or Kemal Sarica.

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Zeng, G., Zhu, W., Robertson, W.G. et al. International Alliance of Urolithiasis (IAU) guidelines on the metabolic evaluation and medical management of urolithiasis. Urolithiasis 51, 4 (2023). https://doi.org/10.1007/s00240-022-01387-2

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