Updates in the Metabolic Management of Calcium Stones

  • Kristina L. Penniston
  • Stephen Y. Nakada
Endourology (P Mucksavage, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Endourology


Purpose of Review

Urinary risk factors, such as hypercalciuria, hypocitraturia, and hyperoxaluria, either in combination or alone, are associated with calcium stones. Dietary habits as well as underlying medical conditions can influence urinary risk factors. Evaluation of the conglomerate of patients’ stone risks provides evidence for individualized medical management, an effective and patient-supported approach to prevention.

Recent Findings

Many patients with stones desire prevention to avoid repeated surgical interventions. Yet, recent practice pattern assessments and health care utilization data show that many patients are rarely referred for metabolic evaluation or management. Innovations in metabolic management over the past decade have improved its effectiveness in reducing risk and preventing calcium stones. Although no new pharmacologic agents for calcium stone prevention have recently become available, there is relatively new thinking about some diet-based approaches.


This review will synthesize current evidence to support individualized metabolic management of calcium stones.


Metabolic management Medical management Prevention Diet Urolithiasis Nephrolithiasis 


Compliance with Ethical Standards

Conflict of Interest

Kristina L. Penniston reports personal fees from Retrophin.

Stephen Y. Nakada declares no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Nutrition ServicesUniversity of Wisconsin Hospital and ClinicsMadisonUSA
  2. 2.Department of UrologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  3. 3.Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  4. 4.Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

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