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Update on the Evaluation of Repeated Stone Formers

  • Office Urology (N Shore, Section Editor)
  • Published:
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Abstract

Office management of stone disease is an important component of a urologist’s practice. Evaluation should include analysis of stone composition, 24-hour urine studies, identification of modifiable risk factors, and targeted dietary, lifestyle, and/or medical therapy. A sizeable portion of investigated etiologies and risk factors for stone disease have centered on the complex interplay between obesity, diabetes, and other disease states that comprise the metabolic syndrome. Alternatives to traditional preventive therapy, such as probiotics and various fruit juices, are still being studied but may prove useful adjuncts to traditional preventive therapy, where the mainstays remain increased fluid intake, dietary modification, and pharmacologic therapy. Future studies on preventive therapy of urolithiasis are likely to focus on strategies to increase compliance, cost-effectiveness, and systems-based implementation.

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References

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

  1. •• Scales Jr CD, Smith AC, Hanley JM, Saigal CS. Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012;62(1):160–5. This cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) database highlights the increase in the prevalence of urolithiasis in America, and also illustrates the close linkage with the chronic disease states of obesity and diabetes.

    Article  PubMed  Google Scholar 

  2. Lotan Y. Economics and cost of care of stone disease. Adv Chronic Kidney Dis. 2009;16(1):5–10.

    Article  PubMed  Google Scholar 

  3. McMahon GM, Seifter JL. Challenges in the diagnostic and therapeutic approach to nephrolithiasis. Curr Opin Nephrol Hypertens. 2012;21(2):183–8.

    Article  PubMed  Google Scholar 

  4. Ekeruo WO, Tan YH, Young MD, et al. Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. J Urol. 2004;172(1):159–63.

    Article  PubMed  Google Scholar 

  5. Parks JH, Coe FL. Evidence for durable kidney stone prevention over several decades. BJU Int. 2009;103(9):1238–46.

    Article  PubMed  Google Scholar 

  6. Lotan Y, Cadeddu JA, Roerhborn CG, Pak CY, Pearle MS. Cost-effectiveness of medical management strategies for nephrolithiasis. J Urol. 2004;172(6 Pt 1):2275–81.

    Article  PubMed  Google Scholar 

  7. Parks JH, Asplin JR, Coe FL. Patient adherence to long-term medical treatment of kidney stones. J Urol. 2001;166(6):2057–60.

    Article  PubMed  CAS  Google Scholar 

  8. Moe OW. Kidney stones: pathophysiology and medical management. Lancet. 2006;367(9507):333–44.

    Article  PubMed  CAS  Google Scholar 

  9. Nowfar S, Palazzi-Churas K, Chang DC, Sur RL. The relationship of obesity and gender prevalence changes in united states inpatient nephrolithiasis. Urology. 2011;78(5):1029–33.

    Article  PubMed  Google Scholar 

  10. •• Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD. Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol. 2012;188(1):247–52. The authors use 25 years of epidemiologic data from Minnesota to demonstrate a dramatic increase in the incidence of urolithiasis among adolescents. Whether this was due to increased detection or actual increase in the disease state could not be determined in this study.

    Article  PubMed  Google Scholar 

  11. Matlaga BR, Schaeffer AJ, Novak TE, Trock BJ. Epidemiologic insights into pediatric kidney stone disease. Urol Res. 2010;38(6):453–7.

    Article  PubMed  Google Scholar 

  12. Semins MJ, Shore AD, Makary MA, Magnuson T, Johns R, Matlaga BR. The association of increasing body mass index and kidney stone disease. J Urol. 2010;183(2):571–5.

    Article  PubMed  Google Scholar 

  13. • Jeong IG, Kang T, Bang JK, et al. Association between metabolic syndrome and the presence of kidney stones in a screened population. Am J Kidney Dis. 2011. This population-based study reports an increase in relative risk for stone formation in patients with the metabolic syndrome in a large Korean medical center.

  14. Sakhaee K, Capolongo G, Maalouf NM, et al. Metabolic syndrome and the risk of calcium stones. Nephrol Dial Transplant. 2012;27(8):3201–9.

    Article  PubMed  CAS  Google Scholar 

  15. Daudon M, Traxer O, Conort P, Lacour B, Jungers P. Type 2 diabetes increases the risk for uric acid stones. J Am Soc Nephrol. 2006;17(7):2026–33.

    Article  PubMed  CAS  Google Scholar 

  16. Obligado SH, Goldfarb DS. The association of nephrolithiasis with hypertension and obesity: a review. Am J Hypertens. 2008;21(3):257–64.

    Article  PubMed  CAS  Google Scholar 

  17. Sakhaee K, Maalouf NM. Metabolic syndrome and uric acid nephrolithiasis. Semin Nephrol. 2008;28(2):174–80.

    Article  PubMed  CAS  Google Scholar 

  18. West B, Luke A, Durazo-Arvizu RA, Cao G, Shoham D, Kramer H. Metabolic syndrome and self-reported history of kidney stones: the national health and nutrition examination survey (NHANES III) 1988-1994. Am J Kidney Dis. 2008;51(5):741–7.

    Article  PubMed  Google Scholar 

  19. Kadlec AO, Greco K, Fridirici ZC, Hart ST, Vellos T, Turk TM. Metabolic syndrome and urinary stone composition: what factors matter most? Urology. 2012;80(4):805–10.

    Article  PubMed  Google Scholar 

  20. Abate N, Chandalia M, Cabo-Chan Jr AV, Moe OW, Sakhaee K. The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int. 2004;65(2):386–92.

    Article  PubMed  CAS  Google Scholar 

  21. Bell DS. Beware the low urine pH–the major cause of the increased prevalence of nephrolithiasis in the patient with type 2 diabetes. Diabetes Obes Metab. 2012;14(4):299–303.

    Article  PubMed  CAS  Google Scholar 

  22. Maalouf NM, Cameron MA, Moe OW, Adams-Huet B, Sakhaee K. Low urine pH: a novel feature of the metabolic syndrome. Clin J Am Soc Nephrol. 2007;2(5):883–8.

    Article  PubMed  CAS  Google Scholar 

  23. Wagner CA, Mohebbi N. Urinary pH and stone formation. J Nephrol. 2010;23 Suppl 16:S165–9.

    PubMed  Google Scholar 

  24. • Kadlec AO, Greco KA, Fridirici ZC, Gerber D, Turk TM. Effect of renal function on urinary mineral excretion and stone composition. Urology. 2011. This study suggested that impaired glomerular filtration rate is a risk factor for uric acid urolithiasis, perhaps via a concomitant reduction in urine pH.

  25. Eisner BH, Porten SP, Bechis SK, Stoller ML. Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers. J Urol. 2010;183(6):2244–8.

    Article  PubMed  CAS  Google Scholar 

  26. Cupisti A, Meola M, D’Alessandro C, et al. Insulin resistance and low urinary citrate excretion in calcium stone formers. Biomed Pharmacother. 2007;61(1):86–90.

    Article  PubMed  CAS  Google Scholar 

  27. Khan SR. Is oxidative stress, a link between nephrolithiasis and obesity, hypertension, diabetes, chronic kidney disease, metabolic syndrome? Urol Res. 2012;40(2):95–112.

    Article  PubMed  CAS  Google Scholar 

  28. Taguchi K, Okada A, Yasui T, et al. Pioglitazone, a peroxisome proliferator activated receptor gamma agonist, decreases renal crystal deposition, oxidative stress and inflammation in hyperoxaluric rats. J Urol. 2012;188(3):1002–11.

    Article  PubMed  CAS  Google Scholar 

  29. Matlaga BR, Shore AD, Magnuson T, Clark JM, Johns R, Makary MA. Effect of gastric bypass surgery on kidney stone disease. J Urol. 2009;181(6):2573–7.

    Article  PubMed  Google Scholar 

  30. Patel BN, Passman CM, Fernandez A, et al. Prevalence of hyperoxaluria after bariatric surgery. J Urol. 2009;181(1):161–6.

    Article  PubMed  Google Scholar 

  31. Asplin JR, Coe FL. Hyperoxaluria in kidney stone formers treated with modern bariatric surgery. J Urol. 2007;177(2):565–9.

    Article  PubMed  Google Scholar 

  32. Maalouf NM, Tondapu P, Guth ES, Livingston EH, Sakhaee K. Hypocitraturia and hyperoxaluria after roux-en-Y gastric bypass surgery. J Urol. 2010;183(3):1026–30.

    Article  PubMed  CAS  Google Scholar 

  33. Park AM, Storm DW, Fulmer BR, Still CD, Wood GC, Hartle 2nd JE. A prospective study of risk factors for nephrolithiasis after roux-en-Y gastric bypass surgery. J Urol. 2009;182(5):2334–9.

    Article  PubMed  CAS  Google Scholar 

  34. Chen T, Godebu E, Horgan S, Mirheydar HS, Sur RL. The effect of restrictive bariatric surgery on urolithiasis. J Endourol. 2013;27(2):242–4.

    Article  PubMed  Google Scholar 

  35. Semins MJ, Asplin JR, Steele K, et al. The effect of restrictive bariatric surgery on urinary stone risk factors. Urology. 2010;76(4):826–9.

    Article  PubMed  Google Scholar 

  36. Semins MJ, Matlaga BR, Shore AD, et al. The effect of gastric banding on kidney stone disease. Urology. 2009;74(4):746–9.

    Article  PubMed  Google Scholar 

  37. Stanhope KL, Schwarz JM, Havel PJ. Adverse metabolic effects of dietary fructose: Results from the recent epidemiological, clinical, and mechanistic studies. Curr Opin Lipidol. 2013.

  38. Taylor EN, Curhan GC. Fructose consumption and the risk of kidney stones. Kidney Int. 2008;73(2):207–12.

    Article  PubMed  CAS  Google Scholar 

  39. Taylor EN, Curhan GC. Determinants of 24-hour urinary oxalate excretion. Clin J Am Soc Nephrol. 2008;3(5):1453–60.

    Article  PubMed  CAS  Google Scholar 

  40. Asselman M, Verkoelen CF. Fructose intake as a risk factor for kidney stone disease. Kidney Int. 2008;73(2):139–40.

    Article  PubMed  CAS  Google Scholar 

  41. Knight J, Assimos DG, Easter L, Holmes RP. Metabolism of fructose to oxalate and glycolate. Horm Metab Res. 2010;42(12):868–73.

    Article  PubMed  CAS  Google Scholar 

  42. • Coe FL, Evan A, Worcester E. Pathophysiology-based treatment of idiopathic calcium kidney stones. Clin J Am Soc Nephrol. 2011;6(8):2083–92. The authors provide some new insights into the pathophysiology of idiopathic calcium stone disease, specifically the interplay between apatite plaque formation and subsequent growth of calcium oxalate crystals. Future work may identify subsets of idiopathic calcium stone formers who could benefit from targeted treatment.

    Article  PubMed  Google Scholar 

  43. Williams Jr JC, Matlaga BR, Kim SC, et al. Calcium oxalate calculi found attached to the renal papilla: Preliminary evidence for early mechanisms in stone formation. J Endourol. 2006;20(11):885–90.

    Article  PubMed  Google Scholar 

  44. Eisner BH, Sheth S, Dretler SP, Herrick B, Pais Jr VM. Abnormalities of 24-hour urine composition in first-time and recurrent stone-formers. Urology. 2012;80(4):776–9.

    Article  PubMed  Google Scholar 

  45. Krambeck AE, Khan NF, Jackson ME, Lingeman JE, McAteer JA, Williams Jr JC. Inaccurate reporting of mineral composition by commercial stone analysis laboratories: implications for infection and metabolic stones. J Urol. 2010;184(4):1543–9.

    Article  PubMed  Google Scholar 

  46. Kourambas J, Aslan P, Teh CL, Mathias BJ, Preminger GM. Role of stone analysis in metabolic evaluation and medical treatment of nephrolithiasis. J Endourol. 2001;15(2):181–6.

    Article  PubMed  CAS  Google Scholar 

  47. Strohmaier WL, Wrobel BM, Schubert G. Overweight, insulin resistance and blood pressure (parameters of the metabolic syndrome) in uric acid urolithiasis. Urol Res. 2012;40(2):171–5.

    Article  PubMed  CAS  Google Scholar 

  48. Pak CY, Peterson R, Poindexter JR. Adequacy of a single stone risk analysis in the medical evaluation of urolithiasis. J Urol. 2001;165(2):378–81.

    Article  PubMed  CAS  Google Scholar 

  49. Healy KA, Hubosky SG, Bagley DH. 24-hour urine collection in the metabolic evaluation of stone formers: is one study adequate? J Endourol. 2013;27(3):374–8.

    Article  PubMed  Google Scholar 

  50. • Castle SM, Cooperberg MR, Sadetsky N, Eisner BH, Stoller ML. Adequacy of a single 24-hour urine collection for metabolic evaluation of recurrent nephrolithiasis. J Urol. 2010;184(2):579–83. This study adds to a conflicting body of literature about the adequacy of a single (versus multiple) 24-hour urine collections to guide preventive therapy. The authors analyzed specimens from 777 patients and found good concordance between multiple specimens in the same patient collected within three days of each other and found no significant differences in urinary parameters.

    Article  PubMed  CAS  Google Scholar 

  51. Nayan M, Elkoushy MA, Andonian S. Variations between two 24-hour urine collections in patients presenting to a tertiary stone clinic. Can Urol Assoc J. 2012;6(1):30–3.

    PubMed  Google Scholar 

  52. Pak CY, Odvina CV, Pearle MS, et al. Effect of dietary modification on urinary stone risk factors. Kidney Int. 2005;68(5):2264–73.

    Article  PubMed  CAS  Google Scholar 

  53. Taylor EN, Curhan GC. Diet and fluid prescription in stone disease. Kidney Int. 2006;70(5):835–9.

    Article  PubMed  CAS  Google Scholar 

  54. Borghi L, Schianchi T, Meschi T, et al. Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med. 2002;346(2):77–84.

    Article  PubMed  CAS  Google Scholar 

  55. Heller HJ, Doerner MF, Brinkley LJ, Adams-Huet B, Pak CY. Effect of dietary calcium on stone forming propensity. J Urol. 2003;169(2):470–4.

    Article  PubMed  CAS  Google Scholar 

  56. • Lieske JC, Tremaine WJ, De Simone C, et al. Diet, but not oral probiotics, effectively reduces urinary oxalate excretion and calcium oxalate supersaturation. Kidney Int. 2010;78(11):1178–85. This was a negative-result clinical trial that looked at the effect of two probiotics on urinary oxalate excretion in a group of patients on an oxlate-restricted diet.

    Article  PubMed  CAS  Google Scholar 

  57. Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol. 2004;15(12):3225–32.

    Article  PubMed  Google Scholar 

  58. Borghi L, Nouvenne A, Meschi T. Probiotics and dietary manipulations in calcium oxalate nephrolithiasis: two sides of the same coin? Kidney Int. 2010;78(11):1063–5.

    Article  PubMed  CAS  Google Scholar 

  59. Maalouf NM, Adams Huet B, Pasch A, et al. Variability in urinary oxalate measurements between six international laboratories. Nephrol Dial Transplant. 2011;26(12):3954–9.

    Article  PubMed  CAS  Google Scholar 

  60. Goldfarb DS. Prospects for dietary therapy of recurrent nephrolithiasis. Adv Chronic Kidney Dis. 2009;16(1):21–9.

    Article  PubMed  Google Scholar 

  61. Abratt VR, Reid SJ. Oxalate-degrading bacteria of the human gut as probiotics in the management of kidney stone disease. Adv Appl Microbiol. 2010;72:63–87.

    Article  PubMed  CAS  Google Scholar 

  62. • Siener R, Bangen U, Sidhu H, Honow R, von Unruh G, Hesse A. The role of oxalobacter formigenes colonization in calcium oxalate stone disease. Kidney Int. 2013. These authors show a clear inverse association between O. formigenes colonization status and amount of oxalate excreted in the urine, as well as an inverse association between colonization and stone events. Whether these differences will translate into probiotic preventive therapy remains to be seen.

  63. Lieske JC, Goldfarb DS, De Simone C, Regnier C. Use of a probiotic to decrease enteric hyperoxaluria. Kidney Int. 2005;68(3):1244–9.

    Article  PubMed  CAS  Google Scholar 

  64. Jiang J, Knight J, Easter LH, Neiberg R, Holmes RP, Assimos DG. Impact of dietary calcium and oxalate, and oxalobacter formigenes colonization on urinary oxalate excretion. J Urol. 2011;186(1):135–9.

    Article  PubMed  CAS  Google Scholar 

  65. Hoppe B, Groothoff JW, Hulton SA, et al. Efficacy and safety of oxalobacter formigenes to reduce urinary oxalate in primary hyperoxaluria. Nephrol Dial Transplant. 2011;26(11):3609–15.

    Article  PubMed  Google Scholar 

  66. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996;155(3):839–43.

    Article  PubMed  CAS  Google Scholar 

  67. • Fink HA, Akornor JW, Garimella PS, et al. Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials. Eur Urol. 2009;56(1):72–80. This meta-analysis highlights the safety and efficacy of increased fluid intake to prevent kidney stones.

    Article  PubMed  Google Scholar 

  68. Lotan Y, Jimenez IB, Lenoir-Wijnkoop I, et al. Increased water intake as a prevention strategy for recurrence of urolithiasis: major impact of compliance on cost-effectiveness. J Urol. 2012.

  69. • Lotan Y, Buendia Jimenez I, Lenoir-Wijnkoop I, et al. Primary prevention of nephrolithiasis is cost-effective for a national healthcare system. BJU Int. 2012;110(11):E1060–7. A cost-analysis Markov model was used to show that increased fluid intake in stone-forming patients, even at a compliance rate of 25 %, leads to cost savings attributable to reduction in costs associated with workup and treatment of recurrent stone episodes.

    Article  PubMed  Google Scholar 

  70. Koff SG, Paquette EL, Cullen J, Gancarczyk KK, Tucciarone PR, Schenkman NS. Comparison between lemonade and potassium citrate and impact on urine pH and 24-hour urine parameters in patients with kidney stone formation. Urology. 2007;69(6):1013–6.

    Article  PubMed  Google Scholar 

  71. Penniston KL, Steele TH, Nakada SY. Lemonade therapy increases urinary citrate and urine volumes in patients with recurrent calcium oxalate stone formation. Urology. 2007;70(5):856–60.

    Article  PubMed  Google Scholar 

  72. Seltzer MA, Low RK, McDonald M, Shami GS, Stoller ML. Dietary manipulation with lemonade to treat hypocitraturic calcium nephrolithiasis. J Urol. 1996;156(3):907–9.

    Article  PubMed  CAS  Google Scholar 

  73. Odvina CV. Comparative value of orange juice versus lemonade in reducing stone-forming risk. Clin J Am Soc Nephrol. 2006;1(6):1269–74.

    Article  PubMed  CAS  Google Scholar 

  74. McHarg T, Rodgers A, Charlton K. Influence of cranberry juice on the urinary risk factors for calcium oxalate kidney stone formation. BJU Int. 2003;92(7):765–8.

    Article  PubMed  CAS  Google Scholar 

  75. Yilmaz E, Batislam E, Basar M, Tuglu D, Erguder I. Citrate levels in fresh tomato juice: a possible dietary alternative to traditional citrate supplementation in stone-forming patients. Urology. 2008;71(3):379–83. discussion 383–4.

    Article  PubMed  Google Scholar 

  76. Tracy CR, Pearle MS. Update on the medical management of stone disease. Curr Opin Urol. 2009;19(2):200–4.

    Article  PubMed  Google Scholar 

  77. Meschi T, Nouvenne A, Borghi L. Lifestyle recommendations to reduce the risk of kidney stones. Urol Clin North Am. 2011;38(3):313–20.

    Article  PubMed  Google Scholar 

  78. Pak CY, Sakhaee K, Fuller C. Successful management of uric acid nephrolithiasis with potassium citrate. Kidney Int. 1986;30(3):422–8.

    Article  PubMed  CAS  Google Scholar 

  79. Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak CY. Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol. 1993;150(6):1761–4.

    PubMed  CAS  Google Scholar 

  80. Scholz D, Schwille PO, Sigel A. Double-blind study with thiazide in recurrent calcium lithiasis. J Urol. 1982;128(5):903–7.

    PubMed  CAS  Google Scholar 

  81. Pearle MS, Roehrborn CG, Pak CY. Meta-analysis of randomized trials for medical prevention of calcium oxalate nephrolithiasis. J Endourol. 1999;13(9):679–85.

    Article  PubMed  CAS  Google Scholar 

  82. Sakhaee K, Nicar M, Hill K, Pak CY. Contrasting effects of potassium citrate and sodium citrate therapies on urinary chemistries and crystallization of stone-forming salts. Kidney Int. 1983;24(3):348–52.

    Article  PubMed  CAS  Google Scholar 

  83. Odvina CV, Preminger GM, Lindberg JS, Moe OW, Pak CY. Long-term combined treatment with thiazide and potassium citrate in nephrolithiasis does not lead to hypokalemia or hypochloremic metabolic alkalosis. Kidney Int. 2003;63(1):240–7.

    Article  PubMed  CAS  Google Scholar 

  84. Pak CY, Heller HJ, Pearle MS, Odvina CV, Poindexter JR, Peterson RD. Prevention of stone formation and bone loss in absorptive hypercalciuria by combined dietary and pharmacological interventions. J Urol. 2003;169(2):465–9.

    Article  PubMed  CAS  Google Scholar 

  85. Mechlin C, Kalorin C, Asplin J, White M. Splenda(R) improves tolerance of oral potassium citrate supplementation for prevention of stone formation: Results of a randomized double-blind trial. J Endourol. 2011;25(9):1541–5.

    Article  PubMed  Google Scholar 

  86. Pinheiro VB, Baxmann AC, Tiselius HG, Heilberg IP. The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers. Urology. 2013

  87. El-Gamal O, El-Bendary M, Ragab M, Rasheed M. Role of combined use of potassium citrate and tamsulosin in the management of uric acid distal ureteral calculi. Urol Res. 2012;40(3):219–24.

    Article  PubMed  CAS  Google Scholar 

  88. Lingeman J, Mardis H, Kahnoski R, et al. Medical reduction of stone risk in a network of treatment centers compared to a research clinic. J Urol. 1998;160(5):1629–34.

    Article  PubMed  CAS  Google Scholar 

  89. Mardis HK, Parks JH, Muller G, Ganzel K, Coe FL. Outcome of metabolic evaluation and medical treatment for calcium nephrolithiasis in a private urological practice. J Urol. 2004;171(1):85–8.

    Article  PubMed  Google Scholar 

  90. McCauley LR, Dyer AJ, Stern K, Hicks T, Nguyen MM. Factors influencing fluid intake behavior among kidney stone formers. J Urol. 2012;187(4):1282–6.

    Article  PubMed  Google Scholar 

  91. • Penniston KL, Nakada SY. Development of an instrument to assess the health related quality of life of kidney stone formers. J Urol. 2012. Authors from the University of Wisconsin have developed and validated an instrument that can be used to measure health-related quality of life in stone-forming patients. This may be valuable in future studies.

  92. Traver MA, Passman CM, LeRoy T, Passmore L, Assimos DG. Is the internet a reliable source for dietary recommendations for stone formers? J Endourol. 2009;23(4):715–7.

    Article  PubMed  Google Scholar 

  93. Sood A, Sarangi S, Pandey A, Murugiah K. YouTube as a source of information on kidney stone disease. Urology. 2011;77(3):558–62.

    Article  PubMed  Google Scholar 

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Dr. Adam O. Kadlec reported no potential conflicts of interest relevant to this article.

Dr. Thomas M. Turk reported no potential conflicts of interest relevant to this article.

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  1. Department of Urology, Loyola University Medical Center, 2160 S. First Ave, Bldg 54, Maywood, IL, 60153, USA

    Adam O. Kadlec & Thomas M. Turk

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Kadlec, A.O., Turk, T.M. Update on the Evaluation of Repeated Stone Formers. Curr Urol Rep 14, 549–556 (2013). https://doi.org/10.1007/s11934-013-0347-4

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