By vgreene, 11 July, 2024 If U urate reduce purine intake avoid excessive animal protein intake Strong 1 3
By vgreene, 11 July, 2024 If hyperoxaluria reduce dietary oxalate EO Weak 1 3 and fat1 and maintain nl Ca intake EO 3
By vgreene, 11 July, 2024 Balanced diet with NL Ca 1 1 2 g day up to 2 g day per AUA limited NaCl 4 5 g day veg and fiber rich if low urinary citrate EO 3 limit animal protein 0 8 1 g kg day 1 only if high urinary uric acid EO 3 avoid excessive vitamin supplements1
By vgreene, 11 July, 2024 AUA3 and EAU1 recommend tailoring diet by stone type and blood urine chemistries while ACP2 concludes there s inadequate evidence
By vgreene, 11 July, 2024 Don t further increase fluids if contraindicated or pt already at fluid target per ACP2
By vgreene, 11 July, 2024 Avoid cola if Ca stone per ACP 2 low quality evidence Water is preferred fluid per EUA1
By vgreene, 11 July, 2024 fluids to achieve daily urine output of 2 L day per ACP 2 whereas AUA3 and EUA1 recommend 2 5 3 L day intake to achieve urine output 2 2 5 L day w goal of specific gravity of urine
By vgreene, 11 July, 2024 Perform blood and urine analyses to identify treatable metabolic abnormalities 1 Blood tests Cr Na K Cl ionized Ca or total calcium albumin PO4 uric acid if calcium levels parathyroid hormone PTH and vitamin D Urine tests urine volume urine pH specific gr