Perform blood and urine analyses to identify treatable underlying cause 1 Blood tests Cr Na K Cl ionized Ca or total calcium albumin PO4 if calcium levels PTH Urine tests urine volume urine pH specific gravity calcium phosphate citrate Ca phosphate stones

By vgreene, 11 July, 2024
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<sup>1</sup> <b>EAU 2024.</b> Skolarikos A, et al. EAU Guidelines on Urolithiasis. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis/chapter/guidelines><b>Online</b></a> <a href=https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Urolithiasis-2024.pdf><b>PDF</b></a>
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<sup>2</sup> <b>ACP 2014</b> [WR/L]. Qaseem A, et al. Dietary and Pharmacologic Management to Prevent Recurrent Nephrolithiasis in Adults: A Clinical Practice Guideline From the American College of Physicians. <i>Ann Intern Med</i>. 2014. Nov 4;161(9):659-667. <a href=https://www.acpjournals.org/doi/full/10.7326/M13-2908><b>Accessed 6/24/24</b></a>
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<sup>3</sup> <b>AUA 2014</b> [S/B]. Pearle M, et al. Medical management of kidney stones: AUA Guideline. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006><b>PDF</b></a>
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Perform blood and urine analyses to identify treatable, underlying cause.<sup>1</sup> Blood tests: Cr, Na, K, Cl, ionized Ca (or total calcium + albumin), PO4; if ↑ calcium levels, PTH. Urine tests: urine volume, urine pH, specific gravity, calcium, phosphate, & citrate. Ca phosphate stones may be carbonate apatite stones typically assoc w/ infxn or brushite stones assoc w/ HPT and RTA, therefore exclude HPT & RTA. If urine pH>5.8 consider RTA & perform ammonium chloride loading test. If HPT, tx underlying dz w/ surgery