How is ongoing medical therapy for nephrolithiasis monitored?

Updated: Sep 16, 2021
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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If a patient older than 40 years has formed a single stone that passed spontaneously or was easily treated, follow-up care for recurrent stones may be unnecessary. Such patients are at a reasonably low risk for recurrence if they maintain adequate fluid intake. In other patients, whether or not they have elected directed metabolic therapy, routine follow-up care consists of plain abdominal radiography (or renal ultrasonography in the case of radiolucent stones) every 6-12 months.

If medical therapy is instituted, a 24-hour urinalysis 3 months after starting any new therapy should be performed to assess the degree of patient compliance and the adequacy of the metabolic response. Checking all possible metabolic parameters—not just the previously abnormal ones—is necessary because of the possibility of new problems arising as a result of the new therapy. Once a stable regimen has been established, annual 24-hour urinalyses are adequate.

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