By vgreene, 30 December, 2015 If relatively low urine citrate: Increase fruits + vegetables, limit nondairy animal protein, per AUA7
By vgreene, 30 December, 2015 If relatively high UCa++: Limit dietary Na+ ≤2,300 mg/day and consume dietary Ca++ 1,000-1,200 mg/day, per AUAU1
By vgreene, 30 December, 2015 ACP7 concluded multicomponent diet studies showed mixed results. Inadequate evidence on tailoring tx by stone type or blood/urine chemistries, per ACP7 and AHRQ3
By vgreene, 30 December, 2015 If unresponsive to diet + urinary alkalinization, or if large recurrent stone burden, use cystine-binding thiol drug, per AUA,13 EAU14
By vgreene, 30 December, 2015 Alkalinize diet (↑fruits, veggies), per EAU,12 AUA;9 limit animal protein, per AUA.9 Restrict Na+ intake ≤2,300 mg/day, per AUA;9 EAU12 recommends
By vgreene, 30 December, 2015 Alkalinize urine to pH of 7.0 w/ K+ citrate, per AUA;10 EAU recommends pH 7.5-8.511
By vgreene, 30 December, 2015 If fluid-restricted (eg, CHF, CKD, etc) consider reducing target urine volume, per ACP5
By vgreene, 30 December, 2015 ↑fluids: Oral intake >4 L/day recommended by AUA;1 urine output of ≥2 L/day per ACP2 and AHRQ;3 ≥2.5 L/day per EUA4
By vgreene, 29 December, 2015 Alkalinize urine via medications and diet; use allopurinol adjunctively. F/U 24-hr urine @ 6 mo;8 if no tx response, repeat stone analysis, per AUA9