By vgreene, 29 December, 2015 If fluid-restricted (eg, CHF, CKD, etc) consider reducing target urine volume, per ACP6
By vgreene, 29 December, 2015 Tx w/ thiazide, citrate, or allopurinol. ✓ single 24-hr urine @ 6 mo;7 if no tx response, repeat stone analysis, per AUA8
By vgreene, 29 December, 2015 ↑fluids to achieve daily urine output of ≥2 L/day per ACP1 and AHRQ;2 whereas AUA3 and EUA4 recommend ≥2.5 L/day
By vgreene, 29 December, 2015 Tx w/ thiazide, citrate, or allopurinol. ✓ single 24-hr urine @ 6 mo;8 if no tx response, repeat stone analysis, per AUA9
By vgreene, 29 December, 2015 EAU4 recommends diet w/ NL Ca++, limited Na+ (4-5 g/day), ↑fiber (veg, fruit), ↓oxalate, ↓animal protein (0.8-1 g/kg/day); avoid excessive Ca++/vitamin supplements
By vgreene, 29 December, 2015 Inadequate evidence on tailoring drug/diet19 tx by stone type or blood/urine chemistries, per ACP7
By vgreene, 29 December, 2015 AUA, EAU suggest stone analysis + urine metabolic studies to guide drug15,16 + diet17,18 tx
By vgreene, 29 December, 2015 Thiazide (higher dose),10 citrate, or allopurinol, per ACP11 and AHRQ.12 Combo tx (thiazide + citrate) not supported by AHRQ,13 ACP14