Exclude Patient Type Detail Header
No
Footnote
<sup>1</sup> <b>ACP 2014 [WR/L].</b> Urine output emphasized rather than PO intake levels, due to insensible losses via sweat, etc. Ca++ stones are most common type; no trials assessed tx in uric acid or cystine stones. 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>Accessed 1/25/21</a>
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<sup>2</sup> <b>AHRQ 2013 [L].</b> <i>Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies</i>. AHRQ Pub. No.12(13)-EHC049-3. <a href=https://www.ncbi.nlm.nih.gov/books/NBK99762/pdf/Bookshelf_NBK99762.pdf>PDF</a>
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<sup>3</sup> <b>AUA 2014 [S/B]. </b>Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
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<sup>4</sup> <b>EAU 2014 [1b/A].</b> Turk C, et al. <i>Guidelines on Urolithiasis</i>. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis>Online</a>
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<sup>5</sup> <b>ACP 2014 [L].</b> Evidence applicable primarily to calcium stones. Benefit to ↓soft drinks was limited to pts who drank phosphoric-acid drinks (cola), not citric-acid drinks (eg, fruit-flavored soda). 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>Accessed 1/25/21</a>
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<sup>6</sup> <b>AHRQ 2013 [L].</b> Low level of evidence for cola restriction (1 study in men). <i>Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies.</i> AHRQ Pub. No.12(13)-EHC049-3. <a href=https://www.ncbi.nlm.nih.gov/books/NBK99762/pdf/Bookshelf_NBK99762.pdf>PDF</a>
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<sup>7</sup> <b>ACP 2014.</b> 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>Accessed 1/25/21</a>
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<sup>8</sup> <b>AUA 2014 [EO].</b> Single 24-hr specimen for urine stone risk factors; consider tailoring chemistries vs. standard panel (eg, for pure uric acid: urine pH, uric acid, creatinine). Imaging annually/tailored clinically: plain film, renal US, or low-dose CT [EO]. Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
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<sup>9</sup> <b>AUA 2014 [EO].</b> Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
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<sup>10</sup> <b>AUA 2014 [EO].</b> K+ citrate to raise urinary pH to 6.0. Most uric acid stone pts have low U pH, rather than hyperuricosuria, as predominant risk factor, so alkalinization w/ K+ citrate is 1st-line. Allopurinol not 1st-line, but if alkalinization unsuccessful/ineffective, use allopurinol as adjunct. Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
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<sup>11</sup> <b>EAU 2014.</b> Target pH 6.2-6.8 for recurrence prevention, 6.5-7.2 for chemolysis. Turk C, et al. <i>Guidelines on Urolithiasis</i>. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis>Online</a>
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<sup>12</sup> <b>EAU 2014.</b> Turk C, et al. <i>Guidelines on Urolithiasis</i>. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis>Online</a>
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<sup>13</sup> <b>AHRQ 2013.</b> Allopurinol tx reduced stone recurrence rate for pts w/ elevated blood/urine uric acid. <i>Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies</i>. AHRQ Pub. No.12(13)-EHC049-3. <a href=https://www.ncbi.nlm.nih.gov/books/NBK99762/pdf/Bookshelf_NBK99762.pdf>PDF</a>
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<sup>2</sup> <b>AHRQ 2013 [L].</b> <i>Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies</i>. AHRQ Pub. No.12(13)-EHC049-3. <a href=https://www.ncbi.nlm.nih.gov/books/NBK99762/pdf/Bookshelf_NBK99762.pdf>PDF</a>
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<sup>3</sup> <b>AUA 2014 [S/B]. </b>Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
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<sup>4</sup> <b>EAU 2014 [1b/A].</b> Turk C, et al. <i>Guidelines on Urolithiasis</i>. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis>Online</a>
<br><br>
<sup>5</sup> <b>ACP 2014 [L].</b> Evidence applicable primarily to calcium stones. Benefit to ↓soft drinks was limited to pts who drank phosphoric-acid drinks (cola), not citric-acid drinks (eg, fruit-flavored soda). 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>Accessed 1/25/21</a>
<br><br>
<sup>6</sup> <b>AHRQ 2013 [L].</b> Low level of evidence for cola restriction (1 study in men). <i>Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies.</i> AHRQ Pub. No.12(13)-EHC049-3. <a href=https://www.ncbi.nlm.nih.gov/books/NBK99762/pdf/Bookshelf_NBK99762.pdf>PDF</a>
<br><br>
<sup>7</sup> <b>ACP 2014.</b> 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>Accessed 1/25/21</a>
<br><br>
<sup>8</sup> <b>AUA 2014 [EO].</b> Single 24-hr specimen for urine stone risk factors; consider tailoring chemistries vs. standard panel (eg, for pure uric acid: urine pH, uric acid, creatinine). Imaging annually/tailored clinically: plain film, renal US, or low-dose CT [EO]. Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
<br><br>
<sup>9</sup> <b>AUA 2014 [EO].</b> Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
<br><br>
<sup>10</sup> <b>AUA 2014 [EO].</b> K+ citrate to raise urinary pH to 6.0. Most uric acid stone pts have low U pH, rather than hyperuricosuria, as predominant risk factor, so alkalinization w/ K+ citrate is 1st-line. Allopurinol not 1st-line, but if alkalinization unsuccessful/ineffective, use allopurinol as adjunct. Pearle M, et al. <i>Medical management of kidney stones: AUA Guideline</i>. <a href=https://www.auajournals.org/doi/epdf/10.1016/j.juro.2014.05.006>PDF</a>
<br><br>
<sup>11</sup> <b>EAU 2014.</b> Target pH 6.2-6.8 for recurrence prevention, 6.5-7.2 for chemolysis. Turk C, et al. <i>Guidelines on Urolithiasis</i>. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis>Online</a>
<br><br>
<sup>12</sup> <b>EAU 2014.</b> Turk C, et al. <i>Guidelines on Urolithiasis</i>. European Association of Urology. <a href=https://uroweb.org/guidelines/urolithiasis>Online</a>
<br><br>
<sup>13</sup> <b>AHRQ 2013.</b> Allopurinol tx reduced stone recurrence rate for pts w/ elevated blood/urine uric acid. <i>Recurrent Nephrolithiasis in Adults: Comparative Effectiveness of Preventive Medical Strategies</i>. AHRQ Pub. No.12(13)-EHC049-3. <a href=https://www.ncbi.nlm.nih.gov/books/NBK99762/pdf/Bookshelf_NBK99762.pdf>PDF</a>
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Increase fluid intake to achieve target urine output; alkalinize urine