Table 7. Management of all types of kidney stones.
| Abnormality | Evaluate | Management |
|---|---|---|
| Hypercalciuria | Urine Na and urea nitrogen | Na, protein restriction, Thiazide, not low Ca diet |
| Hypercalcemia | PTH, ionized Ca, vitamin D, malignancy, thyroid, bone disease etc | Parathyroidectomy, treat underlying disorder |
| Hyperoxaluria | Dietary oxalate, low dietary Ca, vitamin D, sweeteners, ileal disease, gastric bypass, ethylene glycol, enzyme deficiencies | Restrict oxalate, supplement magnesium, Ca, pyridoxine, cholestyramine |
| Hypocitraturia | Urinary citrate, serum potassium (K), creatinine, malabsorption, RTA, acetazolamide | Alkali (potassium citrate), sodium citrate if volume deplete |
| Hyperuricosuria | Dietary purines | Purine restriction, allopurinol, alkali |
| Acid urine (pH) | Exclude chronic diarrhea, gout, ileostomy | Alkali (Potassium citrate) |
| Low urine volume | 24 hr urine volume | At least 2.5 liters fluid intake |
PTH: parathyroid hormone, RTA: renal tubular acidosis.