Table 3.

Summary of medical management depending on stone composition

Stone type	Metabolic status	AUA recommended interventions	AUA strength of recommendation	EAU recommended interventions	EAU strength of recommendation
Calcium oxalate	Hypercaluria	Limit sodium and calcium intake	Standard	Thiazide and alkaline citrates	Strong
		Thiazide	Standard
	Hyperoxaluria	Avoid oxalate-rich foods but	Expert opinion	Oxalate intake restriction	Weak
		maintain normal calcium intake		Enteric - Alkaline citrates	Weak
				Calcium and magnesium	Weak
				Primary-Pyridoxine	Strong
	Hyperuricosuria	Limit non-dairy animal protein	Expert opinion	Avoid excessive intake of animal protein	Strong
		Allopurinol	Standard	Allopurinol (first-line)	Strong
				Febuxostat (second-line)	Strong
	Hypomagnesuria			Magnesium
	Hypocitraturia	Increase the intake of fruit and vegetables and limit non-dairy animal intake.	Expert opinion	Alkaline citrates and sodium bicarbonate	Strong
		Potassium citrate	Standard
	Hypernaturia			Restricted salt intake	Strong
Calcium Phosphate	Hypercaluria			Thiazide	Strong
	Acidic urine			L-methionine	Weak
Uric Acid	Alkaline urine	Potassium citrate	Standard	Alkaline citrates	Strong
	Hyperuricouria			Allopurinol	Strong
Cystine		Increase fluid intake	Expert opinion	Increase fluid intake
		Limit sodium and protein intake		Alkaline citrates
		Potassium citrate	Standard	Tiopronin (added if above treatments are insufficient)
		Tiopronin (second-line, if unresponsive to above)	expert opinion
Struvite		Surgical intervention (first-line)	Option	Surgical intervention (first-line)	Strong
		AHA (second-line)		AHA (second-line)
	Acidic urine			Ammonium chloride or methionine	Weak
	Persistent bacteriuria			Antibiotics	Strong

AHA: acetohydroxamic acid; AUA: American Urological Association; EAU: European Association of Urologists