Preventing Recurrent Nephrolithiasis in Adults

Advise patients to drink at least 2 L daily; consider drug therapy for patients with “active” stone formation.

Sponsoring Organization: American College of Physicians (ACP)

Target Audience: Primary care clinicians

Background and Objective

Clinicians are expected to advise patients with symptomatic nephrolithiasis on strategies to prevent recurrent episodes. The ACP developed this guideline based on a review of evidence supporting dietary and pharmacologic interventions.

Key Recommendations

For preventing recurrent nephrolithiasis, the ACP recommends:

Increased fluid intake to achieve 2 L of urine output daily (weak recommendation; low-quality evidence).
Drug therapy with a thiazide diuretic, citrate, or allopurinol for patients with active disease despite increased fluid intake (weak recommendation; moderate-quality evidence). “Active disease” was not defi…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose