Table Of ContentPractical Controversies in Medical Management
of Stone Disease
Margaret S. Pearle • Stephen Y. Nakada
Editors
Practical Controversies
in Medical Management
of Stone Disease
1 3
Editors
Margaret S. Pearle Stephen Y. Nakada
Department of Urology Department of Urology
University of Texas Southwestern University of Wisconsin School
Medical Center of Medicine and Public Health
Dallas Madison
Texas, USA Wisconsin, USA
ISBN 978-1-4614-9574-1 ISBN 978-1-4614-9575-8 (eBook)
DOI 10.1007/978-1-4614-9575-8
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2014930307
© Springer Science+Business Media New York 2014
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Preface
Practical Controversies in Medical Management of Stone Disease is targeted at
the practitioner interested in caring for patients with kidney stones. Kidney stone
disease is a common condition, affecting nearly 1 in 11 individuals in the USA
at some time in their lives. Furthermore, the risk of developing a stone does not
disappear with passage or treatment of the stone, as recurrence rates for those who
have had a stone approach 50 % at 5 years. Consequently, strategies aimed at stone
prevention are desirable. Although the literature is replete with books and articles
outlining management approaches for stone prevention, there are many areas of dis-
agreement over treatment recommendations, even among stone experts. This book
focuses on controversial or misunderstood aspects of evaluation, diet therapy, and
medical treatment of stone patients. In each chapter, an expert in the field presents
and synthesizes the evidence on a topic from the literature and translates the infor-
mation into rational treatment recommendations. The aim of this book is to dispel
commonly held but incorrect notions about stone disease and to highlight areas ripe
for further study. As such, this book will benefit all stakeholders in stones disease,
both patients and those caring for them.
Margaret S. Pearle
Stephen Y. Nakada
v
Contents
1 Metabolic Evaluation: Underused or Overdone? ................................... 1
Juan C. Calle and Manoj Monga
2 Dietary oxalate and calcium oxalate stones: a theoretical
or real concern? .......................................................................................... 7
Kristina L. Penniston
3 Dietary Calcium and Prevention of Calcium Stones:
More or Less? ............................................................................................. 29
Jodi Antonelli and Margaret S. Pearle
4 Citrus Juices and Prevention of Calcium Stones:
Some, but Not All? ..................................................................................... 45
Michael P. Kurtz and Brian H. Eisner
5 Bariatric Surgery and Stone Disease: Help or Hindrance? ................... 63
Gautam Jayram and Brian R. Matlaga
6 Protein Restriction and Stone Disease: Myth or Reality? ...................... 71
Sara L. Best
7 Uric Acid Nephrolithiasis: Uric Acid or Urine pH? ................................ 91
Khashayar Sakhaee
8 Cystinuria: Assessing and Managing Risk .............................................. 105
Nicola T. Sumorok and David S. Goldfarb
9 Potassium Citrate and Calcium Stones: Benefit or Risk? ...................... 115
Ramy F. Youssef, Glenn M. Preminger and Michael E. Lipkin
vii
viii Contents
10 Thiazides and Calcium Stones: Overrated or Underused? .................... 131
John J. Knoedler and Amy E. Krambeck
Index .................................................................................................................. 143
Contributors
Jodi Antonelli Department of Urology, University of Texas Southwestern Medical
Center, Dallas, USA
Sara L. Best Department of Urology, University of Wisconsin School of Medicine
and Public Health, Madison, USA
Juan C. Calle Department of Nephrology and Hypertension, Cleveland Clinic,
Cleveland, USA
Brian H. Eisner Department of Urology, Massachusetts General Hospital, GRB
1102, Boston, USA
David S. Goldfarb Nephrology, New York Harbor VA Healthcare System, NYU
Langone Medical Center, New York, USA
Gautam Jayram The Johns Hopkins Hospital, James Buchanan Brady Urological
Institute, Baltimore, USA
John J. Knoedler Department of Urology, Mayo Clinic, Rochester, USA
Amy E. Krambeck Department of Urology, Mayo Clinic, Rochester, USA
Michael P. Kurtz Department of Urology, Massachusetts General Hospital, GRB
1102, Boston, USA
Michael E. Lipkin Comprehensive Kidney Stone Center, Urology Division,
Surgery Department, Duke University Medical Center, Durham, USA
Brian R. Matlaga The Johns Hopkins Hospital, James Buchanan Brady Urological
Institute, Baltimore, USA
Manoj Monga Stevan Streem Center of Endourology and Stone Disease, Cleveland
Clinic, Cleveland, USA
Margaret S. Pearle Department of Urology, University of Texas Southwestern
Medical Center, Dallas, USA
Kristina L. Penniston Department of Urology, University of Wisconsin School of
Medicine and Public Health, Madison, USA
ix
x Contributors
Glenn M. Preminger Comprehensive Kidney Stone Center, Urology Division,
Surgery Department, Duke University Medical Center, Durham, USA
Khashayar Sakhaee Charles and Jane Pak Center for Mineral Metabolism and
Clinical Research, University of Texas Soutwestern Medical Center, Dallas, USA
Nicola T. Sumorok Medical Service, New York Harbor VA Healthcare System,
NYU Langone Medical Center, New York, USA
Ramy F. Youssef Comprehensive Kidney Stone Center, Urology Division, Surgery
Department, Duke University Medical Center, Durham, USA
Chapter 1
Metabolic Evaluation: Underused or Overdone?
Juan C. Calle and Manoj Monga
Introduction
Urolithiasis is a very common clinical problem that places a heavy economic
burden on society and has serious effects on the quality of life [1]. It affects both
men and women with lifetime prevalence as high as 13 and 7 %, respectively [2].
Over the past few decades, it has been shown that the incidence and prevalence
of nephrolithiasis has steadily increased. This is attributed presumably to multiple
factors including, but not limited to, changes in diet and lifestyle, increments in the
prevalence of obesity and diabetes mellitus, which have also been associated with
the formation of kidney stones, migration from rural cooler settings to warmer ur-
ban areas, and even possible changes associated to global warming [3, 4]. With this
rising prevalence, an increased emphasis has been placed on identifying effective
approaches to stone prevention.
The importance of appropriate management of kidney stone disease is under-
scored by the high incidence of recurrence of the disease after a first episode. Mul-
tiple studies have demonstrated that up to 50 % of patients may present with another
episode within 5 years of the first kidney stone [5]. When the follow-up period is
extended 25 years beyond the incident of stone event, up to 100 % recurrence has
been reported [6, 7].
With more than 2 million emergency room visits per year due to renal colic or renal
calculus, this ailment represents a massive burden to the health care system and the
economy as a whole. The annual direct costs calculated based on data from a private
insured, employed population during the year 2000 surpassed US$ 4.5 billion. After
J. C. Calle ()
Department of Nephrology and Hypertension, Cleveland Clinic, 9500 Euclid Avenue,
Cleveland, OH 44195, USA
e-mail: [email protected]
M. Monga
Stevan Streem Center of Endourology and Stone Disease, Cleveland Clinic,
Q10-1 9500 Euclid Avenue,Cleveland, OH 44195, USA
e-mail: [email protected]
M. S. Pearle, S. Y. Nakada (eds.), Practical Controversies in Medical Management 1
of Stone Disease, DOI 10.1007/978-1-4614-9575-8_1,
© Springer Science+Business Media New York 2014
