Kidney stones: prevent recurrence

A frequent pathology

10% of the population will have at least one kidney stone. Risk of recurrence: 50% in 5 years.

Renal colic

Sudden, intense pain in the flank, radiating to the genitals, with agitation, often with nausea. Hematuria. Treatment: NSAIDs (1st intention), antispasmodics, hydration. Look for fever (urgent: febrile obstructive pyelonephritis).

Diagnosis

Non-contrast abdominal CT (gold standard), ultrasound. Metabolic workup after the 1st stone or if recurrence.

Treatment of stones

• Spontaneous passage if <5 mm
• Extracorporeal lithotripsy (ESWL)
• Flexible ureteroscopy, percutaneous nephrolithotomy

Prevention

Hydration >2L/day (diluted urine), moderate sodium intake, normal calcium (no restriction), limit oxalates (spinach, chocolate, nuts), limit animal protein. Adapted treatment according to stone composition (allopurinol, citrate, etc.).