ABSTRACT

Nephrolithiasis incidence is rising in the United States and worldwide, and in populations formerly at lower risk for kidney stones, women and young adolescents. Preventing recurrence is largely specic to the type of stone. Even when the stone cannot be retrieved, urine pH and 24-hour urine assessment can guide prevention. Medications such as the HIV protease inhibitors, antibiotics, and some diuretics elevate the risk of forming specic types of kidney stones; anticipating the increased risk imposed by medications allows clinicians to counsel at-risk patients accordingly. This chapter explains how to leverage diet, medication, and nutrient intakes to prevent calcium oxalate, calcium phosphate, uric acid, struvite (ammonium urate), and cystine stones. The recommendations are correlated with the strength of clinical evidence and the biologic rationale.