Management of kidney stones

A complete history of drugs use can help identify those that are known to increase the risk of kidney stones (box 1).w3 Box 1 Important factors to identify in the patient's history Presence of systemic illness Primary hyperparathyroidism Renal tubular acidosis Cystinuria Gout Diabetes mellitus Inflammatory bowel disease Renal insufficiency Sarcoidosis Medullary sponge kidney Anatomical features Presence of horseshoe kidney Previous urinary diversion Obstruction of the ureteropelvic junction Solitary kidney Previous renal or ureteral surgery Previous kidney disease History of urinary tract infection or pyelonephritis, or both Family history of urolithiasis Detailed history of previous stone events Treatment Stone analysis Drugs that affect stone disease Carbonic anhydrase inhibitors (topirimate) Ephedrine Guaifenesin Calcium with vitamin D Triamterene Indinavir or sulfadiazine Assessment should include measurement of vital signs because fever may be an indication for acute intervention (box 2). [...]microscopic urinalysis may identify crystals, such as the classic hexagonal crystals seen in cystinuria.