Giovanni Gambaro 1 , Emanuele Croppi , 2 , Fredric Coe 3 , James Lingeman 4 , Orson Moe 5 , Elen Worcester 3 , Noor Buchholz 6 , David Bushinsky 7 , Gary C. Curhan 8 , Pietro Manuel Ferraro 1 , Daniel Fuster 9 , David S. Goldfarb 10 , Ita Pfeferman Heilberg 11 , Bernard Hess 12 , John Lieske 13 , Martino Marangella 14 , Dawn Milliner 15 , Glen M. Preminger 16 , Jose’ Manuel Reis Santos 17 , Khashayar Sakhaee 18 , Kemal Sarica 19 , Roswitha Siener 20 , Pasquale Strazzullo 21 , James C. Williams 22 , The Consensus Conference Group 1
25 July 2016
Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research.
A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved.
Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients.
This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified.