Medical Management of Renal Stones
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Dr. Sainath Pattewar
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Kidney stones affect 1 in 11 people globally, with a high recurrence rate within 5–10 years.1 In India, about 2 million cases of urolithiasis are reported annually. Most stones are calcium-based (70–80%), followed by uric acid, cystine, struvite, and mixed types. Risk factors include genetic predisposition, metabolic syndrome, low fluid intake, and high intake of sodium, animal protein, and oxalate-rich foods. Common symptoms include renal colic, flank pain, hematuria, and urinary tract infections (UTIs).2 Diagnostic evaluation involves KUB X-ray, ultrasound, intravenous pyelogram (IVP), or helical CT, which has a sensitivity of 97%.1 Management includes increased fluid intake, adequate dietary calcium (1000–1200 mg/day) in recurrent calcium stone formers, and reduction of sodium and oxalate intake, along with correction of hypocitraturia.1,3 Pharmacological options—based on stone type—include thiazides, potassium citrate, allopurinol, pyridoxine, and tiopronin.3 Medical expulsive therapy with tamsulosin, nifedipine, and steroids helps facilitate ureteric stone passage.1