Metaphylaxis of urolithiasis

Abstract

The urolithiasis is a growing disease because of the changes in dietary habits and in he general life style. Urolithiasis is characterized by the recurrent clinical manifestation and possible effect of structural damage of the kidneys and of the urinary tract ast well as the potential increase in systemic blood pressure. Moreover, frequent need for medical cure and invasive urological treatment exposes the patient to the complications of such procedures. The lithogenic process involves a wide number of systemic pathologies that are often undiagnosed. However, once identified they can be treated more precisely having an impact on the stone's forming process. For these reasons, prevention of new urolithiasis in patients, and in particular in those with high risk, appears to be clinically important. Metaphylaxis can be differentiated in two ways: "general metaphylaxis" in patients with lithiasis of the urinary tract, and "specific metaphylaxis" meant for patients with risk factors for recurrent calculosis. The aim of this narrative review is to present an algorithm for clinical practice for patients that have undergone one or more attacks of renal/ureteral colic from lithiasis in order to prevent further attacks. As such, this review deals with a method of secondary prevention (prophylaxis) that aims at identifying and correcting metabolic disorders (from which the term metaphylaxis comes) that favor and support the lithogenic process in the urinary tract.