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Review
. 2019 Mar;28(2):148-153.
doi: 10.1097/MNH.0000000000000478.

Leave no stone unturned: defining recurrence in kidney stone formers

Matthew R D'Costa  1 , Vernon M Pais  2 , Andrew D Rule  1   3
Affiliations
Review

Leave no stone unturned: defining recurrence in kidney stone formers

Matthew R D'Costa et al. Curr Opin Nephrol Hypertens. 2019 Mar.

Abstract

Purpose of review: Established guidelines provide recommendations on the management of kidney stones to prevent recurrence. However, clear and clinically useful terminology for recurrence of kidney stones is needed. This review describes the various manifestations of kidney stone recurrence and the reported rates of kidney stone recurrence in various clinical settings.

Recent findings: Kidney stone recurrence has a wide range of symptomatic and radiographic presentations. Symptomatic recurrence may include characteristic symptoms of stone passage via the ureter (renal colic and gross hematuria). This may be self-managed or result in clinical care, with or without confirmation of an obstructing stone on imaging. Radiographic recurrence has been variably defined as new stone formation, stone growth, or stone disappearance (from passage with or without symptoms). Studies have used inconsistent definitions of recurrence, and recurrence rates vary substantially. Stone free rates and residual stone fragment size after surgical interventions are useful predictors of symptomatic recurrence.

Summary: The recurrence rate of kidney stones has been assessed in stone formers from sub-specialty clinics, the general community, and clinical trials. The definition of recurrence is quite heterogenous between studies, but the rate of recurrence generally increases as more manifestations are included in the definition.

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Conflict of interest statement

Conflicts of Interest

None

Figures

Figure.
Figure.
A conceptual model for the biology of kidney stone recurrence and its detection by symptoms or imaging. Dashed boxes show the biological changes and solid boxes show how these changes may be detected.
See this image and copyright information in PMC

References

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