CUA guideline on the evaluation and medical management of the kidney stone patient - 2016 update

CUA guideline on the evaluation and medical management of the kidney stone patient - 2016 update

Despite technological advances in the surgical management of upper tract urinary stone disease that have significantly reduced patient morbidity and recovery time, new stone formation and recurrence remain significant health issues. Data from the U.S. National Health and Nutrition Examination Survey (NHANES) published in 2012 noted a kidney stone prevalence of 10.6% in men and 7.1% among women.¹ Comparing these results to a similar survey conducted between 1976 and 1994, the overall prevalence of stone disease in the U.S. population has increased from 5.2 to 8.2%.² An increase in stone formation, particularly among women, has also been observed such that the male:female ratio appears to be decreasing.^3,4 Recent evidence also suggests there may be an increase in the incidence of certain stone compositions, such as uric acid, a type of stone clearly linked to both dietary and metabolic risk factors.⁵

In 2010, the Canadian Urological Association (CUA) Guidelines Committee commissioned the development of a clinical practice guideline on the evaluation and medical management of patients with upper tract urolithiasis. The aims of the guideline were to help clinicians identify patients at heightened risk of stone recurrence, to outline the required investigations to assess these patients, and to provide up-to-date advice on dietary and medical interventions of proven benefit in the Canadian context. In accordance with the CUA’s policy of reviewing the content of guidelines every five years, this topic was felt to be ready for revision to reflect new advances in the preventative management of patients with renal stones. It should be noted that this guideline addresses the evaluation and medical prophylaxis of upper tract stones and not stones forming within the bladder.


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