Update on the medical management of stone disease

Chad R. Tracy, Margaret S Pearle

Research output: Contribution to journalReview articlepeer-review

50 Scopus citations


Purpose of review Recurrent nephrolithiasis is a burden to the individual patient as well as the healthcare system. A lack of new medications for treatment of stone disease and continued poor compliance with drug therapy has led to a growing interest in dietary manipulation and novel therapies aimed at preventing recurrent stone formation. Recent findings Despite initial enthusiasm for lemonade therapy, recent metabolic studies suggest that beverages with a high potassium citrate content, rather than citric acid, may be more effective in reducing stone risk because of the alkali load and citraturic response. In addition, there is increasing epidemiologic and metabolic evidence that obesity and dietary excess, including fructose-rich and purine-rich foods, are associated with increased stone risk. Finally, alternative measures for reducing urinary risk factors, such as probiotics, show promise in reducing urinary oxalate and may be effective in the treatment of primary and enteric hyperoxaluria or even idiopathic calcium oxalate nephrolithiasis. Although changes in urinary stone risk factors may reduce the need for surgical treatment of stone disease, the best management for recurrent nephrolithiasis is likely a combination of surgical and medical therapy. Summary Dietary measures and novel probiotic therapy are promising adjuncts for preventing recurrent nephrolithiasis.

Original languageEnglish (US)
Pages (from-to)200-204
Number of pages5
JournalCurrent opinion in urology
Issue number2
StatePublished - Mar 2009


  • Citrus
  • Lemonade therapy
  • Metabolic syndrome
  • Probiotic
  • Stone risk

ASJC Scopus subject areas

  • Urology


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