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Conditions

Renal Calculi

Condition: Renal Calculi

Section Author: Jon Rees

Review Date: September 2017

Overview

A common issue in primary care – kidney stones.

There are a few key issues for the GP:

  • How to manage acute renal colic – who to admit, what analgesia and imaging if not admitting
  • When to refer asymptomatic stones
  • Advice on preventing further calculi, especially for recurrent stone formers

Healthcare Professional Links

Management of renal colic – review in BMJ 2012: http://www.bmj.com/content/345/bmj.e5499

SUSPEND trial – randomised controlled trial from UK, published n 2015 – showed no benefit of ‘medical expulsive therapy’ such as tamsulosin, to aid passage of calculi: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60933-3/fulltext?rss%3Dyes (free – open access)

EAU guidelines on nephrolithiasis 2015 – if you really want to know the detail – 71 pages: http://uroweb.org/wp-content/uploads/22-Urolithiasis_LR_full.pdf

BJU International ‘Guideline of Guidelines: Kidney Stones’: http://onlinelibrary.wiley.com/doi/10.1111/bju.13080/full - an excellent review of both the EAU and AUA guidelines, published in 2015.

Advice on fluid management: http://www.cystinuriauk.co.uk - this website is intended for patients with cystinuria -  rare complaint – but excellent guidance in the ‘Diet – tell me more’ section on how to maintain a good fluid intake.

Preventing kidney stones – excellent patient information sheet from Guys & St Thomas’s written by Matt Bultitude and the hospital dietitians – well worth signposting patients towards this: http://www.guysandstthomas.nhs.uk/resources/patient-information/urology/stones/diet-and-lifestyle-advice-for-the-prevention-of-kidney-stones.pdf

BAUS info sheet for patients on ‘dietary advice for stone formers’: http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Stone_diet.pdf

A detailed blog on ‘the kidney stone diet’ – worth a look for recurrent stone formers: http://kidneystones.uchicago.edu/the-kidney-stone-diet/

What activities are safe with kidney stones? Short paper with useful advice re DVLA, pilots, foreign travel, armed services etc: http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2007.06553.x/full

Information for patients

BAUS http://www.baus.org.uk/patients/conditions/6/kidney_stones

NHS Choices http://www.nhs.uk/Conditions/kidney-stones/Pages/Introduction.aspx

 

Administration: Janis.Troup@rightangleuk.com and Sabah.Allawati@rightangleuk.com