Calcium stones are common and recurrent in nature, yet few therapeutic tools are available for secondary prevention. Personalized approaches for stone prevention have been informed by 24-hour urine testing to guide dietary and medical interventions. However, current evidence is conflicting about whether an approach guided by 24-hour urine testing is more effective than a generic one. The available medications for stone prevention, namely thiazide diuretics, alkali, and allopurinol, are not always prescribed consistently, dosed correctly, or tolerated well by patients. New treatments on the horizon hold the promise of preventing calcium oxalate stones by degrading oxalate in the gut, reprogramming the gut microbiome to reduce oxalate absorption, or knocking down expression of enzymes involved in hepatic oxalate production. New treatments are also needed to target Randall's plaque, the root cause of calcium stone formation.
Advances in kidney disease and health. 2023 Mar [Epub]
Deepa A Malieckal, Calyani Ganesan, Denisse Arellano Mendez, Alan C Pao
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Division of Kidney Diseases and Hypertension, Department of Medicine, Great Neck, NY., Stanford University School of Medicine, Division of Nephrology, Department of Medicine, Palo Alto, CA., Mexican Social Security Institute, Division of Nephrology, Department of Internal Medicine, Guadalajara, Jalisco, Mexico., Stanford University School of Medicine, Division of Nephrology, Department of Medicine, Palo Alto, CA; Veterans Affairs Palo Alto Health Care System, Medical Service, Division of Nephrology, Palo Alto, CA; Stanford University School of Medicine, Department of Urology, Palo Alto, CA. Electronic address: .