Aetiological Examination of Recurrent Urinary Stone Formers in General Practice

Abstract

As a part of a project performed in general practice 93 recurrent urinary stone formers were examined by means of a programme comprising a thorough medical history, clinical examination, serum determinations, a chemical stone analysis, two consecutive 24h urine collections and i.v.-pyelography. The diagnostic information obtained from the different examinations is presented. In 64 (69%) of the patients the probable aetiology of the stone formation was revealed. Twenty seven (29%) of all patients had combined aetiology. Hyperuricosuria and hypercalciuria were groups of equal size, comprising all together 45 patients, and emphasizing the necessity of 24h urine collections. Hyperparathyroidism (surgically verified) was diagnosed in four patients, based on serum calcium. Seven patients had infectious stone. It is stated that an aetiological examination of the recurrent stone former may be adequately carried out in general practice and lead to important therapeutical consequences.

Thiazide Prophylaxis of Urolithiasis

“…The study was performed during 1977-81 in a group practice (Nedre Eiker Legesenter) serving a population of about 17000 inhabitants in a partly rural municipality in Norway. The study population comprised 50 (38 men and 12 women) out of 93 etiologically examined recurrent stone formers encountered in general practice (either by one of the authors or by other practitioners and referred to the author) (8).…”

Is It Possible to Characterize Recurrent Urinary Stone Formers Who Benefit from Thiazide Prophylaxis?

“…Twenty-three recurrent urinary stone formers were treated for median 40 (range 12-51) months with a daily dose of 50 mg hydrochlorthiazide, and 25 patients were treated for median 38 (range 1245) months with placebo. Prior to inclusion in the trial the patients were etiologically examined and classified as previously described ( 5 , 7,8). Serum phosphate was determined on three occasions (mean value is given) with an interval of minimum one week.…”