Nephrolithiasis is a common health problem across the globe with a prevalence of 15%-20%. Idiopathic
hypercalciuria is the most common cause of
nephrolithiasis, and
calcium oxalate stones are the most common type of stones in idiopathic hypercalciuric patients.
Calcium phosphate stones are frequently associated with other diseases such as
renal tubular acidosis type 1,
urinary tract infections, and
hyperparathyroidism. Compared with flat abdominal film and renal sonography, a noncontrast helical computed tomography scan of the abdomen is the diagnostic procedure of choice for detection of small and radiolucent
kidney stones with sensitivity and specificity of nearly 100%. Stones smaller than 5 mm in diameter often pass the urinary tract system and rarely require surgical interventions. The main risk factors for stone formation are low urine output, high urinary concentrations of
calcium, oxalate,
phosphate, and
uric acid compounded by a lower excretion of
magnesium and
citrate. A complete metabolic workup to identify the risk factors is highly recommended in patients who have passed multiple
kidney stones or those with recurrent disease.
Calcium oxalate and
calcium phosphate stones are treated by the use of
thiazide diuretics,
allopurinol, and
potassium citrate. Strategies to prevent
kidney stone recurrence should include the elimination of the identified risk factors and a dietary regimen low in
salt and
protein, rich in
calcium and
magnesium which is coupled with adequate fluid intake.