AUA 2017: Plenary: Next Frontier: State-of-the-Art Lecture: Epidemiological Studies in Stone Disease

Boston, MA ( Dr. Gary Curhan, MD from the Department of Nephrology at Harvard Medical School provided an up-to-date epidemiological summary of the state of renal stone disease in the United States. Dr. Curhan performed an analysis of the current literature as it relates to risk factors in nephrolithiasis and gave his own recommendations for patient care and counseling for renal stone recurrence. The primary aim was to discuss risk factors as they relate to recurrent nephrolithiasis (5% reported in adults) rather than primary prevention of renal stone disease.

Among many interesting findings, Dr. Curhan discussed the role of dietary variables as significant concerns for both patients and urologists. As reported previously, higher calcium intake was associated with a lower risk and incidence of calcium-based stones. On the other hand, patients on a low calcium diet had a greater risk of nephrolithiasis. Importantly, the source of calcium, arguably largely derived from dairy products in the U.S., was no different than non-diary based dietary calcium with respect to a decreased risk of kidney stone disease. Additinally, he recommended both spinach and potatoes as foods that should be avoided in patients at risk for calcium-oxoalate stones, and he spoke of a study that found a decreased quantity of oxalate-consuming bacteria in the flora of patients with nephrolithiasis. Although lemonade can be consumed in high amounts, its alkali content is not sufficient enough to be a single therapy. Lastly, patient weight, as an independent risk factor (i.e. controlled for dietary variables), was associated with a substantial risk of renal stone disease.

Dr. Curhan closed by reporting an increase in the absolute risk of other systemic illnesses in patients with nephrolithiasis, which include chronic kidney disease, cardiovascular disease, and hypertension. Thus, the importance of the treatment and prevention of recurrent nephrolithiasis cannot be understated.

Presented By: Dr. Gary Curhan, MD

Author(s): Gary Curhan, MD, ScD

Affiliation: Harvard Medical School, Cambridge, MA

Written By: Linda Huynh (BS), an assistant research specialist from the University of California, Irvine, on behalf of

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA