Specific Therapies for Nephrolithiasis
| Stone Type | Dietary Modifications | Other |
|---|---|---|
| Calcium oxalate | Increase fluid intake | Citrate supplementation (calcium or potassium salts > sodium) |
| Moderate sodium intake | ||
| Moderate oxalate intake | Cholestyramine or other therapy for fat malabsorption | |
| Moderate protein intake | ||
| Moderate fat intake | Thiazides if hypercalciuric | |
| Allopurinol if hyperuricosuric | ||
| Calcium phosphate | Increase fluid intake | Thiazides if hypercalciuric |
| Moderate sodium intake | Treat hyperparathyroidism if present | |
| Alkali for distal renal tubular acidosis | ||
| Struvite | Increase fluid intake; same as calcium oxalate if evidence of calcium oxalate nidus for struvite | Methenamine and vitamin C or daily suppressive antibiotic therapy (e.g., trimethoprim-sulfamethoxazole) |
| Uric acid | Increase fluid intake | Allopurinol |
| Moderate dietary protein intake | Alkali therapy (K+ citrate) to raise urine pH to 6.0-6.5 | |
| Cystine | Increase fluid intake | Alkali therapy |
| Penicillamine |
Note: Sodium excretion correlates with calcium excretion.