Empiric therapy for kidney stones

Urolithiasis. 2019 Feb;47(1):107-113. doi: 10.1007/s00240-018-1090-6. Epub 2018 Nov 26.


Careful phenotyping of patients to classify those with kidney stones has a long and important history in revealing the chemical basis for stone formation. Advances in our genetic understanding of kidney stones will lead to incredible insights regarding the pathophysiology of this common disorder. At this time, both evaluation of urine chemistry and genotyping of patients are extremely useful in the setting of a university and research-based kidney stone clinic. For much of the world, in a more clinically focused setting, these techniques are neither available nor absolutely necessary. Careful implementation of an empiric prescription based on stone composition would have an important effect to reduce stone recurrence in the world's many stone formers. Increased fluid intake, generic dietary manipulations, and prescription of potassium citrate and thiazides are all appropriate empiric therapies for people with calcium and uric acid kidney stones.

Keywords: Diet; Genetics; Kidney calculi; Nephrolithiasis; Potassium citrate; Thiazides; Uric acid; Urolithiasis.

Publication types

  • Review

MeSH terms

  • Calcium / chemistry
  • Calcium / urine
  • Diet, Sodium-Restricted
  • Dietary Approaches To Stop Hypertension
  • Fluid Therapy / methods*
  • Genetic Testing / economics
  • Genetic Testing / methods
  • Humans
  • Kidney Calculi / chemistry
  • Kidney Calculi / genetics
  • Kidney Calculi / therapy*
  • Kidney Calculi / urine
  • Potassium Citrate / therapeutic use*
  • Recurrence
  • Thiazides / therapeutic use*
  • Treatment Outcome
  • Uric Acid / chemistry
  • Uric Acid / urine


  • Thiazides
  • Uric Acid
  • Potassium Citrate
  • Calcium