PROSPECTIVE THERAPEUTIC STUDIES IN NEPHROLITHIASIS

Prospective randomized trials with respect to stone prophylaxis deal m ainly with idiopathic calcium stone disease. There is a lot of evidenc e that alkali citrate, thiazides and allopurinol are effective in many patients. However, appropriate patient selection seems to be crucial. Alkali citrate and allopurinol have proven clinical efficacy in patie nts with hypocitraturia or hyperuricosuria, respectively. The correct method of patient selection for treatment with thiazides remains uncle ar. Despite the lack of prospective randomized trials, it is generally accepted that the first steps in the prophylaxis of idiopathic calciu m stone disease are high fluid intake and a sensible diet.