Urine and stone analysis for the investigation of the renal stone former: a consensus conference
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INVITED REVIEW
Urine and stone analysis for the investigation of the renal stone former: a consensus conference James C. Williams Jr.1 · Giovanni Gambaro2 · Allen Rodgers3 · John Asplin4 · Olivier Bonny5 · Antonia Costa‑Bauzá6 · Pietro Manuel Ferraro7 · Giovanni Fogazzi8 · Daniel G. Fuster9 · David S. Goldfarb10 · Félix Grases6 · Ita P. Heilberg11 · Dik Kok12 · Emmanuel Letavernier13 · Giuseppe Lippi14 · Martino Marangella15 · Antonio Nouvenne16 · Michele Petrarulo17 · Roswitha Siener18 · Hans‑Göran Tiselius19 · Olivier Traxer20 · Alberto Trinchieri21 · Emanuele Croppi22 · William G. Robertson23 Received: 13 July 2020 / Accepted: 11 September 2020 © The Author(s) 2020
Abstract The Consensus Group deliberated on a number of questions concerning urine and stone analysis over a period of months, and then met to develop consensus. The Group concluded that analyses of urine and stones should be routine in the diagnosis and treatment of urinary stone diseases. At present, the 24-h urine is the most useful type of urine collection, and accepted methods for analysis are described. Patient education is also important for obtaining a proper urine sample. Graphical methods for reporting urine analysis results can be helpful both for the physician and for educating the patient as to proper dietary changes that could be beneficial. Proper analysis of stones is also essential for diagnosis and management of patients. The Consensus Group also agreed that research has shown that evaluation of urinary crystals could be very valuable, but the Group also recognizes that existing methods for assessment of crystalluria do not allow this to be part of stone treatment in many places. Keywords Nephrolithiasis · Urine analysis · Stone analysis · Crystalluria
Introduction The use of urine analysis as a guide to the diagnosis and treatment of kidney stones is recommended for at least some stone formers in all of the published international guidelines [1–4] (see Supplemental Table 1), but data suggest it is not generally utilized as widely as has been recommended. For example, a recent study of a large cohort within the United States (US) Veterans Affairs Health Care System found that fewer than 1-in-6 stone forming patients had undergone 24-h A Consensus Conference, held as part of the 4th International Meeting of the Menarini Foundation on Nephrolithiasis Renal Stones in Practice: An Advanced Course: 20−22 June 2019, Verona, IT. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00240-020-01217-3) contains supplementary material, which is available to authorized users. * James C. Williams Jr. [email protected] Extended author information available on the last page of the article
urine testing that would have been relevant to managing their urinary stone disease [5]. A possible interpretation of this low utilization of urine data is that physicians in the US are unconvinced that urine testing is valuable and cost-effective [6–8]. In the UK, most health authorities have abandoned the routin
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