Medical treatment
Medical treatment should be based on the specific
clinical condition in a given patient as also the observed
metabolic abnormalities. These have been discussed
under individual stone headings. Medical prophylaxis is
effective in upto 80% of patients with recurrent stones.
Prospective clinical trials lasting for more than 3 years
have shown that selective treatments have a distinctive
benefit for idiopathic calcium oxalate stones11. Three
prospective trials of potassium citrate salts have been
performed and it has shown fewer recurrences of stones
as compared to controls. Thiazide diuretics have shown
therapeutic benefit in treating stone recurrence. Diet has
long been thought to be an important risk factor for
stones. Excessive intake of animal protein, salt, oxalate,
and calcium have all been implicated by epidemiological
or pathophysiological studies as possible contributors
to calcium stone formation12. There is however, notable
lack of prospective trials of dietary manipulations in such
patients. The existing data has failed to show any