skip to main content

Comprehensive Stone Prevention — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRenal Stone DiseaseComprehensive Stone PreventionESENeph

A 55-year-old man presents with flank pain and CT-KUB shows a 15 mm lower pole renal stone. Stone analysis from a previous episode showed calcium oxalate. His 24-hour urine shows: low volume (1.2 L), high calcium (9 mmol/day), high oxalate, low citrate. What combination of lifestyle and pharmacological measures is most comprehensive?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Fluid intake >2.5 L/day + dietary sodium restriction + normal calcium intake + Thiazide + Potassium citrate

Comprehensive stone prevention for recurrent calcium oxalate stones includes: high fluid intake (>2.5 L/day targeting urine output >2 L/day), dietary sodium restriction (<2 g/day – reduces urinary calcium), normal (not low) dietary calcium (binds oxalate in the gut), low oxalate foods, Thiazide diuretic (reduces hypercalciuria), and Potassium citrate (corrects hypocitraturia and alkalinises urine). Low calcium diets paradoxically increase stone risk. Vitamin C supplementation increases oxalate and is harmful.

Reference: EAU 2024 – Urolithiasis Guidelines; NICE NG118 2019