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Recurrent calcium nephrolithiasis — ABFM Board MCQ

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HardUrology/RenalRecurrent calcium nephrolithiasisABFM Board

A 37-year-old man has recurrent calcium oxalate kidney stones. CT confirms a 4-mm distal ureteral stone. Serum calcium is normal, urinalysis has microscopic hematuria, and creatinine is normal. Which of the following would you advise this patient to reduce recurrence?

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Correct answer: D — Increase fluid intake to produce at least 2.5 L urine daily

Prevention of recurrent calcium stones begins with high fluid intake to achieve urine output of at least 2.5 L/day. Normal dietary calcium is generally maintained, while sodium and excessive oxalate may be reduced.

Reference: AUA Medical Management of Kidney Stones Guideline