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• W2894797921 abstract "Roughly half of all symptomatic renal calculi are potentially preventable if patients were properly diagnosed and treated for their underlying chemical stone promoting risk factors. There is little question that our current level of medical evaluation and prophylactic therapy of recurrent nephrolithiasis is badly underutilized and generally inadequate. In 2012, the yearly direct and indirect costs were estimated at over $10 billion. This figure is predicted to exceed $15 billion by the year 2030 due not only to general population growth, but also to the increasing prevalence of diabetes, metabolic syndrome and obesity, all risk factors for kidney stone disease, in our society. Additionally, quality of life scores are dramatically lowered in nephrolithiasis patients, even in those with asymptomatic stones. There may be no other body of chemistry tests in any branch of medical practice that is potentially as useful and so often indicated, yet so infrequently utilized, as the 24-hour urine test for nephrolithiasis prophylaxis. In a large series of almost 29,000 high-risk stone formers, only 7.4% of patients underwent 24-hour urine testing within six months of their kidney stone. Nephrolithiasis patients were three times more likely to do 24-hour urine testing if they were treated by a nephrologist or urologist compared to a primary care physician. Repeat testing within six months of the initial 24-hour urine test, which is highly recommended to verify treatment efficacy and compliance, was only 16%.There are multiple reasons for this. Like all 24-hour urine collection tests, doing the collection itself is often considered tedious by patients as it drastically limits their activities the day of the specimen collection. Portions of the urinary chemistry are sometimes sent to different reference laboratories which often leads to unacceptable delays and incomplete results that cannot be easily interpreted. The most critical results are often buried amid paragraphs of obligatory boilerplate, again making it almost impossible to identify the most critical results. Even worse, results are often presented as 24-hour totals that are either high or low or normal or abnormal without regard for concentration, pH or what optimal levels of these chemistries would be because providing such information is not readily available or legally required.Once the critical data is available, analysis and treatment selection still needs to be done. Evaluation and interpretation of the laboratory results is often erroneously perceived as overly complex and complicated. There are many different ways the various chemistry reference laboratories hide the data or otherwise make it confusing. Even for experienced experts, finding and clarifying the critical data can be challenging.The purpose of this review is to simplify the analysis and evaluation of 24-hour urine collections as well as treatment selection, so local practitioners will be more comfortable using and interpreting this important test for their nephrolithiasis patients." @default.
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• W2894797921 date "2019-09-29" @default.
• W2894797921 modified "2023-09-26" @default.
• W2894797921 title "24-Hour Urine Testing for Nephrolithiasis Interpretation" @default.
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