Medical Stone Management: 35 Years of Advances

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: The urological community has had a vital role in the author's 35 years of research on the medical management of urolithiasis. The goal of this article is to review the progress made from the perspective of collaborating urologists and urological journals in which the findings were reported. Materials and Methods: The author's work appeared in 94 articles in urological journals, including 63 in The Journal of Urology®, and in 28 other journals with collaborating urologists. Progress on various aspects of medical management of stone disease was reviewed based on these articles. Results: Pathophysiological exploration was performed by elucidating metabolic-dietary etiologies of hypocitraturia, separating hypercalciuria into 3 types, and linking gouty diathesis (uric acid stones) with obesity and insulin resistance. Physicochemical consequences of hypocitraturia were delineated and semi-empirical methods were developed to assess calcium salt saturation. Potassium-rich fruit juices differed from potassium-poor fruit juices and excessive salt intake increased the stone forming risk. Vital to diagnostic separation was a comprehensive analysis of urine for stone risk factors. As an example of selective treatment, potassium citrate was shown to be useful for controlling uric acid stones by urinary alkalinization as well as calcareous stones by hypercitraturia. Conclusions: During the last 35 years much progress has been made on the pathophysiology of stone formation, crystallization of stone forming salts, diagnostic separation and prevention of stone recurrence. The author's contribution in this effort would not have been possible without the active participation and support of the urological community.

Original languageEnglish (US)
Pages (from-to)813-819
Number of pages7
JournalJournal of Urology
Volume180
Issue number3
DOIs
StatePublished - Sep 2008

Fingerprint

Salts
Uric Acid
Potassium
Potassium Citrate
Hypercalciuria
Urinary Calculi
Urolithiasis
Disease Susceptibility
Urology
Disease Management
Crystallization
Insulin Resistance
Biomedical Research
Obesity
Urine
Calcium
Recurrence
Fruit and Vegetable Juices
Urologists
Therapeutics

Keywords

  • 21st century
  • citric acid
  • crystallization
  • history
  • lectures
  • urolithiasis

ASJC Scopus subject areas

  • Urology

Cite this

Medical Stone Management : 35 Years of Advances. / Pak, Charles Y C.

In: Journal of Urology, Vol. 180, No. 3, 09.2008, p. 813-819.

Research output: Contribution to journalArticle

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