"Basic" Diagnostic Approach To Nephrolithiasis

Primeval cause(s) of nephrolithiasis remain elusive, at least for the majoriry of cases still classified as "idiopathic". More or less complex diagnostic protocols have been proposed and used in the last 20 years in order to allow, if not a full comprehension of the disease (as formerly hoped), at least an easy detection of biochemical risk factors, to select patients at higher risk or recurrences, and to guide therapy. While such an approach may well have allowed an optimal clinical management of the disease and an effective prevention of recurrences, its costs now question about its widespread use. Present health politics urgently impose drastic cuts in caregiving costs. This paper presents a "basic", cheap diagnostic protocol which should allow the clinician to know the essentials (albeit not all) for an adequate clinical management with a minimum cost. Rare "complex" patients will obviously still require much more, as will research for a full comprehension of this still mysterious disease.