Letter to the Editor

Response to "Nephrolithiasis: Evaluation and Management"

Authors: Zachary Z. Brener, MD, James F. Winchester, MD, Michael Bergman, MD

Abstract

To the Editor: We would like to thank the author for his valuable comments on our paper "Nephrolithiasis: Evaluation and Management."1 He emphasized the importance of detailed medication history in accurate identification of kidney stone sources. Drug-induced stones comprise 1% to 2% of all kidney stones and occur more often during high-dose or long-term treatments, especially in patients with risk factors in relation to urine pH and urine output.2 More than 40 drugs and substances have been linked to nephrolithiasis. Main substances that were identified in stones over the past decade were indinavir monohydrate (31.4%), triamterene (11.1%), sulfonamides (10.5%) and amorphous silica (4.5%).2 The main drugs involved in the nucleation and growth of stones were calcium and vitamin D supplementation (15%) and long-term treatment with carbonic anhydrase inhibitors (8%).2

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Brener ZZ, Winchester JF, Salman H, et al. Nephrolithiasis: evaluation and management. South Med J 2011;104:133-139.
 
2. Daudon M, Junger P. Drug induced renal calculi: epidemiology, prevention and management. Drugs 2004;64:245-275.
 
3. Ettinger B, Tang A, Citron JT, et al. Randomized trial of allopurinol in the prevention of calcium oxalate calculi. N Engl J Med 1986;315:1386-1389.
 
4. Favus MJ, Coe FL. The effects of allopurinol treatment on stone formation on hyperuricosuric calcium oxalate stone-formers. Scand J Urol Nephrol Suppl 1980;53:265-271.
 
5. Coe FL. Treated and untreated recurrent calcium nephrolithiasis in patients with idiopathic hypercalciuria, hyperuricosuria, or no metabolic disorder. Ann Intern Med 1977;87:404-410.