Therapeutic Target
Prevention of stone recurrence (recurrence of urinary stones).
Therapy recommendations
Reduction of risk factors
- Behavioral risk factors
- Dehydration
- Disease-related risk factors
- Medication
- Chronic antibiotic therapy
- Laxative abuse (misuse of laxatives)
* Obligate urease-forming bacteria: Proteus spp, Morganella morganii, Corynebacterium urealyticum, Ureaplasma urealyticum and Providencia rettgeri;also some of the E. coli and Pseudomonas aeruginosa can produce urease.Optional urease-forming bacteria: Klebsiella spp, Staphylococcus spp, Serratia marcescens, Enterobacter gergoviae and Providencia stuartii.
Nutritional therapy
- Fluid intake 2.5-3 l/day.
Agents or measures of metaphylaxis.
- Complete removal of the infectious stone mass from the hollow system (if present).
- Treatment of the urinary tract infection with a tested antibiotic (resistogram!).
- L-methionine or ammonium chloride for urine acidification (setting an acid urine pH between 5.8-6.2).
Operative therapy
- When removing the stones, flush the kidney with hemacidrin (solution that dissolves struvite stones).