Nephrolithiasis is a metabolic disease with high incidence and prevalence in primary care consultations. It is characterized by the appearance of stones in the upper urinary system. Calcium oxalate lithiasis is the most frequent and nephritic colic is the most common form of presentation. The clinical history, imaging techniques, analysis of kidney stones and metabolic study, if necessary, determine the most appropriate treatment. This treatment includes the management of nephritic colic (treatment pharmacological, hygienic-dietic measures and expulsive treatment) and the treatment of prevention of recurrences. The initial approach of nephritic colic is aimed at relieving pain. Non-steroidal anti-inflammatories are the drugs of first choice, followed by opioids and dipyrone; the use of spasmolytic drugs is discouraged. The probability of expulsion of a calculation depends on its size and location. As an expulsion medical treatment, tamsulosin has been shown to be more effective than calcium antagonists, in addition to reducing the intensity and duration of pain. As a treatment to prevent recurrence in recurrent lithiasis, a specific treatment will be proposed according to the metabolic study or the mineralogical analysis of the stones. The increase of calcium and the reduction of animal proteins in the diet, together with the achievement of a diuresis greater than 1-1.5 l of urine / day has been shown to reduce the risk of recurrence. With a few exceptions, the vast majority of patients with lithiasis can be followed in primary care.
Nephrolithiasis; Renal colic; Expulsive treatment
Ferrer-Moret S, Pérez-Morales D. Actualització en el tractament de la litiasi renal. Butll Inf Ter. 2018 maig;29(04):21-28.
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