Renal lithiasis: addressing the risks of austere desert deployments

Area of Science:

• Urology
• Military Medicine
• Environmental Health

Background:

• Renal lithiasis (kidney stones) affects 5% of the population, with risks increasing with age and gender.
• Air Force deployments to desert environments heighten the risk of kidney stone development among personnel.
• This poses a risk to mission accomplishment and service member health.

Purpose of the Study:

• To review kidney stone causation, prevention, diagnosis, and management in deployed Air Force personnel.
• To assess the adequacy of current military recommendations for deployed personnel.
• To explore alternative diagnostic and management strategies for renal lithiasis in austere settings.

Main Methods:

• Case review of seven Air Force personnel with presumed renal lithiasis in a desert setting.
• Comprehensive literature review on kidney stone epidemiology and clinical practice.
• Analysis of diagnostic and management options suitable for deployed environments.

Main Results:

• Standard hydration recommendations may not adequately prevent kidney stones in deployed settings.
• Beverage selection and prevention of voluntary dehydration are crucial for primary prevention.
• Portable ultrasound is a viable diagnostic tool in deployed settings.
• Non-narcotic pain management (e.g., subcutaneous Lidocaine, heat) may be valuable.

Conclusions:

• Hydration strategies, particularly beverage choices, require re-evaluation for deployed forces.
• Portable ultrasound offers a practical diagnostic solution for renal lithiasis in the field.
• Nontraditional pain management therapies should be explored for deployed environments.