[What kind of stone prevention for whom? Risk-adjusted metaphylaxis following urinary stone disease]

Approximately 5% of the German population suffers from urinary stone disease, but only 25% of these urolithiasis patients are at risk of recurrent stone disease or a severe metabolic disorder. It is important that patients at high risk are picked up early, so that appropriate therapy and measures designed to prevent secondary stone disease can be implemented. Risk classification is easily achieved by combining stone analysis with a basic diagnostic program. Patients at low risk need no further diagnostic evaluation or treatment, so that it is enough to recommend general metaphylaxis in these cases. In contrast, patients at high risk require additional specific aftercare and should be evaluated with the aid of a comprehensive diagnostic program from the start to allow precise definition of the metabolic targets.