[Recurrent nephrolithiasis - what next?]

Nephrolithiasis is a common disease with a high recurrence rate. It is associated with a significant morbidity for an individual patient, but also an immense socioeconomic burden. A better understanding and recognition of underlying risk factors and prevention strategies are therefore of great importance. The evaluation for metaphylaxsis consists of a thorough patient history, metabolic examination of blood and urine, imaging of the kidney and urinary tract, and whenever possible a stone analysis. On the basis of the results, preventative measures can be performed. Therapeutic goals in stone prevention are to reduce the urine saturation of stone forming salts, to increase the urine concentration of stone formation inhibitors, and if necessary, the modification of urine pH. A dietary modification is the cornerstone of a successful metaphylaxis.