What are the EAU guidelines for the evaluation of nephrolithiasis?

Updated: Jun 21, 2018
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Guidelines from the European Association of Urology (EAU) recommend the following laboratory tests in all patients with an acute stone episode [1] :

  • Urinary sediment/dipstick test for demonstration of blood cells, with a test for bacteriuria (nitrite), urinary pH, and urine culture in case of a positive reaction

  • Serum creatinine level, as a measure of renal function

  • Serum uric acid, (ionized) calcium, sodium, and potassium

  • Complete blood cell count (CBC)

  • C-reactive protein

  • Coagulation testing, if intervention is likely or planned: Activated partial thromboplastin time (aPTT) and prothrombin time (PT) with International Normalized ratio (INR)

  • If no intervention is planned, examination of sodium, potassium, C-reactive protein (CRP), and blood coagulation time can be omitted

  • Based on the most recent guideline update in 2018, the EAU now recommends ultrasound for initial assessment when there is concern for an acute symptomatic stone followed by non-contrast-enhanced computed tomography to confirm stone diagnosis. [1]

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