The Stone Clinic Effect in Patients With Idiopathic Calcium Urolithiasis

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Abstract
The stone clinic effect refers to the effect of encouraging a high intake of fluid and avoiding dietary excesses on stone formation and growth in patients with urolithiasis. To determine the extent of this effect the clinical courses of 108 patients with idiopathic Ca urolithiasis and indeterminant metabolic activity were reviewed. There was no evidence of stone growth or new stone formation (metabolic inactivity) after a mean followup of 62.6 mo. in 63 of the 108 patients (58.3%), including 12 of 17 (70.6%) with hypercalciuria and 7 of 15 (46.7%) with hyperuricosuria. Comparison of initial and followup 24-h urine volumes demonstrated a significant increase in patients who were metabolically inactive at followup (P < 0.0005), while no increase was detected in patients who were metabolically active at followup. It is recommended that specific drug therapy should not be given to patients with idiopathic Ca urolithiasis until the stone clinic effect has been evaluated.

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