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Guidelines

Renal and Ureteric Stone guidelines from NICE recommend use of potassium citrate alongside diet and lifestyle advice for prevention of stones in patients with predominantly calcium oxalate stones. (NICE, NG118). Until now the recommendation has been based on the off-label use of products that are indicated for other conditions.

Picture of patient experiencing lower back pain as a result of a kidney stone.
Flow chart showing the management pathway for suspected renal or ureteric stones: person with suspected stone leads to diagnostic imaging, then pain management, followed by options of medical expulsive therapy for distal ureteric stones less than 10 mm, watchful waiting for asymptomatic renal stones, or surgical treatment. After treatment, ongoing management includes metabolic testing and dietary and lifestyle advice to prevent recurrence, with potassium citrate and thiazides for recurrent stones.