Editing Stones: Evaluation and Medical Management (section)

== Follow-up==
*'''<span style="color:#ff0000">Labs</span>'''
**'''<span style="color:#ff0000">Repeat 24-hour urine collection</span>'''
***'''<span style="color:#ff0000">A single 24-hour urine specimen for stone risk factors should be obtained within 6 months of the initiation of treatment to assess response to dietary and/or medical therapy</span>'''
***'''<span style="color:#ff0000">After the initial follow-up, a single 24-hour urine specimen should be obtained annually or with greater frequency, depending on stone activity, to assess patient adherence and metabolic response</span>'''
**'''<span style="color:#ff0000">Periodic blood testing should be obtained to assess for adverse effects in patients on pharmacological therapy.</span>'''
***'''<span style="color:#ff0000">Thiazide therapy may promote hypokalemia and glucose intolerance</span>'''
*** '''<span style="color:#ff0000">Allopurinol and tiopronin may cause an elevation in liver enzymes</span>'''
***'''<span style="color:#ff0000">AHA and tiopronin may induce anemia and other hematologic abnormalities</span>'''
***'''<span style="color:#ff0000">Potassium citrate may result in hyperkalemia</span>'''
***'''Patients with undiagnosed primary hyperparathyroidism may develop hypercalcemia after initiation of thiazide therapy'''
**Repeat stone analysis, when available, should be obtained especially in patients not responding to treatment
*'''<span style="color:#ff0000">Imaging'''
** '''<span style="color:#ff0000">Periodic imaging to assess for stone growth or new stone formation based on stone activity (plain abdominal imaging, renal ultrasonography or low dose CT).'''
*'''<span style="color:#ff0000">Patients with struvite stones should be monitored for reinfection with urease-producing organisms and utilize strategies to prevent such occurrences.'''
**Monitoring should include surveillance urine culture testing on a periodic basis. In some cases, recurrences may be reduced with long-term, prophylactic antibiotic therapy
*If patients remain stone free on their treatment regimen for an extended period of time, discontinuation of follow-up testing may be considered.