Table of ContentsView AllTable of ContentsWhat They AreCausesSymptomsDiagnosisTreatmentDietary GuidelinesRecoveryRecurrence
Table of ContentsView All
View All
Table of Contents
What They Are
Causes
Symptoms
Diagnosis
Treatment
Dietary Guidelines
Recovery
Recurrence
Calcium oxalate is a crystallized compound that forms when oxalate from foods like leafy green vegetables and nuts binds tocalcium. When the levels of calcium and oxalate in your urine are persistently high, the crystals can form into a solid mass known as arenal calculior kidney stone.
Calcium oxalate stones are the most common type of kidney stone. Roughly 75% of stones are composed either partially or fully of calcium oxalate.
This article explains what causes calcium oxalate crystals to form and under what conditions crystals can develop into stones. It also describes how calcium oxalate stones are diagnosed and treated, including ways to manage pain as a stone is passed.
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Calcium Oxalate Crystals in Urine: Are They Stones?
Having calcium oxalate crystals in your urine increases your risk of kidney stones, but doesn’t necessarily mean that you have stones. In the human body, the formation of calcium oxalate crystals is very common and generally of little significance.
It is only when other factors contribute that the crystals can start to stick together in your urine and grow into larger masses, known as kidney stones.
Formation
Calcium oxalate is created from the binding of oxalate to calcium. Oxalate, also known as oxalic acid, is either obtained from foods you eat or produced when the liver breaks down (metabolizes)vitamin Candamino acids. It is generally thought of as a waste product.
Under normal circumstances, oxalate binds to calcium in the intestine and is excreted in stool. Any excess, unbound oxalate will be absorbed into the bloodstream and excreted through thekidneysin urine.
Calcium (derived solely from foods or supplements) also leaves the body in urine and stool. Of the calcium that passes through the kidneys, around 98% is reabsorbed into the bloodstream for reuse in the body. About 2% is excreted in urine.
Calcium oxalate stones can form if these systems are disrupted. This can happen if one or more of the following occurs:
Oxalate Stones vs. Other Kidney Stones
Calcium oxalate stones may be the most common type of kidney stone, but there are others. These include calcium phosphate stones, which account for 5% of all calcium stones, and mixed calcium stones (composed of oxalate andphosphate), which account for 45%. Only half of all calcium stones are pure oxalate.
Among the other types of kidney stones are:
It is possible to have more than one type of stone at once. Many of the same factors that give rise to other stones (such as a high purine diet) also contribute to the formation of calcium oxalate stones.
What Causes Calcium Oxalate Crystals?
These include:
Symptoms: How Do Oxalate Stones Feel?
Kidney stones can range in size from as small as a grain of sand to as large as a pearl (or bigger).
The shape can also vary. With a calcium oxalate stone, deposits of a type of oxalate called oxalate monohydrate can result in a smoother stone that may be easier to pass. Deposits of another type, called oxalate dihydrate, will result in a jagged stone that is harder to pass.
Possible symptoms include:
Do I Have Appendicitis or a Kidney Stone?
Diagnosing Crystalized Calcium Oxalate Stones
Kidney stones can be diagnosed with imaging studies, while other tests can help determine whether you have a calcium oxalate stone or some other type of stone.
The determination of the stone type may only be performed after it is passed. Unless there is a reason for an investigation (such as having a kidney stone at a young age), the determination may or may not be relevant to treatment.
Thereafter, the following tests or procedures may be ordered:
Genetic testing may be recommended if type 1 primary hyperoxaluria is suspected in a child with kidney stones or if someone has physical signs of the disease (like changes in eye pigment due to oxalate crystal deposits).
Expert RecommendationAccording to the American Urological Association, the current gold standard for confirming kidney stones is anon-contrastCT scan of the abdomen and pelvis.
Expert Recommendation
According to the American Urological Association, the current gold standard for confirming kidney stones is anon-contrastCT scan of the abdomen and pelvis.
Dissolving and Passing Oxalate Stones
The main goal of treatment is to pass a kidney stone (meaning to dislodge it and pass it whole or in fragments in urine). In most cases, kidney stones pass without damage but usually with significant pain and discomfort.
Fluids and pain relievers may be the only treatments needed for smaller stones. Other treatments may be needed for larger stones. In severe cases, surgery may be required.
The determination of treatment is largely based on the size of the stone in millimeters (mm) and how likely it will pass naturally.
Passing a Stone Naturally
Generally, a calcium oxalate stone smaller than 4 mm has a good chance ofpassing on its own. To aid in the passing, your healthcare provider will likely recommend:
Are There Solutions That Dissolve Stones?There are no oral solutions you can drink that can dissolve calcium stones. The only solution available works on uric acid stones and can take weeks or months to work. Larger stones or denser stones (like calcium oxalate) do not respond to oral dissolution treatment.
Are There Solutions That Dissolve Stones?
There are no oral solutions you can drink that can dissolve calcium stones. The only solution available works on uric acid stones and can take weeks or months to work. Larger stones or denser stones (like calcium oxalate) do not respond to oral dissolution treatment.
The 4 Stages of Passing a Kidney Stone
Surgery and Other Procedures
Only 50% of stones between 4 mm and 6 mm will pass without medical intervention. Anything larger than 6 mm will almost always need medical treatment to help remove them. In cases like these, clinical expertise is needed to determine the best course of treatment, some of which may be more invasive than others.
Options include:
Kidney Stone Surgery: Everything You Need to Know
In 2023, The Food and Drug Administration approved Rivfloza (nedosiran), a lactate dehydrogenase A (LDHA)-Directed Small Interfering Ribonucleic Acid (siRNA). Rivfloza blocks the enzyme LDH, lowering urinary oxalate levels and decreasing kidney stone formation. Rivfloza is a once-monthly injection approved for children 9 years of age and adults with (PH1).
Diet Recommendations With Calcium Oxalate Crystals
As diet is a major contributing factor to calcium oxide stones, theavoidance of oxalate-rich foodscan help avoid recurrence. Some of these foods should be avoided entirely, particularly if you have a history of recurrence, while others need to be limited.
Foods to avoid include:
Foods to limit or restrict include:
Some experts also recommend theDASH (Dietary Approaches to Stop Hypertension) dietto help guide your eating habits. The diet was created for people with high blood pressure and focuses on vegetables, fruits, whole grains, low-fat dairy, beans, fish, and poultry.
A 2014 study in theAmerican Journal of Kidney Diseasefound that the DASH diet reduces the supersaturation of calcium and oxalate in the kidneys (meaning these minerals are in high concentration and are prone to form crystals).The diet is also associated with weight loss and a reduction in sodium and protein intake,all of which benefit people with calcium oxalate stones.
Managing Pain During Healing
Even after a stone is passed, you can experience significant pain for several days. With proper rest, hydration, and the appropriate use of painkillers, most people recover quickly.
On the other hand, if you had surgery to remove a kidney stone, the recovery time can take longer. Even with ESWL, some urologists may recommend that you take several days to a week off from work to allow fragments to pass.For PCNL and other more invasive procedures, as many as three weeks may be needed before you can manage without pain.
During this time, the following measures can help ease pain and speed recovery:
Why Is Recurrence Possible?
Compared to other kidney stones, calcium stones are the type most likely to recur.This is due to underlying conditions that give rise to them, some of which can be modified (like diet, hydration, and obesity) and others that cannot.
To reduce your risk of recurrence, your healthcare provider will want to manage contributing conditions. This may include treating inflammatory bowel disease with medications like methotrexate, Rinvoq (upadacitinib), and Zeposia (ozanimod)or treating hyperparathyroidism with parathyroidectomy (the surgical removal of the parathyroid gland).
Thiazide diuretics,allopurinol, andcalcium citrate supplementsare also effective in preventing calcium stones that recur despite lifestyle modifications.
Can Kidney Cleanses Prevent Kidney Stones?
Summary
Calcium oxalate crystals form in the urine when oxalate from foods like spinach or rhubarb binds to calcium. If calcium or oxalate levels are high and/or urine volumes are low, the crystals can stick together and form calcium oxalate stones.
The kidney stones can range in size from a grain of sand to larger than a pea. Passing a calcium oxalate stone can be extremely painful and, depending on the size, may be passed on its own or require surgery or procedures like extracorporeal shock wave lithotripsy (ESWL).
Change in diet, weight loss, and ample hydration can reduce the risk of calcium stone recurrence, Medications like thiazide diuretics and calcium citrate supplements can also prevent recurrence if lifestyle changes don’t help.
10 Steps to Prevent Kidney Stones
25 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alelign T, Petros B.Kidney stone disease: an update on current concepts.Adv Urol.2018;2018:3068365. doi:10.1155/2018/3068365Singh P, Enders FT, Vaughan LE, et al.Stone composition among first-time symptomatic kidney stone formers in the community.Mayo Clinic Proceed.2015;90(10):1356–1365. doi:10.1016/j.mayocp.2015.07.016Stepanova N.Oxalate homeostasis in non-stone-forming chronic kidney disease: a review of key findings and perspectives.Biomedicines.2023;11(6):1654. doi:10.3390/biomedicines11061654Institute of Medicine (US).Dietary reference intakes for calcium and vitamin D.National Kidney Foundation.Calcium oxalate stones.Poore W, Goyd CJ, Singh NP, Wood K, Gower B, Assimos DG.Obesity and its impact on kidney stone formation.Rev Urol.2020;22(1):17–23.Crohn’s and Colitis Foundation.Kidney disorders.Milliner DS, McGregor TL, Thompson A, et al.End points for clinical trials in primary hyperoxaluria.Clin J Am Soc Nephrol.2020;15(7):1056–1065. doi:10.2215/CJN.13821119Khan SR, Pearle MS, Robertson WG, et al.Kidney stones.Nat Rev Dis Primers.2016;2:16008. doi:10.1038/nrdp.2016.8National Kidney Foundation.Kidney stones.American Urological Association.Medical student curriculum: kidney stones.Dias IA, Carahalho M, Bahniuk A, Froehner S, Dos Reis JM.Mineral identification of human kidney stones in South Brazil.Research Sq. 2022 [Online ahead of print]. doi:10.21203/rs.3.rs-2272271/v1Cakici OU, Ener K, Keske M, et al.Open stone surgery: a still-in-use approach for complex stone burden.Cent European J Urol.2017 Jun 30;70(2):179–184. doi:10.5173/ceju.2017.1205Food and Drug Administration.Rivfloza label.Mitchell T, Kumar P, Reddy T, et al.Dietary oxalate and kidney stone formation.Am J Physiol Renal Physiol.2019;316(3):F409–F413. doi:10.1152/ajprenal.00373.2018Medical College of Wisconsin.Kidney stone oxalate diet.Arias-Rico J, Macias-Leon FJ, Alanis-Garcia E, et al.Study of edible plants: effects of boiling on nutritional, antioxidant, and physicochemical properties.Foods.2020;9(5):599. doi:10.3390/foods9050599Noori N, Honarkar E, Goldfarb DS, et al.Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: a randomized controlled trial comparing DASH (dietary approaches to stop hypertension)-style and low-oxalate diets.Am J Kidney Dis.2014;63:456–463. doi:10.1053/j.ajkd.2013.11.022Soltani S, Shirani F, Chitsazi MJ, Salehi-Abarquoei A.The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials.Obes Rev. 2016;17(5):442-454. doi:10.1111/obr.12391Alic J, Heljic J, Hadziosmanovic O, et al.The efficiency of extracorporeal shock wave lithotripsy (ESWL) in the treatment of distal ureteral stones: an unjustly forgotten option?Cureus.2022;14(9):e28671. doi:10.7759/cureus.28671University of Utah.What to expect at your kidney stone surgery.Demasi M, Segall M, Mengotti A, et al.Optimizing pain management following kidney stone surgery: can we avoid narcotics?World J Urol.2022 Dec;40(12):3061-3066. doi:10.1007/s00345-022-04214-wFeuerstein JD, Isaacs KL, Schneider Y, et al.AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis.Gastroenterology.2020:158(5):1450-1461. doi:10.1053.j.gastro.2020.01.006Alore EA, Suliburk JW, Ramsey DJ, et al.Diagnosis and management of primary hyperparathyroidism across the Veterans Affairs Health Care System.JAMA Intern Med. 2019;179(9):1220-1227. doi:10.1001/jamainternmed.2019.1747Fontenella LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496
25 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alelign T, Petros B.Kidney stone disease: an update on current concepts.Adv Urol.2018;2018:3068365. doi:10.1155/2018/3068365Singh P, Enders FT, Vaughan LE, et al.Stone composition among first-time symptomatic kidney stone formers in the community.Mayo Clinic Proceed.2015;90(10):1356–1365. doi:10.1016/j.mayocp.2015.07.016Stepanova N.Oxalate homeostasis in non-stone-forming chronic kidney disease: a review of key findings and perspectives.Biomedicines.2023;11(6):1654. doi:10.3390/biomedicines11061654Institute of Medicine (US).Dietary reference intakes for calcium and vitamin D.National Kidney Foundation.Calcium oxalate stones.Poore W, Goyd CJ, Singh NP, Wood K, Gower B, Assimos DG.Obesity and its impact on kidney stone formation.Rev Urol.2020;22(1):17–23.Crohn’s and Colitis Foundation.Kidney disorders.Milliner DS, McGregor TL, Thompson A, et al.End points for clinical trials in primary hyperoxaluria.Clin J Am Soc Nephrol.2020;15(7):1056–1065. doi:10.2215/CJN.13821119Khan SR, Pearle MS, Robertson WG, et al.Kidney stones.Nat Rev Dis Primers.2016;2:16008. doi:10.1038/nrdp.2016.8National Kidney Foundation.Kidney stones.American Urological Association.Medical student curriculum: kidney stones.Dias IA, Carahalho M, Bahniuk A, Froehner S, Dos Reis JM.Mineral identification of human kidney stones in South Brazil.Research Sq. 2022 [Online ahead of print]. doi:10.21203/rs.3.rs-2272271/v1Cakici OU, Ener K, Keske M, et al.Open stone surgery: a still-in-use approach for complex stone burden.Cent European J Urol.2017 Jun 30;70(2):179–184. doi:10.5173/ceju.2017.1205Food and Drug Administration.Rivfloza label.Mitchell T, Kumar P, Reddy T, et al.Dietary oxalate and kidney stone formation.Am J Physiol Renal Physiol.2019;316(3):F409–F413. doi:10.1152/ajprenal.00373.2018Medical College of Wisconsin.Kidney stone oxalate diet.Arias-Rico J, Macias-Leon FJ, Alanis-Garcia E, et al.Study of edible plants: effects of boiling on nutritional, antioxidant, and physicochemical properties.Foods.2020;9(5):599. doi:10.3390/foods9050599Noori N, Honarkar E, Goldfarb DS, et al.Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: a randomized controlled trial comparing DASH (dietary approaches to stop hypertension)-style and low-oxalate diets.Am J Kidney Dis.2014;63:456–463. doi:10.1053/j.ajkd.2013.11.022Soltani S, Shirani F, Chitsazi MJ, Salehi-Abarquoei A.The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials.Obes Rev. 2016;17(5):442-454. doi:10.1111/obr.12391Alic J, Heljic J, Hadziosmanovic O, et al.The efficiency of extracorporeal shock wave lithotripsy (ESWL) in the treatment of distal ureteral stones: an unjustly forgotten option?Cureus.2022;14(9):e28671. doi:10.7759/cureus.28671University of Utah.What to expect at your kidney stone surgery.Demasi M, Segall M, Mengotti A, et al.Optimizing pain management following kidney stone surgery: can we avoid narcotics?World J Urol.2022 Dec;40(12):3061-3066. doi:10.1007/s00345-022-04214-wFeuerstein JD, Isaacs KL, Schneider Y, et al.AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis.Gastroenterology.2020:158(5):1450-1461. doi:10.1053.j.gastro.2020.01.006Alore EA, Suliburk JW, Ramsey DJ, et al.Diagnosis and management of primary hyperparathyroidism across the Veterans Affairs Health Care System.JAMA Intern Med. 2019;179(9):1220-1227. doi:10.1001/jamainternmed.2019.1747Fontenella LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Alelign T, Petros B.Kidney stone disease: an update on current concepts.Adv Urol.2018;2018:3068365. doi:10.1155/2018/3068365Singh P, Enders FT, Vaughan LE, et al.Stone composition among first-time symptomatic kidney stone formers in the community.Mayo Clinic Proceed.2015;90(10):1356–1365. doi:10.1016/j.mayocp.2015.07.016Stepanova N.Oxalate homeostasis in non-stone-forming chronic kidney disease: a review of key findings and perspectives.Biomedicines.2023;11(6):1654. doi:10.3390/biomedicines11061654Institute of Medicine (US).Dietary reference intakes for calcium and vitamin D.National Kidney Foundation.Calcium oxalate stones.Poore W, Goyd CJ, Singh NP, Wood K, Gower B, Assimos DG.Obesity and its impact on kidney stone formation.Rev Urol.2020;22(1):17–23.Crohn’s and Colitis Foundation.Kidney disorders.Milliner DS, McGregor TL, Thompson A, et al.End points for clinical trials in primary hyperoxaluria.Clin J Am Soc Nephrol.2020;15(7):1056–1065. doi:10.2215/CJN.13821119Khan SR, Pearle MS, Robertson WG, et al.Kidney stones.Nat Rev Dis Primers.2016;2:16008. doi:10.1038/nrdp.2016.8National Kidney Foundation.Kidney stones.American Urological Association.Medical student curriculum: kidney stones.Dias IA, Carahalho M, Bahniuk A, Froehner S, Dos Reis JM.Mineral identification of human kidney stones in South Brazil.Research Sq. 2022 [Online ahead of print]. doi:10.21203/rs.3.rs-2272271/v1Cakici OU, Ener K, Keske M, et al.Open stone surgery: a still-in-use approach for complex stone burden.Cent European J Urol.2017 Jun 30;70(2):179–184. doi:10.5173/ceju.2017.1205Food and Drug Administration.Rivfloza label.Mitchell T, Kumar P, Reddy T, et al.Dietary oxalate and kidney stone formation.Am J Physiol Renal Physiol.2019;316(3):F409–F413. doi:10.1152/ajprenal.00373.2018Medical College of Wisconsin.Kidney stone oxalate diet.Arias-Rico J, Macias-Leon FJ, Alanis-Garcia E, et al.Study of edible plants: effects of boiling on nutritional, antioxidant, and physicochemical properties.Foods.2020;9(5):599. doi:10.3390/foods9050599Noori N, Honarkar E, Goldfarb DS, et al.Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: a randomized controlled trial comparing DASH (dietary approaches to stop hypertension)-style and low-oxalate diets.Am J Kidney Dis.2014;63:456–463. doi:10.1053/j.ajkd.2013.11.022Soltani S, Shirani F, Chitsazi MJ, Salehi-Abarquoei A.The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials.Obes Rev. 2016;17(5):442-454. doi:10.1111/obr.12391Alic J, Heljic J, Hadziosmanovic O, et al.The efficiency of extracorporeal shock wave lithotripsy (ESWL) in the treatment of distal ureteral stones: an unjustly forgotten option?Cureus.2022;14(9):e28671. doi:10.7759/cureus.28671University of Utah.What to expect at your kidney stone surgery.Demasi M, Segall M, Mengotti A, et al.Optimizing pain management following kidney stone surgery: can we avoid narcotics?World J Urol.2022 Dec;40(12):3061-3066. doi:10.1007/s00345-022-04214-wFeuerstein JD, Isaacs KL, Schneider Y, et al.AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis.Gastroenterology.2020:158(5):1450-1461. doi:10.1053.j.gastro.2020.01.006Alore EA, Suliburk JW, Ramsey DJ, et al.Diagnosis and management of primary hyperparathyroidism across the Veterans Affairs Health Care System.JAMA Intern Med. 2019;179(9):1220-1227. doi:10.1001/jamainternmed.2019.1747Fontenella LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496
Alelign T, Petros B.Kidney stone disease: an update on current concepts.Adv Urol.2018;2018:3068365. doi:10.1155/2018/3068365
Singh P, Enders FT, Vaughan LE, et al.Stone composition among first-time symptomatic kidney stone formers in the community.Mayo Clinic Proceed.2015;90(10):1356–1365. doi:10.1016/j.mayocp.2015.07.016
Stepanova N.Oxalate homeostasis in non-stone-forming chronic kidney disease: a review of key findings and perspectives.Biomedicines.2023;11(6):1654. doi:10.3390/biomedicines11061654
Institute of Medicine (US).Dietary reference intakes for calcium and vitamin D.
National Kidney Foundation.Calcium oxalate stones.
Poore W, Goyd CJ, Singh NP, Wood K, Gower B, Assimos DG.Obesity and its impact on kidney stone formation.Rev Urol.2020;22(1):17–23.
Crohn’s and Colitis Foundation.Kidney disorders.
Milliner DS, McGregor TL, Thompson A, et al.End points for clinical trials in primary hyperoxaluria.Clin J Am Soc Nephrol.2020;15(7):1056–1065. doi:10.2215/CJN.13821119
Khan SR, Pearle MS, Robertson WG, et al.Kidney stones.Nat Rev Dis Primers.2016;2:16008. doi:10.1038/nrdp.2016.8
National Kidney Foundation.Kidney stones.
American Urological Association.Medical student curriculum: kidney stones.
Dias IA, Carahalho M, Bahniuk A, Froehner S, Dos Reis JM.Mineral identification of human kidney stones in South Brazil.Research Sq. 2022 [Online ahead of print]. doi:10.21203/rs.3.rs-2272271/v1
Cakici OU, Ener K, Keske M, et al.Open stone surgery: a still-in-use approach for complex stone burden.Cent European J Urol.2017 Jun 30;70(2):179–184. doi:10.5173/ceju.2017.1205
Food and Drug Administration.Rivfloza label.
Mitchell T, Kumar P, Reddy T, et al.Dietary oxalate and kidney stone formation.Am J Physiol Renal Physiol.2019;316(3):F409–F413. doi:10.1152/ajprenal.00373.2018
Medical College of Wisconsin.Kidney stone oxalate diet.
Arias-Rico J, Macias-Leon FJ, Alanis-Garcia E, et al.Study of edible plants: effects of boiling on nutritional, antioxidant, and physicochemical properties.Foods.2020;9(5):599. doi:10.3390/foods9050599
Noori N, Honarkar E, Goldfarb DS, et al.Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: a randomized controlled trial comparing DASH (dietary approaches to stop hypertension)-style and low-oxalate diets.Am J Kidney Dis.2014;63:456–463. doi:10.1053/j.ajkd.2013.11.022
Soltani S, Shirani F, Chitsazi MJ, Salehi-Abarquoei A.The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials.Obes Rev. 2016;17(5):442-454. doi:10.1111/obr.12391
Alic J, Heljic J, Hadziosmanovic O, et al.The efficiency of extracorporeal shock wave lithotripsy (ESWL) in the treatment of distal ureteral stones: an unjustly forgotten option?Cureus.2022;14(9):e28671. doi:10.7759/cureus.28671
University of Utah.What to expect at your kidney stone surgery.
Demasi M, Segall M, Mengotti A, et al.Optimizing pain management following kidney stone surgery: can we avoid narcotics?World J Urol.2022 Dec;40(12):3061-3066. doi:10.1007/s00345-022-04214-w
Feuerstein JD, Isaacs KL, Schneider Y, et al.AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis.Gastroenterology.2020:158(5):1450-1461. doi:10.1053.j.gastro.2020.01.006
Alore EA, Suliburk JW, Ramsey DJ, et al.Diagnosis and management of primary hyperparathyroidism across the Veterans Affairs Health Care System.JAMA Intern Med. 2019;179(9):1220-1227. doi:10.1001/jamainternmed.2019.1747
Fontenella LF, Sarti TD.Kidney stones: treatment and prevention.Am Fam Physician.2019;99(8):490-496
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