Pathway for the Outpatient Evaluation/Treatment of the Child with Nephrolithiasis

Detailed History and Physical Examination

Diet
  • Ketogenic
  • Atkins
  • Vitamin C or D
  • Mineral supplements
Medications
  • Lasix
  • Calcitriol
  • Topamax
  • Anti-retrovirals
  • Steroids
Family History
  • Stones or renal failure
PMH
  • Bone disease
  • Rickets
  • Neuromuscular disease
  • Bladder exstrophy
  • Myelomeningocele
  • GI disease
  • Cystic fibrosis
  • Gout
  • Deafness
  • Failure to thrive
  • Seizure disorder
  • Immobility
  • Cerebral Palsy
  • Spina Bifida
  • Nephrectomy
  • Single kidney
  • Hydration status
  • Salt, potassium intake
Physical Examination
  • VS, BP
  • Growth parameters
  • CVA tenderness
  • Abdominal tenderness, mass
  • Edema

Review Laboratory Studies and Imaging

Consult Nephrology for interpretation of abnormal laboratory results