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Pharmacotherapy of urolithiasis: evidence from clinical trials.
[cystinuria]
Urolithiasis
is
a
worldwide
problem
with
significant
health
and
economic
burdens
.
Medical
therapy
that
alters
the
course
of
stone
disease
has
enormous
medical
and
financial
impact
.
Urolithiasis
is
a
final
manifestation
of
a
broad
range
of
etiologies
and
pathogenesis
.
The
modest
progress
in
understanding
the
pathophysiology
has
hampered
successful
development
of
targeted
therapy
.
Current
regimens
are
based
mostly
on
rational
alteration
of
urinary
biochemistry
and
physical
chemistry
to
lower
the
risk
of
precipitation
.
In
terms
of
pharmacotherapy
,
there
are
drugs
to
successfully
improve
hypercalciuria
,
hypocitraturia
,
aciduria
,
hyperuricosuria
,
and
hypercystinuria
.
These
agents
have
been
proven
to
be
effective
in
randomized
controlled
trials
in
improving
urinary
biochemical
and
physicochemical
risk
factors
,
as
well
as
clinical
outcomes
.
Although
our
current
regimens
have
clearly
improved
the
management
and
lives
of
stone
formers
,
there
are
still
clearly
identifiable
immense
voids
in
the
knowledge
of
pathophysiology
of
stone
disease
that
can
be
filled
with
combined
basic
science
and
clinical
studies
.
