Abstract：
The aim of this study was to construct the fourth in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis (IAU) that by providing a clinical framework for the metabolic evaluation, prevention, and follow-up of patients with urolithiasis based on the best available published literature. All recommendations were summarized following a systematic review and assessment of the literature in the PubMed database from January 1976 to June 2022. Each generated recommendation was graded using a modified GRADE methodology. Guideline recommendations were developed that addressed the following topics: initial evaluation, metabolic testing, dietary measures, medical management, and follow-up of recurrent stone formers. It was emphasized by the Panel that prevention of new stone formation is as important as the surgical removal of the stones. Although general preventive measures may be effective in reducing stone recurrence rates in some patients, specific medical and dietary management should be well considered and eventually applied in an individualized manner based on the outcomes of metabolic work-up, stone analysis and some certain patient related factors. A detailed follow-up of each case is essential depending on the metabolic activity of each individual patient.
摘要：
本研究的目的是构建国际尿石症联盟（IAU）关于尿石症治疗的一系列指南中的第四个，该指南通过为代谢评估提供临床框架，预防,并根据现有的最佳已发表文献对尿石症患者进行随访。在1976年1月至2022年6月对PubMed数据库中的文献进行系统回顾和评估后，总结了所有建议。使用修改的GRADE方法对每个生成的建议进行分级。针对以下主题制定了准则建议：初步评估，代谢测试,饮食措施，医疗管理,以及复发性结石形成者的随访。专家小组强调，防止新结石形成与手术切除结石同样重要。尽管一般的预防措施可能有效地降低某些患者的结石复发率，具体的医疗和饮食管理应得到充分考虑，并最终根据代谢检查的结果以个性化的方式应用，结石分析和某些患者相关因素。根据每个患者的代谢活动，每个病例的详细随访至关重要。
