Evaluation of patient with first stone episode

History: medications, occupation, family history of stones or other kidney disease, inflammatory bowel Disease (e.g., Crohn's disease)

Diet: intake of protein, purines, sodium, fluids, oxalate and calcium

Laboratory tests: electrolyte, blood urea nitrogen, creatinine, calcium, phosphate and uric acid levels, urinalysis, urine culture if indicated, stone analysis if available (if not, consider qualitative cystine screening)

Radiology: plain radiographs, ultrasonography and/or intravenous pyelography (or helical computed tomography) to find more stones, radiolucent stones or anatomic abnormalities

Consider: renal tubular acidosis, hyperparathyroidism and sarcoidosis

Evaluation of patient with recurrent stone formation (and all children)

Twenty-four–hour urine collection: volume, pH, levels of calcium, phosphorus, sodium, uric acid, oxalate, citrate, creatinine, calcium oxalate (supersaturation), calcium phosphate and uric acid

Repeat as necessary: 24-hour urine collection and analysis to monitor response to dietary changes and effectiveness of treatment