Full Text Guidelines Summary of Changes Scientific Publications & Appendices Pocket Guidelines Archive Panel

ISBN 978-94-92671-13-4

C. Türk (Chair), A. Neisius, A. Petřík, C. Seitz, A. Skolarikos (Vice-chair), B. Somani, K. Thomas, G. Gambaro (Consultant nephrologist)
Guidelines Associates: N.F. Davis, J.F. Donaldson, R. Lombardo, L. Tzelves


1.1.Aims and scope

The European Association of Urology (EAU) Urolithiasis Guidelines Panel has prepared these guidelines to help urologists assess evidence-based management of stones/calculi in the urinary tract and incorporate recommendations into clinical practice. This document covers most aspects of the disease, which is still a cause of significant morbidity despite technological and scientific advances. The Panel is aware of the geographical variations in healthcare provision. Management of bladder stones are dealt with in a separate guideline authored by the same guideline group.

It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account. Guidelines are not mandates and do not purport to be a legal standard of care.

1.2.Panel composition

The EAU Urolithiasis Guidelines Panel consists of an international group of clinicians with particular expertise in this area. All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU, website Uroweb: http://uroweb.org/guideline/urolithiasis/.

1.3.Available publications

A quick reference document (Pocket guidelines) is available, both in print and as an app for iOS and Android devices. These are abridged versions, which may require consultation together with the full text versions. A number of scientific publications are also available [1-3]. All documents can be accessed through the EAU website: http://uroweb.org/guideline/urolithiasis/.

1.4.Publication history and summary of changes

1.4.1.Publication history

The EAU Urolithiasis Guidelines were first published in 2000. This 2021 document presents a limited update of the 2020 version.

1.4.2.Summary of changes

The literature for the entire document has been checked and, wherever relevant, updated (see Methods section 2.1).

For 2021, conclusions and recommendations have been rephrased and strength ratings reassessed across several sections. References and supporting text have also been refreshed. Additional information has been added to the chapter on “Prevalence, aetiology, risk of recurrence” including “Table 3.4 Risk factors for chronic kidney disease and end stage kidney disease in stone formers” and “Table 3.5 Risk factors for chronic kidney disease and renal stones”. A consultant nephrologist has now been added to the panel and has reviewed the entire text. Updated recommendation strength ratings include the following: Guidelines for laboratory examinations and stone analysis


Strength rating


Serum blood sample:

• creatinine;

• uric acid;

• (ionised) calcium;

• sodium;

• potassium;

• blood cell count;

• C-reactive protein.

Strong Guidelines for the management of tubular acidosis


Strength rating

Prescribe alkaline citrates for distal renal tubular acidosis.