Summary of changes

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

For 2020, conclusions and recommendations have been rephrased and strength ratings reassessed across a number of sections. Updated recommendations include the following: Guidelines for laboratory examinations and stone analysis

RecommendationsStrength rating

Dipstick test of spot urine sample:

• red cells;

• white cells;

• nitrite;

• approximate urine pH;

• urine microscopy and/or culture.


Serum blood sample:

• creatinine;

• uric acid;

• (ionised) calcium;

• sodium;

• potassium;

• blood cell count;

• C-reactive protein.

Weak Summary of evidence and guidelines for the management of renal stones

RecommendationsStrength rating
Consider the stone composition before deciding on the method of removal, based on patient history, former stone analysis of the patient or Hounsfield unit (HU) on unenhanced computed tomography (CT). Stones with density > 1,000 HU (and with high homogeneity) on non-contrast-enhanced CT are less likely to be disintegrated by shock wave lithotripsy.Strong