LITHOSCREEN: a comprehensive screening program and database for the assessment and treatment management of patients with kidney stones.

ABSTRACT

The aim of the LITHOSCREEN project was to construct a comprehensive screening program and database for recording and assessing the various risk factors for stone-formation in patients with urolithiasis. It is intended for use in Stone Clinics and is now being made available free of charge to researchers in the field who wish to maintain a comprehensive record of their patients' medical histories, demographic backgrounds, lifestyle activities, metabolic abnormalities, biochemical risk of forming stones of various types, diet histories, stone analysis and long-term treatment records. From the recorded data for each patient, the program automatically calculates numerous functions important in the understanding of the clinical and chemical risk factors for stone-formation, including the renal handling of the ions involved, various metabolic functions, the biochemical risk of forming kidney stones (PSF), the Tiselius Indices of the supersaturation of urine with respect to calcium oxalate and calcium phosphate, the projected effects of changing the composition of each patient's urinary composition on the risk of stone recurrence, and a program for analysing the diet of patients. It automatically produces one-page Summaries of each patient's biochemical and dietary records with abnormal values highlighted according to a "traffic-light" colour-coding system and generates charts designed to improve patient compliance with treatment in the form of colour-coded "Target Diagrams" showing (a) the patient's 24-h urine composition, (b) the patient's biochemical risk of forming stones of different types and (c) the composition of the patient's diet. The Summary pages and "Target Diagrams" are suitable for inclusion in the patient's Case Notes. LITHOSCREEN also produces charts projecting the effect of changing the composition of urine on the patient's biochemical risk of forming further stones. These graphs provide clues as to which urinary risk factors to target to reduce the patient's risk of stone recurrence.