Renal colic

• Perform a urine dipstick
• Urine microscopy and cultureif neededNitrites or leucocytes on urine dipstick (looking for infection); also recommended if managed in the emergency department.
• Serum creatinine with eGFRif neededEmergency department management, or complicated renal colic: patient factors (chronic renal failure, solitary or transplanted kidney, pregnancy, known uropathy) or oligoanuria.
• FBCif neededEmergency department management: the chapter of the French urologists' college cites FBC, platelets, serum electrolytes, serum creatinine, CRP ^[2]; the EAU cites creatinine, uric acid, calcium, sodium, potassium, FBC, CRP in every patient managed as an emergency ^[3]. Not required in the community for simple colic.
• Serum electrolytesif neededEmergency department management: the chapter of the French urologists' college cites FBC, platelets, serum electrolytes, serum creatinine, CRP ^[2]; the EAU cites creatinine, uric acid, calcium, sodium, potassium, FBC, CRP in every patient managed as an emergency ^[3]. Not required in the community for simple colic.
• CRP (management in the emergency department)if neededEmergency department management: the chapter of the French urologists' college cites FBC, platelets, serum electrolytes, serum creatinine, CRP ^[2]; the EAU cites creatinine, uric acid, calcium, sodium, potassium, FBC, CRP in every patient managed as an emergency ^[3]. Not required in the community for simple colic.

Laboratory tests

• Morphological and compositional analysis of a urinary stone with infrared spectrophotometry

Fasting laboratory tests

• Serum creatinine with eGFR
• Serum calcium
• Serum phosphate (extended work-up)if neededExtended work-up (recurrent, bilateral or multiple stones, solitary kidney, onset before age 25, chronic renal failure, nephrocalcinosis, electrolyte abnormalities) or calcium oxalate dihydrate or calcium phosphate stone: the AFU 2022 then adds phosphate, ionised calcium and PTH to the first-line tests ^[6]. The EAU 2024 requests it in the work-up of calcium oxalate stones ^[3]; the AFU 2008 cites it among the second-line tests ^[8].
• Serum albumin (if total serum calcium without ionised calcium)if neededWhen serum calcium is measured as total and not ionised calcium, to correct it: the EAU 2024 requests, for calcium oxalate stones, ionised calcium or total calcium with albumin ^[3]. The AFU 2022 accepts total or ionised serum calcium without citing serum albumin ^[6].
• 25-hydroxyvitamin D (extended work-up)if neededExtended work-up (recurrent, bilateral or multiple stones, solitary kidney, onset before age 25, chronic renal failure, nephrocalcinosis): the AFU 2022 includes it in the suggested blood tests ^[6]. The EAU 2024 requests it only if calcium is raised ^[3]. Outside the reimbursed indications in France ^[9].
• Serum urate
• Fasting plasma glucose
• PTHif neededHypercalcaemia in the first-line tests (pointing to hyperparathyroidism), or extended work-up: the AFU 2022 includes it in the suggested tests ^[6]. The EAU requests it only if calcium is raised ^[3].

24-hour urine collection

• Proteinuria (extended work-up)if neededSecond-line tests (multiple, bilateral or recurrent stone, child, nephrocalcinosis, renal failure): the AFU 2008 adds proteinuria and phosphaturia ^[8]. The EAU 2024 has urinary protein looked for in the urine tests at diagnosis ^[3]. It is not in the first-line tests of the AFU 2022 ^[6].
• Urinary creatinine
• Urinary calcium
• Urinary phosphate (extended work-up)if neededExtended work-up: the AFU 2022 includes 24-hour urinary phosphate in the suggested tests ^[6]; the AFU 2008 cites it as second-line ^[8]. Outside the first-line tests of the AFU 2022 ^[6].
• Urinary urate
• Urinary sodium
• Urinary potassium (at the prescriber's discretion)if neededNone of these recommendations (AFU 2022, French urologists' college, AFU 2008, EAU 2024) cites urinary potassium in the work-up of a stone ^[2,3,6,8]; to be requested only if the doctor judges it useful for interpreting the collection.
• Urinary urea (not in the French fee schedule)if neededCited in the first-line 24-hour urine tests by the AFU 2022, the 2008 AFU article and the French urologists' college (reflecting protein intake) ^[2,6,8]; no NABM code, not reimbursed in France ^[9].

Spot urine test

• Urine pH by pH meter
• Specific gravity
• Crystalluria
• Urine dipstick