J Pharm Educ Res Vol. 1, Issue No. 1, June 2010 21 Introduction Kidney stone formation is a worldwide problem, sparing no geographical, cultural, or racial groups. Kidney stone affects 5-15% of the population worldwide [1] . Calcium containing stones are the most common comprising about 75% of all urinary calculi, which may be in the form of pure calcium oxalate (50%) or calcium phosphate (5%) and a mixture of both (45%). The management of this ailment mainly involves techniques like extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy, however, the prevention of recurrence of stone formation is not assured. Besides, these treatments cause undesirable side effects such as hemorrhage, hypertension, tubular necrosis and subsequent fibrosis of the kidney leading to cell injury and recurrence of renal stone formation [2] . The kidney stone forming patients are prone to its recurrence even after its surgical removal. Recurrence rates are close to 50%, [3] and the cost of urolithiasis to individuals and society is high. In addition to the surgical management of the problem there are certain drugs and other conventional therapies Non-surgical management therapies for kidney stones Rakesh Kumar Bijarnia 1* , Tanzeer Kaur 2 , Surinder K. Singla 3 , Chanderdeep Tandon 4 1 Department of Biotechnology, Chandigarh College of Technology, Landran, Mohali 2 Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Mohali 3 Department of Biochemistry, Panjab University, Chandigarh 4 Department of Biotechnology, Jaypee University of Information Technology, Solan Received June 28, 2010; Accepted June 30, 2010 ABSTRACT Kidney stone formation is a worldwide problem, sparing no geographical, cultural, or racial groups. Its treatment has become easier and less invasive with the development of extracorporeal shockwave lithotripsy and endourologic techniques. Apart from surgical management of this ailment, the medicinal management is not fully explored. Recurrent stone formation can be prevented by the use of reasonable dietary and fluid recommendations, and directed pharmacologic intervention. During recent decades, pharmacologic intervention has become more effective in stone disease: drugs can control the pain of kidney stones, interfere at various levels in lithogenesis, and contribute to its expulsion. Calcium-sparing diuretics such as thiazides are also used for its treatment. Citrate medications increase levels of this naturally occurring stone inhibitor. There are several herbal formulations used affluently for preventing recurrence stone formation. Oxalate degrading bacteria is the latest focus for researchers towards kidney stone management. In this review article, we provide an update on the non-surgical treatments of stone disease, focusing our attention on what is known and what is new in kidney stone management. Key words: Kidney stone, non-surgical therapy, fluid intake therapy, diuretic therapy, expulsive therapy, herbal therapy, probiotic therapy. Email: drbijarnia@gmail.com which are recommended for its control. A few numbers of drugs [4] and some dietary measures [5] have been shown in randomized trials to reduce the rate of stone recurrence. Indeed, a meta-analysis of randomized medical therapy trials showed a 22.6% risk reduction in stone recurrence rates with the initiation of drug and dietary therapy [4] . Despite these effective treatments, however, the disease shows no signs of abating, in part because of poor patient compliance with prescribed therapies. This review brings together different therapeutic strategies for kidney stone managements available so far. Non-surgical therapies Fluid intake therapy One of the best proven means to decrease kidney stones is by increasing fluid intake, thereby decreasing urinary supersaturation. The positive effect of fluid intake has been proven in epidemiological and prospective intervention studies suggesting that people in specific region with less water intake are more prone to kidney stone formation [6] . Taylor et al [7] have conducted a prospective cohort study of 45,619 men without a history of nephrolithiasis to correlate dietary factors with kidney stone formation.