guidelines

renal & ureteric stones: assessment and management (nice ng118)

a practical pathway for suspected renal colic: red flags, imaging choices, pain control priorities, when met is appropriate, and recurrence prevention based on nice ng118.

last reviewed: 2026-02-13
based on: NICE NG118 (published 8 Jan 2019; last reviewed 26 Feb 2021)

MET (medical expulsive therapy): don’t assume it’s routine

Frequently asked questions

What is the key emergency to not miss?
An infected obstructed kidney (stone + infection). If there is fever/systemic illness with obstruction suspicion, treat as urgent and escalate for drainage.
Do all stones need metabolic work-up?
Not all, but recurrent stones, young age, or atypical features often justify metabolic evaluation and prevention counselling per NG118 pathways.

Transparency

This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.