A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor?

A. BMI less than 25: A lower BMI (under 25) is generally not considered a risk factor for urolithiasis. In fact, higher BMI and obesity are associated with increased risk due to changes in urinary composition that promote stone formation. B. Diuretic use: Certain diuretics, such as thiazides, can actually reduce the risk of kidney stones by decreasing urinary calcium excretion. Not all diuretics increase stone risk, so this is not a common associated risk factor. C. Hypocalcemia: Low calcium levels are not typically linked to kidney stone formation. Hypercalcemia or hypercalciuria, where excess calcium is excreted in urine, is a known risk factor for calcium-based stones, unlike hypocalcemia. D. Family history: A family history of kidney stones significantly increases a person’s risk of developing urolithiasis. Genetic predisposition affects stone formation through inherited metabolic abnormalities or structural differences in the urinary tract.