Rethinking nephrolithiasis in military aviation.

BACKGROUND Nephrolithiasis is a common medical condition among aviation personnel that can negatively impact their health and careers. Due to the potentially severe consequences of in-flight renal colic associated with nephrolithiasis, current Navy regulations stipulate extensive evaluation for any aircrew member who has an instance of kidney stones. CASE REPORT Two cases of Naval aircrew members with kidney stones are reviewed and current Navy standards regarding nephrolithiasis are discussed. DISCUSSION Current Navy standards for granting aeromedical waivers for kidney stones do not differentiate between pilots in actual control of the aircraft and other aircrew members among aircraft personnel. Furthermore, a premium is placed on stone-free status, even for asymptomatic, incidentally found nephroliths. This policy has many similarities, but also significant differences from those of other services and those of civilian aviation authorities. This difference in protocols across aviation communities should be re-examined in order to promote more efficient return to flying duties of operational personnel without compromising safety of flight.