Do you recommend obtaining a DEXA scan for patients with recurrent nephrolithiasis and hypercalciuria of unknown etiology?  

I think this is an important question. I agree with Dr. @Sprague. In my practice, if the patient is female, especially peri- or postmenopausal, I generally recommend a DEXA scan. If bone density is borderline or low, I typically refer the patient to an endocrinologist in our Bone Clinic for consider...

I would definitely recommend a DEXA for a female age 40-45 or above with idiopathic hypercalciuria and stones. In regards to males, I would only recommend it if they had other risk factors for osteoporosis or a family history of osteoporosis with idiopathic hypercalciuria.