Statement of Principles concerning renal stone disease (Reasonable Hypothesis) (No. 69 of 2019) (Cth)

Statement of Principles concerning RENAL STONE DISEASE (Reasonable Hypothesis) (No. 69 of 2019) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 21 June 2019

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Repeal 5 Application 6 Definitions 7 Kind of injury, disease or death to which this Statement of Principles relates 8 Basis for determining the factors 9 Factors that must exist 10 Relationship to service 11 Factors referring to an injury or disease covered by another Statement of Principles Schedule 1 - Dictionary 1 Definitions

1 Name This is the Statement of Principles concerning renal stone disease (Reasonable Hypothesis) (No. 69 of 2019). 2 Commencement This instrument commences on 22 July 2019. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning renal stone disease No. 65 of 2010 (Federal Register of Legislation No. F2010L02304) made under subsection 196B(2) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about renal stone disease and death from renal stone disease. Meaning of renal stone disease (2) For the purposes of this Statement of Principles, renal stone disease: (a) means the presence of one or more calculi in the kidney (nephrolithiasis) or ureter (ureterolithiasis), which result from crystallisation of mineral salts in the urine; and (b) excludes nephrocalcinosis (renal parenchymal calcification) and primary calculus of the lower urinary tract (urinary bladder or urethra). Note: Renal stones are typically composed of calcium salts (calcium oxalate or calcium phosphate), uric acid, cystine or struvite (magnesium, ammonium and phosphate). (3) While renal stone disease attracts ICD‑10‑AM code N20, in applying this Statement of Principles the meaning of renal stone disease is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4. Death from renal stone disease (5) For the purposes of this Statement of Principles, renal stone disease, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's renal stone disease. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that renal stone disease and death from renal stone disease can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA. Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting renal stone disease or death from renal stone disease with the circumstances of a person's relevant service: (1) being a prisoner of war of the Japanese before the clinical onset of renal stone disease; (2) having primary hyperparathyroidism within the ten years before the clinical onset of renal stone disease; (3) having post-surgical hypoparathyroidism at the time of the clinical onset of renal stone disease; (4) having a malignant neoplasm, other than non-metastatic non-melanotic malignant neoplasm of the skin, at the time of the clinical onset of renal stone disease; (5) having a haematological disease from the specified list of haematological diseases at the time of the clinical onset of renal stone disease; Note: specified list of haematological diseases is defined in the Schedule 1 - Dictionary. (6) having gout or hyperuricaemia at the time of the clinical onset of renal stone disease; Note: hyperuricaemia is defined in the Schedule 1 - Dictionary. (7) having tumour lysis syndrome at the time of the clinical onset of renal stone disease; Note: tumour lysis syndrome is defined in the Schedule 1 - Dictionary. (8) having diarrhoea on more days than not, for a continuous period of at least four weeks, within the three months before the clinical onset of renal stone disease; (9) having hypokalaemia for a continuous period of at least the four weeks before the clinical onset of renal stone disease; (10) having distal renal tubular acidosis at the time of the clinical onset of renal stone disease; Note: distal renal tubular acidosis is defined in the Schedule 1 - Dictionary. (11) having a urinary tract infection with urease-producing bacteria within the five years before the clinical onset of renal stone disease; Note: urease-producing bacteria is defined in the Schedule 1 - Dictionary. (12) having an acquired narrowing or obstruction of the ureter, ureteropelvic junction or renal calyx, on the affected side, at the time of the clinical onset of renal stone disease; (13) having a gastrointestinal disease from the specified list of gastrointestinal diseases at the time of the clinical onset of renal stone disease; Note: specified list of gastrointestinal diseases is defined in the Schedule 1 - Dictionary. (14) having undergone: (a) a malabsorptive bariatric procedure; or (b) ileal resection or ileal bypass surgery; or (c) Roux-en-Y gastric bypass surgery;