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Kidney Stones w/ Low Citrate, Low Potassium

Hi all!

Let me start by applauding everyone here for dealing with so many stones - I've been lurking a bit.

I am a 20 yo female and have myself had two kidney stone "attacks" in the past 1.5 years, though I have frequent mild-to-moderate kidney pain, usually in my right kidney. MRI results show at least two 2.0mm stones in each kidney. I passed my second stone (left kidney) a couple of weeks ago, and ever since then, my right kidney has been giving me on-and-off pain. Should I be concerned about this chronic, low grade pain? I always wonder if it's sand passing, but I'm not sure now.

The last 2 or 3 urine tests I've had done have all shown a low level of protein in the urine. My GP, urologist, and ER doctor all felt this was no big deal, though what I've read online about the matter suggests otherwise! I also had ketonuria, but I know this can be due to stress as well.

My urologist had me do a 24 urine test, which indicated that I do not drink enough water (I knew this already), have a high supersaturation of calcium though the actual level is fine, have a severely low level of citrate, and am low on magnesium. My blood tests often show a borderline low level of potassium. During my first stone attack in December 2011, the ER tests showed a potassium level of 2.3, so they kept me overnight and loaded me up with potassium. After taking giant K+ pills for a few weeks, my blood tests indicated my level was fine. No one was able to explain why it fell so dangerously low that time, though I had no symptoms that I could tell, other than excruciating pain from the stone. During my most recent ER visit on 6/30/13, my K+ level was 3.1, which is below the ideal range but still considered ok.

To add to this, I was diagnosed with a 7cm ovarian cyst on my right ovary in late May. Because it is a follicular, simple cyst, the Gyn wanted to keep an eye on it every month and hope that it doesn't twist my ovary or rupture...no biggie... I haven't been able to follow up on it, as I did have a stone attack since then, and the MRI showed no evidence of a cyst. The doctor there explained to me that the cyst may fluctuate in size in accordance to my cycle, and since I've been having worsening pain in the past couple of days, I'm wondering if it is my kidney or if it's my ovary! It's a little frustrating - isn't one issue at a time enough?

I have begun taking magnesium citrate supplements, drink 1.5+ liters of water per day (I know it's not much, but I only weigh 105lbs, and there's only so much I can drink!), and started on an herbal supplement supposedly made specifically for kidney stone sufferers. Has anyone had any luck with citrate preventing future stone formation??

My only concern now is that the protein in my urine points to the beginnings of bigger kidney problems? My BUN, creatinine, and ratio are fine, but one still worries a bit.

Thanks in advance for the input. Stones are the most frustrating thing in the world - I don't know how I can suffer through more, so my hat off to all of you who deal with them by the dozens!!
1 Responses
Avatar universal
MEDICAL PROFESSIONAL
Hi,
I understand your concern regarding your kidney stones as well as your  ovarian cyst. Low citrate may be caused by dietary (meat protein), systemic acidosis such as during diarrhea,magnesium or potassium depletion as well as from idiopathic causes. Low potassium, on the other hand, may be attributed to a variety of issues like vomiting, diarrhea, medication effect, magnesium deficiency as well as underlying medical conditions. Small stones usually respond well to increased fluid intake or  medication. Proteinuria, a condition in which urine contains a detectable amount of protein, may be a sign of chronic kidney disease and warrants further evaluation also. Continue conservative measures and regular follow-up with your ob-gyne is highly recommended also. Take care and do keep us posted.
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