I recently noticed I have severe pain in my lower back (left side) if I go too long without taking my thiazide medicine. Could this mean some type of abnormal kidney function??
As soon as I take the thiazide and release all of the fluid, my back stops hurting.
What could this mean?
I continue to produce calcium kidney stones. I have been having surgery to remove them, as last year, they removed over 50 stones, and calcification of the kidney. I passed some in Dec. and another one about 3 weeks ago. To top it off, I have Interstitial Cystitis, and osteopena, in which they want me to take calcium and vit. D. We did find out that my body is not producing Citrate, so I am on heavy doses of Uricit K. I want to know why I keep getting these stones, and is there anything else that can be done, or that I can do? I am in quite a bit of pain, and I am not taking any narcotics. I just want them gone! Please help! Thank You, Cathy
Dear Lorie,
I think it is important for your to understand what is happening with your body, and it is both the physician and the patients responsibility to ensure that understanding is achieved. Medullary Sponge Kidney (MSK) has less than 5% of patients with poor long-term outcomes, although they due have painful stone episodes(renal colic) . Usually with hydration and proper medical therapy, many stones can be avoided. It is not unreasonable to postpone treatment of existing stones, because often the calcifications are still in the collecting ducts ( not the renal pelvis) where the stones may never cause a problem.
It is usually the sequella of medullary sponge kidney that require management (stones and infection). Many patients have hypercalciuria and are treated with thiazide diurectics to limit stone formation. If thiazides cannot be used, inorganic phosphates may be appropriate, if no infections are present. For patients with renal stones, thiazides should be given even if they do not have hypercalciuria. Some studies show that these medications arrest the development of nephrolithiasis (stone formation). However, thiazides often cannot be taken for long periods of time because the mechanism of action eventually leads to higher levels of calcium in the blood. Thiazides work by increasing the absorption of calcium in the kidney. Inorganic phosphates, block absorption of calcium from the bowels. They both decrease the amount of calcium in the urine.
Because infections are not unusual, cultures should be periodically sent. Coagulase-positive staphlococci are most common and should be treated even if cultures are less than 100,000.
Overall, your best mode of therapy is to drink plenty of fluids. If necessary, a thiazide diuretic can be started. Good Luck!
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Medullary Sponge Kidney