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Stone analysis and recurrence prevention

  I have been treated for kidney/ureteral stones 3 times in 4 years by cystoscopic removal and ESWL. Two stones have been sent for analysis. They were composed of calcium oxalate and calcium carbonate. I am not a big dairy product eater. In fact I get far less than the recommended calcium intake for women. I am a 34 year old female.  My urologist seems to not be very interested in further testing. It feels as thought he is simply saying
  "See you next time" I would rather look for ways to prevent stones than just to intervene when one forms. Do you feel that blood and urine screenings for calcium levels are warranted in my situation. Also what is the criteria for parathyroid testing? I have almost all of the symptoms for hyperparathyroidism that I can find anywhere on the web. I am no doctor but I try to keep well informed about my health. Any input from you would be greatly appreciated. Thank you very much.
1 Responses
Avatar universal

Dear Tammy,
Kidney stones often return in patients who have previously been affected.  The best way to prevent kidney stones is by increasing the fluid intake.  Try to drink enough so that you make at least 2 to 3 liters of urine a day.  An increased sodium intake and high protein diet can also increase the risk so in general back off on added salt and consider decreasing your protein intake by 1/3.  For most patients with calcium oxalate stones, oral calcium intake should not be reduced.  In fac, if you are at risk for developing osteoporosis, then calcium supplements are indicated.
Many urologist do not do a further work-up for the first stone.  However, for recurrent stone formers, those with a family history for stones, or pediatric stone formers further work-up is indicated.  This typically includes both blood tests and an analysis of a 24 hour urine collection.  The parathyroid hormone level is routinely checked as this hormone is involved in calcium metabolism.  If metabolic abnormalities are identified, diet change, medicines, or surgery may be indicated.
This information is provided for general medical information purposes only. Please consult  your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital  and its suburban locations (I-800-653-6568).
* Keyword:stones, metabolic evaluation

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