In my 13 years of working with stone formers, as a nurse in residence at Litholink Corporation and in my own practice, the number one question has always been: ‘How much water do I really need to drink?’ Maybe as important is: ‘How Do I Do It?’ Tread Slowly Many patients leave their doctor’s office with the vague instruction to increase their water input. How much are you supposed to drink to reduce your stone risk? Even more, patients are told to go home and start drinking a gallon of water a day. If you don’t drink more than a couple of glasses per day now, how are you supposed to drink a gallon tomorrow? Drinking more water is a simple way to … Continued


Ciudin et al JOURNAL OF ENDOUROLOGY Volume 28, Number 8, August 2014 Mary Ann Liebert, Inc. Pp. 1016–1021 Dr Jim Lingeman sent along a PDF of this article, which seems so useful and so germane to our current posts I decided to write about it. WHAT THE AUTHORS DID They Identified People with Prior CT Scans They did a cohort followup study of an initial 1000 people who had an CT performed between January and March 2005. From the 1000, 576 fulfilled their initial inclusion criteria which included that the CT was not performed for stone disease. Of these 177 were lost to followup leaving 362 study patients. They Measured Radiological Papillary Density In each of these 362 cases, papillary radiographic density was estimated by … Continued


Three Pathways for Kidney Stone Formation          All kidney stones share similar presenting symptoms, and urine supersaturation with respect to the mineral phase of the stone is essential for stone formation. These clinical similarities have made it difficult for researchers to development treatments plans to successfully arrest stone formation for a specific stone former. However, recent studies using papillary biopsies of stone formers provide a view of the histology of renal crystal deposition which suggests that the early sequence of events leading to stone formation differs greatly depending on the type of stone and on the urine chemistry leading to supersaturation. Three general pathways for kidney stone formation (Figure 1) are seen: 1) stones fixed to the … Continued


Supersaturation Because crystals are at the heart of all kidney stones, when we talk about preventing stones we mean preventing crystals from forming and from growing. Fortunately, universal and quantitative laws govern how atoms and molecules form crystals so we can predict the risk of crystals using equations that apply everywhere, even in the kidneys and urine. Supersaturate your own sugar solution One way to understand these laws is to make crystals on your own. Find a heat resistant glass container, fill it with water, and stir in table sugar until no more will dissolve and there is extra sugar at the bottom. The water is ‘saturated’ with sugar, meaning it holds all it can. It is ‘full’ of sugar. … Continued