THE SCIENCE OF FLUID PRESCRIPTION FOR KIDNEY STONES

WATER LOWERS SUPERSATURATION Supersaturation is What Drives Stone Crystal Formation This point has already been made in other posts. Because we can measure it in standard medical practice, and because it is fundamental in stone formation, we have chosen supersaturation as a basis for estimating fluid needs in stone treatment.  The principle involved is this: The kidneys perform work to make urine supersaturated; the stored energy from that work makes stone crystals form. Drinking extra water relieves kidneys from the necessity of supersaturating urine, which is what we desire for stone prevention. But, how do we decide how much water? Supersaturation is Stored Energy Stir Sugar Into Water. The solution is inert. Remember the post on sugar and water? You can stir sugar into water all … Continued

A THIRST FOR VARIETY

I have heard this one million times from patients in my practice. Make stones? Drink water. Water, water, and more water. Drink it all day long, all night long. Just drink water. What about other fluids? Are they safe? Are they high in oxalate? Will they count toward your daily intake? Is caffeine a problem? Your Physician Prescribes How Much I will be offering as much variety as I can, and encouraging you to drink, but the volume you need comes from your physician. This applies especially to my two day long examples. I made them to provide very large amounts of fluids for those who need them. If your physician prescribes less, just scale my recommendations back. Under no circumstances should you … Continued

PRICE OF POTASSIUM CITRATE

WHAT IS POTASSIUM CITRATE We have reached the point in the evolution of this site where the main stone risk factors are introduced and detailed, and the importance of citrate established. I have written about the price of potassium citrate because many patients and physicians have told me that it has risen steeply in recent months, and I would like to be of help. A LOUD DISCLAIMER In this post I will mention beverages and medications by name. Let me be clear: I have no financial relationships with the companies that produce or sell the products I write about here. Likewise neither I nor my colleagues at University of Chicago receive any support, financial or otherwise from these companies. WHAT DOES … Continued

THE COKE TREATMENT IS USELESS

The featured image points to a widespread idea now on the web concerning how cola drinks might promote kidney stone passage. It has been called the ‘Coke Treatment for Kidney Stones.‘ Fluids are valuable for all stone formers, but the suggested usage may not be ideal and this post points out some of the drawbacks. OUR PATIENT A few months ago, a delightful 71-year-old woman presented to our clinic for a metabolic evaluation to try to stop her chronic kidney stones. She passed her first kidney stone about 5 years ago. A year later she developed another kidney stone, which required shockwave lithotripsy therapy. Ultimately her stone was analyzed and she was told it was a “calcium stone.” Over the following few years, … Continued

ROLE OF INNATE IMMUNITY IN PLAQUE FORMATION

The complex but interesting featured graphic introduces aspects of the innate immune system which is present and active in the kidney and may have a role in stone genesis. Although innate immunity in kidney is a well established area of research, the specific links to plaque and stone formation have not been explored thus far. So, my post is meant to interest people in the possibility and perhaps give rise to some new scientific research. Toll Like Receptors (TLRs) The innate immune system is an ancient system of defense against environmental threats that is found in all classes of plant and animal life. Innate immunity provides immediate, non-specific defense against infection and products of cell damage or stress. Toll-like receptors (TLRs), … Continued