Web Apps and Smart Bottles

This is an article for all of you to write. The web is awash in apps for tracking fluid intake, and kidney stone prevention is all about fluids. Some ‘smart bottles‘ have arrived on the market. They track what you drink and keep the results on your smartphone. Since some of these are kickstarter efforts there is even an article on Slate about them. Some appear to be finished and rather sleek products. We know nothing about them. There are apps for sodium intake, calcium intake – We think. The field looks thin for calcium apps. Low sodium and high calcium diets are important in stone prevention. We even found one app for preventing kidney stones – see if you can find it. … Continued

Control of Urine Oxalate Excretion

Although seemingly devoid of biological importance in humans, oxalate traces a curiously elaborated path in and out of the body. Incidentally, and from time to time, it contributes to calcium oxalate stones, and in extreme instances, to kidney damage and even kidney failure. You have two choices. You can read the article OR you can watch this brief movie which says what is in the article by way of an introduction. The Main Factors The large drawing that heads this article summarizes oxalate movements through the body. What enters the blood is the sum of oxalate produced by the liver plus the amount absorbed from foods, minus the amount transported out of blood back into the gut lumen. What enters the urine is the sum of … Continued

My Lab Report

To me at least, the lovely Blue Door watercolor by Andrew Wyeth is simplicity created by studied art. Take a look at your lab report(s) and answer these questions. If you have two 24 hour urine collections this time answer from the more abnormal in every case. Here is help for reading these if you are confused. Here is more help. But keep this in mind. I assume here you have personal physicians; that you have been screened properly to rule our systemic diseases as a cause of your stones; and that your other health issues are being looked after by your physicians. This kind of simplified approach is nice for otherwise healthy idiopathic calcium or uric acid stone formers. Others may … Continued


Physicians can only do so much with stone prevention because a large part of the work can only be done by patients themselves. The Five Steps to Stone Prevention, the two articles on how to read your 24 hour laboratory reports for calcium and uric acid stones, and the article on how to be a successful kidney stone patient are the reference materials you need to accomplish your part of your personal stone prevention program. It is now time to pull these four articles together into an organized approach that any patient can follow. USE YOUR PHYSICIAN INTELLIGENTLY Before your visit to decide on prevention Read the article on how to be a successful kidney stone patient, where  you will find lists of materials to … Continued


The pretty picture shows uric acid crystals in urine magnified 400x under polarized light to bring out their shapes with special clarity. Here is what to look for and what to do if your stones have uric acid in them or are entirely uric acid. A caution: Occasional stones are not uric acid but a salt of uric acid: Sodium hydrogen urate or ammonium hydrogen urate. This article is not for them, They occur in unusual situations, not as yet covered here or anywhere else on this site. Urine pH Uric acid is a large carbon based molecule. Water ‘dissolves’ molecules because of charge attraction. But there is not a lot of charge on this kind of molecule. In fact there … Continued


Jeff, a reader of this site, suggested this topic and I realized it was one that I should have written long ago. You can make sense of all those numbers in the 24 hour kidney stone reports. You can use those numbers to understand how things stand with you. Reading the numbers can help you achieve your best possible chance at stone prevention – which is the only reason all those lab tests were done in the first place. This article deals with calcium stones. A second one will cover uric acid stones. Be Sure You Have Been Screened For Systemic Diseases Your physician does this part. But even for systemic diseases stone risk is gauged in the urine so you can read along … Continued


Thiazide Type Diuretics Reduce Stone Formation The common thiazide type drugs in use today are hydrochlorothiazide, chlorthalidone, and indapamide. All three have been used in stone prevention trials and shown to have beneficial effects. A nice recent review is also the source for the drug structures pictured above. I have obtained and studied nine trials. In all nine trials, there was a comparison – untreated – group. This spreadsheet contains links to the trial documents, but you will find it not easy to obtain the original publications unless you have access to a university library system. For this reason I have copied out the key data. Briefly, there were 330 controls, of which 149 relapsed (45%), and 314 treated subjects of whom 72 relapsed (23%), … Continued


At the end of it all, the science, the medical visits, the surgeries, what we really want is to prevent new stones. That is the main goal. Modern surgery is a blessing for those with stones. But no surgery is far better than even the most skilled and effective surgery. Prevention of stones is orderly and occurs only over time. Here is how to do it. This article is designed to go with my other one which tells how to organize your medical visits so as to achieve these steps.  What is the Science of the Five Steps? Stones are made of crystals. Supersaturation drives crystal formation and growth – this is a physical law that must always apply. Supersaturation … Continued

Does Too Much Protein Increase Stones or Damage Bones?

Certainly, we all need protein in our diet. Some of us overdo things with shakes and powders, some with 2 pound steaks. Others who love sweets too much may not eat much protein. Like all the diet factors in stone and bone disease, protein intake is complex. Experts debate the best course, and patients wonder what to do. Abraham van Beijeren was, according to this public biography, little recognized in his day but not considered a major painter of ‘luxuries’ like this standing roast. I chose this, as opposed to others in the public domain because it looks more modern – I have seen something like this on my own dining room table. How Much Protein Do We Need? Lets begin with … Continued

Control Your Salt for Fewer Stones and Stronger Bones

Here is my ‘bottom line’ on salt: The more you eat, the higher will be your urine calcium and – from what trial data I can find – the higher your risk of forming stones and losing bone mineral. The big articles, on salt and on idiopathic hypercalciuria have put into place the structure I need to make this simple generalization acceptable. That is part of the reason I wrote them – to be a structure I can rely on and work off of. The large image is from a recent publication about the bone disease of idiopathic hypercalciuria. The full report is available and I recommend it.  So here is a new kind of article, from me to you, … Continued