IDIOPATHIC CALCIUM PHOSPHATE STONE FORMERS

Unlike Zeus, or Athene, Janus did not come down to the Romans from the Greeks. Instead Janus appears to have originated in myths concerning what may have been an actual person present very early in Roman history and later deified. Janus presided over beginnings and endings, over gateways and doors, and was invariably dual in nature. Like the idiopathic calcium oxalate stone formers, these are people whose stones are composed of calcium crystals and who have no systemic disease as a cause of their stones – therefore ‘idiopathic’ stone formers. But unlike the calcium oxalate stone formers, their stones contain predominantly calcium phosphate crystals. And unlike their more unitary counterpart, calcium phosphate stones can be one of two different kinds – brushhite … Continued

IDIOPATHIC CALCIUM OXALATE STONE FORMERS (ICSF)

This is the first of a series of articles concerning the stone former phenotypes. ‘Phenotypes’ means literally the types of appearances of stone formers as observed medically, by which is meant observed using the common tests and measurements of medicine. These ‘types’ have value as they constellate abnormalities that might be individually confusing into patterns that can be recognized and that have implications for treatment and prognosis. More precisely, medicine works entirely from abnormalities, meaning departures from what I might call the normative trajectory, the sum of all measurements and characteristics one expects among healthy people as they move through life. The abnormalities of medicine are all departures that produce a state of unwellness, or illness as is more accurately said. … Continued

A Success Story

When my husband, Pat, had his first kidney stone, his doctor advised him to “take the salt shaker off of the table.”  He thought that would be easy.  He didn’t consider that every-day foods are packed with sodium. Sticking to a low-sodium diet isn’t easy.  It takes planning. With so many convenience foods available, I feel like a pioneer woman making chicken stock from bones and canning tomatoes to avoid high sodium canned versions. It’s worth it, though. Pat has now attained sodium consumption below the typical non-stone forming American. We’re all hoping this helps him avoid future issues. “Convenience food” has to be homemade when you are on a low sodium diet. This eliminates frozen meals, canned soup, Velveeta,  frozen … Continued

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

PUTTING IT ALL TOGETHER

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

Ureteroscopy: Background and Current Controversies

MINIMALLY INVASIVE STONE SURGERY (Ureteroscopy) (Images of surgical equipment featured in this article are for patient education only. They are not intended for promotional use or a reflection of personal preference. We accept no fees or other benefits from vendors or their agents.) Evolution of Technique The fascinating history of urology with its captivating depictions, texts and stories rivals any other field in medicine. In particular, the ancient past of lithotomy (treatment and removal of urinary stones) dates back to Mesopotamia (3200 BC), and descriptions and treatments for urinary stone disease have been identified from ancient cultures including Hindu, Greek, and Egyptian. The treatment of stones, which at the time most commonly occurred in the bladder, was very dangerous, often lethal.  As such, it led to the development of one of the first … Continued

HOW TO READ YOUR KIDNEY STONE LAB REPORT – Uric Acid Stones

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

HOW TO READ YOUR KIDNEY STONE LAB REPORT – Calcium stones

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