Glomerular filtration is the main life sustaining kidney function, and kidney stones can cause enough damage to lower it. Usually the reduction is very modest, but sometimes stones can cause kidney failure. This means, like all diseases, stones are best prevented as early and as completely as possible.
This ‘just the facts’ version tells about what filtration is, how physicians measure it, how much kidney stones lower it, and how often that occurs.
Two longer articles give the details. One is comprehensive. The other focuses on only kidney disease, but is long.
Much of this text is redacted from the other two articles. I left out pictures, data, and links to PubMed to emphasize the main points.
The featured painting is by You Si 游思 (b. 1954), based in Shanghai, China. He is the son of two artists who lived through the cultural revolution and paints in new ways. I think his work is gorgeous but could not find a serious biography or critical study, or any museums that show his work.
What Filtration Is
Our two kidneys are each made up of about one million nephron units. A nephron is a complete and complex structure that begins its function by filtering from blood plasma a clear solution of water and small molecules. That filtrate enters the long loopy tubule of the nephron that reabsorbs a vast fraction of water and salts back into the blood leaving behind only that destined for export out of the body.
The glomerulus, a tuft of capillaries nestled in a tiny cup that drains into its tubule, performs this filtration. So we name it glomerular filtration rate, or GFR.
Blood flow and pressure from the heart drive filtration, but kidneys can regulate its rate. The cells that line the tubules regulate what fractions of innumerable individual salts and small molecules are taken back or let go into the urine.
Filtration Keeps Us Alive
Filtration rids the blood plasma of metabolic wastes, like oxalate, and permits us to excrete the extra water, salt, and all other materials we might eat or drink every day. Without filtration we need dialysis or transplantation to continue living. So this kidney function stands above all the others. When physicians speak of kidney function, they mean, and measure, filtration.
Filtration and Kidney Stones
Kidneys filter copious volumes of water and small molecules – like calcium, oxalate, citrate, phosphate, uric acid, sodium – hundreds of distinct materials. They then return most of this flood – 100 to 200 liters a day of water alone – back into the blood keeping behind only what they destine for export as urine.
Because kidneys filter such vast amounts, very subtle variations in what they take back into blood can load the urine with stone forming salts like calcium and oxalate, and cause stones. In other words, stones arise in significant measure because of subtle imbalances between filtration and reabsorption of key materials like calcium, oxalate, citrate, and water itself.
The filtering system, though powerful, is delicate. Through obstruction, infection, loss of one kidney, or surgical trauma stones can injure it. Such injuries reduce the ability of kidneys to protect the body, and when severe can lead to chronic kidney disease and even need for dialysis or transplantation.
How We Measure Glomerular Filtration
Serum Creatinine
Muscles make creatinine steadily and send it into the blood. Like almost all small molecules, kidneys filter it. Serum creatinine therefore reflects the balance between muscle production and filtration. When filtration falls serum creatinine rises. It is like your golf score – bad day, higher score. Serum creatinine gauges filtration adequately enough for clinical practice. But because kidneys not only filter creatinine but also secrete it from blood into urine, creatinine overestimates true filtration.
eGFR
To get a better estimate, scientists compared serum creatinine to true GFR in reasonably large populations and calculated the best fit between them using regression techniques. The resulting regression equation gives estimated GFR, or eGFR, from serum creatinine, age, sex, and race. This highly derived index dominates medical practice. When physicians speak of reduced kidney function they mean reduced eGFR.
Kidney Function in Stone Formers
Average Function is modestly reduced
Our Own Patients
In our own patients, we found that stone formers have lower kidney function than normal people. The common idiopathic calcium stone formers are just slightly low. Likewise for those with primary hyperparathyroidism. But kidney function is reduced by about 20% in people who make stones because of bowel disease or diseases like renal tubular acidosis or cystinuria. Uric acid and struvite stone formers have even greater reductions.
US Health Surveys
The national NHANES data survey results showed modestly reduced kidney function in overweight people who had a history of stones. Women who formed stones had increased risk for serious chronic kidney disease, and even dialysis.
Olmsted County
This community uses Mayo Clinic for care so records are very complete. A history of kidney stones increased risk of CKD and eventual dialysis.
Large Reviews
Two extensive reviews of all published studies – not just the few I mentioned – concluded that where ever looked for, stone forming raised risk of high blood pressure, serious chronic kidney disease, and even dialysis.
Though Increased, Kidney Disease Rates are Not High
Stones raise the risk of serious kidney disease from the very low levels in the general population to higher though still low levels. The vast majority of stone formers do well and never have problems that require special kidney care. Only rarely do stone formers need dialysis. But they can come to need such care more frequently than people who never formed a stone.
The message is obvious. Stone recurrence should be minimized through prevention efforts. Physicians who practice stone prevention need to measure eGFR appropriately, and if it begins to fall take proper steps to mitigate the causes of that fall.
Obstruction from stones always needs prompt, skilled, urological care that minimizes risk and trauma from surgery. Because silent obstruction can destroy a kidney, any symptoms that suggest new stone passage deserve urological attention.
High Blood Pressure
The NHANES and Olmsted County data show that a history of stones raises risk of elevated blood pressure. Loss of kidney function, even subtle, could raise blood pressure, and increased blood pressure can harm kidneys and reduce GFR. Unlike significant kidney disease, high blood pressure is easily treated to prevent strokes, heart disease, and kidney failure. But high blood pressure commonly escapes diagnosis and adequate treatment.
This means kidney stone prevention clinics are high blood pressure clinics, or at least a common place where high blood pressure can be first detected. All stone formers need to know their blood pressure and seek care if it is elevated.
Bottom Line
Stones are a painful and recurrent chronic disease that kidneys generally tolerate with at most a modest amount of injury and function loss. But compared to people without stones, those who make them have measurably increased risk of high blood pressure and loss of kidney function. Years of study have made clear that this disease demands attentive treatments aimed at prevention, and that surgeons who manage stones do everything possible to preserve kidney tissue.
Does this mean there is a higher risk of complications if someone who has had kidney stones donates a kidney to another person?
Hi Terri, This is a vexed issue. Some transplantation centers disqualify as donors anyone with even one stone visible on CT others will accept a donor if there is only one small stone. Certainly all centers disqualify frequent recurrent stone formers. The next article catalogs outcomes for stone formers with only one kidney – one lost because of surgery, infection, silent obstruction. Once again, most do fine. But of course the risk from a stone or surgery goes up. Regards, Fred Coe
Hi! I’m sorry if I should not be asking this here but my Urologist gives me short answers by email …”CT or get you on the operating table.” So I’ve been doing my own research, which brought me here.
I had a emergency room visit and CT scan. Showed one 3mm stone passing (never saw it come out, could it have dissipated?) and one 6mm in my kidney. 6 Months go by. Now Second stone comes down but it appears to be stuck in my ureter. Lingering mild pain made me seek out an Ultrasound which shows partial blockage.
Can I give it some time and see if it passes with water and lemon juice and a roller coaster or am I risking injury to my Kidney by waiting? Also I’m afraid of the radiation of another CT scan..are there alternatives?
Hi Seth, I gather a prior stone has partially passed and is obstructing your kidney. It is 6 mm or more. Your urologist is wise. Leaving an obstructed kidney is not a good idea as kidney damage can occur and be irreversible. The stone is large enough the odds of passage are not ideal. I would agree with your physician on general grounds. He/she has, of course, all the details and responsibility. Do not fool around with possible kidney damage. When you recover, pursue prevention. Regards, Fred Coe
Can my urology labs come back good but my kidneys not be removing fluid unless I take a diuretics?
Hi Robert, yes. Urine flow is regulated, and follows fluid intake. If you do not have heart disease, or other cause of sodium retention, higher fluids will lead to higher urine volumes. Diuretics do not increase urine flow, they merely reduce the body stores of sodium for any sodium intake. If you are on diuretics for a while and stop suddenly – not taper them, you rebound in a phase of sodium retention, especially after lasix. That can last for weeks, and one is tempted to take more diuretic – that leads to continued dependence. Regards, Fred Coe
Dr. Coe, my mom has had low functioning kidneys (between 26-36 on whatever scale is typically used) from almost total failure 7 years ago. She just got gout for the first time, and is now taking Allopurinol. I’m really worried because stones are a possible side effect of this drug. We’re seeing her nephrologist in 5 weeks, but I don’t know if I should ask him before then if she should keep taking this. I don’t want to overreact because of research I’m trying to do on the internet. Your thoughts?
Hi Valerie, Allopurinol does not cause stones. It is a common treatment for gout. Regards, Fred Coe
Hi I have a couple of kidney stones that are and have been just sitting In my kidneys. MY GFR is at low stage two and has stayed there for a few years. I’m wondering if they are the cause of the Stage Two and if they just sit there are going to cause more kidney damage down the road??
Hi Susan, why kidney stone patients tend to lower eGFR and even kidney disease is not as yet clear. Non obstructing stones are usually best left alone, but your physician is the final arbiter. Blood pressure control is very important for you. Likewise, prevention of more stones. Regards, Fred Coe
Correct me if I am wrong but I can’t help but try to figure out how kidney stones affect gfr…. Say, the presence of the stones in the bowman’s means that there is an obstruction to filtrate passage down to the collection ducts…. This means there would be an increased accumulation of the filtrate in the loops and by extension an increase in the hydrostatic pressure exerted by the fluid on the tubular walls.. And as we know, capsular pressure impedes filtration…. Is it therefore right to say that the caliculi reduces gfr by raising capsular pressure?
Hi AsHaBi, Urinary tract obstruction indeed increases hydraulic pressure throughout the nephron – no air, continuous fluid column to the glomerulus. Filtration rate is driven by the intra- capillary (hydraulic pressure – capillary blood oncotic pressure) – bowman space hydraulic pressure; as the trans-capillary pressure falls GFR falls. Bad, and with time the cells die and kidneys are lost. Regards, Fred Coe
My question is whether or not removing a stone is a good idea? I’m 52 and have a 18mm x 9mm non-obstructing stone in my right kidney as determined by CT and X-ray. There is some pain, but not excruciating. My GP said to leave it alone. I sought the opinion of a Urologist who recommended removal by laser dusting. Other factors include borderline HBP 133/85 and a GFR in the low 60’s. Will having this stone removed improve the kidney function or help lower my BP?
Hi James, The large stone, being non obstructing, can be left or removed at your discretion. But it poses a hazard if it moves and obstructs which is no doubt why your urologist advised removal – the proposed choice via ureteroscopy appeals to me. High blood pressure and reduced kidney function are not uncommon in stone formers and the blood pressure needs attending to. The stone removal is not likely to affect kidney function or blood pressure. Regards, Fred Coe
Happy to report the stone was removed. As a result, a couple other items were addressed. Prior to the ureteroscopy my doctor put me on a minimal dosage of Lopressor which has my BP in the 115/75 range. Also, an enlarged thyroid was discovered, but biopsy proved suspicious nodes to be benign. I’m wondering if there could be any kind of connection between a large thyroid and kidney function? As I continue to pursue better health with a kidney stone diet and exercise I can’t help but wonder if addressing the thyroid issue could improve the kidney.
Hi James, I know of no associations unless you mean your thyroid gland is producing an excess of hormone; that latter can promote kidney stones. Regards, Fred Coe
Dear Dr. Coe. I am a kidney stone sufferer. Many years now. My father suffered as well including gout and high blood pressure. I do not have gout but I do have high blood pressure. It runs in my family even my tiny grandma had it. Any way, my eGFR keeps going up and down. The lowest was 51. It rarely goes up past 80. My sodium and carbon dioxide are always low my CREAT goes high norm to high … all this confuses me. Why would my eGFR bounces like it does?
Sincerely
Confused
Hi Alisa, The eGFR is calculated from serum creatinine, so as the latter rises the former falls. That your carbon dioxide is low is important and your physicians need to understand why that is happening. Possibly you have a form of renal tubular acidosis or take a drug that is responsible. Your high blood pressure needs treatment and the kidney stone diet is ideal as a starting place, but given reduced kidney function and the low carbon dioxide you are more complex than usual and it is up to your physicians to figure things out. I am too far away and lack the details. Regards, Fred Coe
Dr. Coe- I’m 46 and have dealt with stones on & off for about 20 yrs now, with the past few yrs yielding an annual attack usually around Feb for some odd reason. I’ve passed all stones on my own without intervention. BP is always below ave (105/65) so no issues there. I just found out my GFR is 61. While within normal range it’s too close to stage 3 for my comfort. Given that stone sufferers tend to have lower GFR numbers, do I need a complete diet overhaul?
Hi Jennifer, Given a normal blood pressure a good way to evaluate your kidney function is via a urine albumin/creatinine test. If it shows a low number, perhaps you have had some mild kidney injury from stones but you have a very low likelihood of progressive disease. Be sure the test is done on urine that is negative for blood on dipstick, and even a little blood can create a false high protein value. Another test of value is a renal ultrasound – no radiation, and it can assess size and quality of your kidney tissue. Finally, perhaps you take meds that lower renal function – check with your physicians. Regards, Fred Coe
I’m a 33 year old, I thought fairly healthy, I was just diagnosed with a large staghorn calcus kidney stone and talk of completely removing my kidney have been brought up. My GFR was 55 about a month ago. Is removing a kidney for this that common?
Hi Fallon, No – removal is done only if the kidney is totally without function. That may be as your total GFR seems very low. I know nothing about your actual situation but strongly recommend consultation before surgery and very complete evaluation as to the cause of stones because your kidney function should not be so low and I am suspicious of some underlying disease that might be lowering it. Regards, Fred Coe
Hi Dr. Coe, I am concerned because I had a blood test come back with a creatinine lvl or 1.34 and I am urinating mor eduring the night. I am 32 white male and had a kidney stone about 7 years ago. I also showed crystals in my urine so I am hoping the high lvl could be due to that. I am just worried about kidney disease and was hoping you could give me some hope.
Hi David, Serum creatinine has a lot of imperfections; for example it can be high in men with large muscle mass – workout types. Your 24 hour kidney stone urines will show how much creatinine you make a day and also your calculated creatinine clearance. If GFR is really reduced, then the cause matters. But one step at a time. Regards, Fred Coe
I have MSK. I have recently had PCNL surgery on my left kidney. The doctor was only able to get a few stones from my tubes. I still have several in the meat of my kidney. He can’t get to them. Is there a way to remove those embedded stones? They will keep growing. Will they take over my kidney? I’m losing hope.
Hi Mandy, stones in the kidneys cannot be removed. Many are tubule plugs – usually in calcium phosphate stone formers. Some are indeed MSK – your physician can tell one from the other. Did you ask if the calcium deposits were in tubules vs. sponges? In general kidney function will suffice life long, so do not despair. Regards, Fred Coe
Hi Dr. Coe. I’m 51 yrs old. My right kidney is 24% functioning with stones. And my left kidney is 76% ok. My doctor advice me to remove my right kidney than to remove the stone alone. Do you think it is better to remove my right kidney?
Hi Diana,I would not remove 24% of kidney function, so no – find a way to preserve the kidney. Sometimes the stone is from infection, but even then I opt to keep whatever function that kidney can offer. If your surgeon is concerned about such preservation I would ask his/her help in referral to a center that can do it. Regards, Fred Coe
I have kidney stone and createnin of 161umol with elevated blood pressure is it must for me to go for diayalisis
Hi Hawa, certainly not. You do have some loss of kidney function but enough for a long life without dialysis. But prevention of stones and treatment of high blood pressure are crucial. Here are some articles for you. Stone prevention. High blood pressure in stone formers. Regards, Fred Coe
Hello Dr. Coe,
Thank you for this overview. I am a male, 58 yrs old and have passed 29 stones over the course of 40 years. The last “set” included 7 stones varying from 4mm to 10mm in Dec 2017. I just had a CT scan and blood work. The CT says I have two stones left. One is way up in the kidney, about 10mm and the other 4mm and moving. My GFR is 39 with Creatinine at 1.39. I’m very concerned. I am on hypertensive meds am controlled. Not overweight and active. What else would you recommend? The good news is it does not appear that I have created any new stones in the past five years. So the diet and changes seems solid.
HI Joe, Your main problem now is reduced kidney function and hypertension. I would recommend you have a nephrologist as your physician. As for the stones, I would no nothing surgically unless they cause obstruction, infection, pain or bleeding. Perhaps the stones are uric acid; these form despite reduced kidney function, and are easily prevented. Calcium stones can be due to systemic diseases that include kidney disease; your physician should be sure about whether such is present or not. Regards, Fred Coe
Hello Dr. Coe, I am a 24 y/o male Asian, weight: 68kg, height: 5ft 5inches. In February 2018, in a regular body check up a high creatinine level was recorded at 1.34 mg/dL. I visited a nephrologist who told me to reduce my diet until it lowers to a normal level, so I did. I basically went on a very strict diet, typically the ones followed by a CKD patient. Over 2 months, in April my creatinine dropped to 0.93 mg/dL. I also completed an ultrasound of kidney, electrolyte balance check, BUN, urea, uric acid test along with hepatitis B, C and thyroid check to detect any abnormalities which may have caused this elevated level. All these tests were normal.
After April, I went back to a normal diet with a relatively low protein intake. Today (July 2018) I rechecked my creatinine and found that it elevated to 1.13 mg/DL. I know this is within normal level but it’s very near to the upper limit even with a low protein diet (daily maximum 40g). What do you think is the probable cause of this tendency for my creatinine to rise. Are there any extra tests that I should take? (Note: I still haven’t completed KUB and creatinine clearance ratio).
Hi Anon, Serum creatinine will vary with creatinine production from muscle and with intake as well. Certainly the easiest way to assess this is a timed urine collection to go with the blood. Even a 24 hour urine creatinine will suffice. Another useful bit of information is urine protein or albumin per gm of creatinine and blood pressure. Some people do not secrete creatinine as well as others, incidentally, so serum values can be a bit higher for a given creatinine excretion rate. There are other more complex tests for glomerular filtration, as your nephrologist knows, just in case your creatinine clearance is indeed a bit low. Regards, Fred Coe
Hello Doctor Coe, I had blood work done a few weeks back, my Creatinine was 1.40 and AST was 39.00 glucose 70 blood pressure 104/70 EGFR was 58 ,I do powerlift and take creatine supplements, what is concerning me is that my doctor told me that I had the kidney function of a 60 year old man, I am a 34 year old w/male. This sounds dire to me I am not an expert and he is a general practitioner. Do these numbers seem that dangerous? Thanks.
Hi Jason, Creatinine is converted to creatinine, so your serum creatinine will increase from the load of creatinine. This is a well known artifact. Regards, Fred Coe
I m shakir from pakistan
My creatinine is 1.0 and my egfr is 60 my both kidney has stone 0.5 mm to 1 mm since 15 years plz tell me what i do thanx
Hi Shakir, The creatinine is not too alarming in itself but your physicians have to determine if your urine has excessive protein in it and if your blood pressure is normal or not. The single stone in each kidney will not cause kidney disease unless they obstruct, and this is also something your physicians can determine. I would discuss this in detail with them. Regards, Fred Coe
Hello Dr Coe
I’m writing from New Zealand.My husband is a chronic kidney stone sufferer,but unfortunately Dr’s here do not seem to treat with any long term medications.My husband only receives short term medications mainly directed at pain control,or easing the passage of stones to help with pain.On the 29th July 2018 my husband suffered an intracerebral hemorrhage (hemorrhagic stroke) of the left parietal lobe,related to hypertension.On the 11th July 2018 my husband had a routine health check at work performed by an occupational health nurse.Blood pressure was 210/140 right arm,190/127 left arm.She sent him urgently from work to Dr (General Practitioner). GP reading 175/100.Unfortunately GP failed to act on blood pressure,and instead concentrated on kidney stone formation even though my husband only had a very mild niggle with his kidneys.I’ve spoken to a trained pharmacist who confirmed to me that Hyoscine butylbromide 10mg tabs (Buscopan) can be detrimental to high blood pressure.GP gave this.My husband has had recurring hypertension when he has been in hospital with extreme kidney pain.Last major episode several months ago,blood pressure in the range of 269/160 as I recall.No one at all has ever treated for hypertension.Our ACC (accident compensation corporation) laws prevent legal action being taken over GP’s failure to act.If it is at all possible for you to more formally help me in a private email,that would be greatly appreciated.Thanking you.
Hi Deborah, The hypertension you describe is very worrisome and the stroke regrettable. Surely his physician has some reason for failure to treat the hypertension as there is now world wide agreement about the benefits of lowering systolic pressure to below 140 and recently below 130 mmHg. Routinej and inexpensive drugs like thiazide diuretics and ACE/ARB are used everywhere. I am pleased to communicate with you via personal email – mine is visible – but of course I am very far away. Regards, Fred Coe
Hi i have stone iam 55 years and creatine is 1.71
Hi Shwan hassan, The high creatinine is worrisome and your physicians need to figure out the cause and offer whatever treatment you need. Given no more information I cannot add beyond this. Regards, Fred Coe
Hi I am 51 with 20% gfr and don’t know what to do to stop it from progressing any further. I had a kidney stone twice many years ago and take bp med for several years now since last pregnancy. My bp is high occassionally usually upon waking. I want to avoid losing the remainder of function, but nephrologist gives no guidance, only monitors. He did start Calcitriol twice a week. I weigh 182 lbs and am exercising trying to lose some weight to see if this will help. Please give advice. Thanks.
Hi Angie, What is the cause of your kidney disease? Have you had 24 hour testing to rule out hyperoxaluria?? Stone formers rarely develop such severe losses apart from those with high oxalate. Check this out. Regards, Fred Coe
Hello Doctor,
Greetings to you, this is related to my father’s condition. He is asian, age 55, takes medicine for sugar and BP, currently he has two stones in his kidney one each side of 3mm. His creatinine level is 1.51 and gfr is 48. Please let me know what best could be done to be normal again. Thanks
Hi Himanshu, I gather your father is diabetic and hypertensive, has several stones and considerable kidney disease. I suspect the kidney disease is from diabetes and hypertension and that his urine albumin (or total protein) is high. It is not the stones but the other two diseases. He needs a skilled nephrologist as soon as possible. Regards, Fred Coe
My son (nearly 22) was diagnosed with PKD then diagnosed with Unicystic instead when he lived on the west coast. I understand it is hereditary. His father won’t get tested. I have so many questions that I don’t know how to pick just one. What is the main thing for him to do right now? He’s been back in Central US for a year being a 20 year old. I am a worrying mother. He is a live while you can kind of person. I don’t know anything except what I read about it. And of course, it all terrifies me. – thanks
Hi Chris, I am not a PKD expert. Given the diagnosis is unclear, he should be evaluated at a center that specializes in PKD as it is indeed a serious condition. If he is in the midwest, we have an expert here at the university. I suspect Mayo would also be fine. Regards, Fred Coe
Sir,after endouroloy of kidney stone I have the problem of blood secretion through urine..can u explain me with reason
Hi Dolly, bleeding after a procedure is not rare. Let your surgeon know, however, so he can be sure. Regards, Fred Coe
Hi, Im a 56 year old male with a 6.5mm stone in right distal ureter at junction of illiac artery. Passed 2 stones , one 7mm and one 4.5mm on left side 2 weeks ago. However today after visiting Dr. , Creatinine has moved from 0.88 to 1.01 and gfr from 68.5 to 60.4 in 5 weeks even after passing stones on left side. Dr. has advised me to wait for another 2-3 more weeks for remaining stone to pass. CT shows moderate hydronephrosis and very swollen ureter to the Kidney. Taking tamsulosin but was recomended silodosin. Please give your views. Thanks.
Hi David, I presume your serum creatinine has risen because your left kidney is partially obstructed. Your surgeon is responsible for the safety of your kidney, and is balancing the risks of waiting vs the risks of surgical intervention. I cannot offer a specific opinion about timing, but perhaps you might discuss with him your concerns about the kidney and whether it might be better to remove the stone. Regards, Fred Coe
Thank you Dr. He mentioned there is no protein in my Urine so he feels we should wait for another 2-3 weeks and I should be physically active and drink 3 liters of water per day then look at movement and kidney function… While I know you can not offer specific advise, I was asking if this sounds reasonable. I am asking as I am an American expat based overseas and while the level of care in the country I am living is high I wanted to see if it was in sync with best practice in the US. Best, David
Hi David, His timing is based on his best judgment. Perhaps he hopes to save you a procedure while exposing you to minimal risk of kidney damage. You will see if your creatinine falls back to its prior level when the stone has passed. Timing of surgery is highly specific to any one patient. Regards, Fred Coe
Hi, I’m 39 and a long term stoner. In the 5 years since I’ve had them I’ve had 2 eswl, 1 pcnl and 2 laser cystoscopy.
Question is, this latest Stone was stuck from December after it hospitalised me a week before Christmas but urologist said to give it time to pass on it’s own another surgery and with my severe anxiety about stone surgery and not tolerating stents at all I never went back.
21st Sept 2018 ended up in ED vomiting uncontrollable pain. Kidney completely blocked. Ct showed stone had grown from 6mm in December to 12mm. Placed in the right ureter near the bladder. Urologist had a hard time getting stent past the blockage and said he couldn’t get any instruments in due to damage. < 2 weeks later had surgery with laser and basket retrieval. Before surgery he said stent would be in for 5 days. After surgery he came and seen me and said the stent would need to stay in minimum of 14 days. He said kidney is still severely swollen. I’m on day 6 now, still in immense pain in the kidney. It’s still quite swollen I can feel that. Have I done irreparable damage by avoiding surgery for so long? How long will it take for the swelling to go down? I’m not tolerating the stent but am also scared having it removed will do more damage long term.
Hi Bianca, Very worrisome. Your surgeon is trying to get drainage for your kidney that has perhaps been blocked for some time. S/he needs to do everything possible to save function on that side and I would advise you follow instructions exactly. Given the stent and so much pain, be sure your surgeon knows; perhaps drainage is not good enough. Regards, Fred Coe
Dr. Coe, I stumbled across your articles as I try and help my husband (a physician) handle multiple kidney stones. (Like many physicians, he doesn’t trust other doctors! LOL ) I want to say thank you both for the informative articles and for your inclusion of such lovely art work.
Hi Karla, Thanks. Here is where I would recommend you start reading. Regards, Fred Coe
Hi Dr. Coe,
I need your help. I’m a healthy, 35 yr old female, and I have reoccurring kidney stone SAND & larger stone attacks.
I was diagnosed with Hashimoto’s Autoimmune Disorder (hypothyroidism) in March 2017. At the time of my diagnosis, I think you’ll find it interesting that my Vitamin D level was LOW at 30.1 ng/mL (30.0-100.0 range). I’ve since added Vitamin D/K2 to my vitamins and it’s twice that number now!
My TSH is “normal” to most docs, but I think I am Euthyroid currently (Last TSH lab (09/18): 1.10 uIU/mL. I avoid all drugs but I do take 15 mg of Armour or similar dosage in Nature Throid. I am trying to protect my thyroid function by doing this. I believe I have the following as well: PCOS & insulin resistance. I think I have an early state of some type of metabolic issue(s). My mother is a Type 1 diabetic and also has Hashimoto’s. I have NO FAMILY history of kidney stones & I think I stay well hydrated and drink water.
My first painful attack happened in 2014 and I passed a stone the following day that tested positive for Calcium Oxalate. I’ve been working on healing my Leaky Gut and it’s back to healthy levels but I just had another painful attack (2 stones passed) this past weekend and I’m wondering if eating a Keto diet may have contributed to the drop in stones. It was only about Day 4 at that point. I’ve checked my old labs for EGFR & Creatine, never had any bad results there. Back in Dec 2017 I saw my Calcium Serum was 8.4 (out of 8.7-10.2). My doctor never mentioned it to me, but my functional medicine doctor saw it and commented. Normally my stones look like sand size and never hurt. I think I pass sand stones maybe a couple times a week for YEARS possibly and just never noticed (even while being mindful of my dietary oxalate intake).
I’m making a list of tests I’d like to run since I haven’t done any 24 hr tests, etc but I would REALLY like someone to weigh in and help me on a nutrition that keeps them at bay forever! I hear Keto may help and I am willing to put in the work, but I need some sound medical advice and don’t know what Specialist, Dr, nutritionist, etc to turn to…. I love your work and KEEP doing what you’re doing. I want to live life without worrying about every thing I put in my mouth damaging my kidneys and don’t want to live in fear anymore.
Any recommendations Doctor Coe? Thank you!
Hi Rachael, You are passing stones and sand and I doubt it is all calcium oxalate. You should analyse the sand – catch it on filter paper – and get a full evaluation with serums and 24 hour urines. I have no idea what is wrong but am sure these tests will show it clearly. Do not delay testing, do not believe in random diet changes. Get the cause clear and treat what is abnormal. Regards, Fred Coe
Hello , 56 yr old male. 651 uric acid stones passed over last 13 years. Largest stone passed was 8 mm and took a few weeks to work its way down and out and lets just say not a happy time. All other stones from 1 mm to 6 mm. Funny how a 1-2 mm stone can drop me to my knees in pain and a 4 mm can just irritate me. Doctor’s in Canada’s emergency rooms are pretty quick administering 10 cc morphine and gravol , toradol into IV and minutes later some relief but always need more morphine 2.5 cc to 5 cc. I have lost good jobs and a marriage over these darn stones and we have tried everything in the book to make them stop but still passing them. I was going to emergency every other day and several times daily as could not handle the pain at times. Once I am treated at the hospital I am sent home with a prescription for toradol and tylenol #3-4 which don’t do much of anything so I suffer and then suffer some more (divorce due to constant suffering ) 18 3 mm – 5 mm stones in past 31 days. and given tylenol #3-4 is a joke. No addiction issues at all and have always followed Doctors orders and prescription dosages to the letter. Why won’t Doctor’s prescribe Endocet/percocet 5 mg ( 1-2 every 4-6 hours when in pain in Canada as they know how many stones and know how many times I have been to emergency rooms over 13 years and getting no better. Alberta Health told me that the narcotic pain relievers are for the patient that needs them and the Doctor / Urologist should have not 1 issue with prescribing them but still no luck. I have become pretty good at predicting stone size and how many over the years currently my urine is BLACK yes no typo BLACK and has happened a few times before when I have 6-7 mm stubborn stones but told to take 1 tylenol 3 every 6 hours for the pain. Any advice on how to get Doctors to start prescribing properly in Alberta Canada?
Hi Neil, I cannot imagine anyone forming repeated uric acid stones as they are stopped completely by sufficient potassium alkali to raise the 24 hour urine pH to about 6. You need 24 hour urine testing to figure out the dose, then the potassium citrate; uric acid stones cannot form when the urine pH is 6. I think the urine turns black from blood in a very acid urine. Anyway, get on alkali and stop the stones so narcotics are unneeded. Regards, Fred Coe
Hi,
My dad has had recurrent bladder stones, he had some blasted out (not sure if that is even the right term) about 9 months ago. Last night he went to the ER, for 3 days he was nauseaous and could not eat- by the third day he was very pale and week. They did a scan and found he had 2 kidney stones and the doctor said he was in kidney failure. One kidney was enlarged and the other was not doing the job to take over. I’m a little beside myself right now and I’m not sure what to think. He’s generally a very healthy 64 year old who works out 4-5 days a week and eats well. He’s had problems with blood sugar and blood pressure in the past, his blood pressure has been good- I’m not sure of blood pressure. They admitted him to the hospital yesterday and he’s staying the night again tonight. They are doing more bloodwork at 5am and his urologist said he will remove the kidney stone if levels have not improved. I’m not sure what all this means, but I really want to help him.
Hi Karlie, Given the little you could tell me, it sounds as if stones may have obstructed a kidney – or both, leading to kidney failure. I imagine his surgeon will want to relieve the obstruction as soon as he can to restore kidney function. The bladder stones may have come from an enlarged prostate with bladder outflow obstruction, and it sounds as if one of his kidneys may have lost function, to the obstructed one is all he has. Of course, from here, these are mere conjecture. By best to him – and you. Regards, Fred Coe
Hello Dr. my regard to you.
I m 36 years old male and I m having problem with my kidney filtration since 2015 to date. Sometimes my creatinine,Urea and Uric acid are raising. The must highest level it reach is creatinine 242mmol,uric acid 502mmol,and urea 9mmol.but no stone was found. what can I do?and is it a serious case?
Hi Mohammed, You appear to have kidney disease and not due to stones. This is outside the purview of my site. I would be concerned and consult a nephrologist, as this kind of specialist focuses on primary kidney diseases. I would do this sooner than later, so as to preserve what function you can. Regards, Fred Coe
My husband is 45 years old and has kidney stone measuring 7mm. Most recent eGFR is 55. In 60s when adjusted for ethnicity. He also has juvenile hypertension (16 years) which has been kept under control until recently. His BP won’t come despite increase dosage of drugs. Could kidney stones by part of the cause of resistant hypertension?
Hi Uch, Your husband has reduced kidney function and high blood pressure and a stone. He needs special evaluation because he may have one of the hereditary diseases that can cause both. Dent disease is one such. I would suggest evaluation at a university center given the potential difficulties. His condition can be diagnosed and treated, of course, but not without a high level of specialized skill. Regards, Fred Coe
My 5yr old daughter was found to have kidney stones this past summer. One was 5mm in the right kidney and a smaller one in the left. We saw a urologist and a nephrologist. The nephrologist ordered a 24hr urine catch which showed severely low citrate levels (71). Started her on potassium citrate. She wanted to wait over 6mo to retest. I wasn’t comfortable with that or with asking her to retest so our primary sent off another 24hr test. Ended up testing for the wrong thing…oxalate numbers. Her oxalates were in the normal range, but her oxalic acid with creatinine was substantially high….102.6. We have an appointment on Monday to discuss this finding with our nephrologist. But in the meantime, what can you tell me about this number? Does it indicate her kidneys are struggling? Should we repeat ultrasound for new stones? Thank you!
Hi Dawn, The low citrate needs to be matched against reliable normal ranges for a 5 year old person. Likewise the ratio of urine oxalate to urine creatinine. A low citrate means one thing, high oxalate another. It is crucial your nephrologist sort this out and I am sure s/he will do so. Of the two, the oxalate is certainly the more serious issue. Regards, Fred Coe
Thank you for your reply! My next question is one I have not been able to find anywhere: what does high oxalic acid/creatinine mean?? Not the same as high oxalate correct? So add the creatinine in, what does it I dictate. All the levels we have been given I assume are ranges for a child. The nephrologist we see is pediatric so the citrate was. The oxalic acid/ creatinine I am not sure.
Hi Dawn, Total urine oxalate excretion, for example in mg/day, is in part a function of size. Small adults will have less than large ones. For children, who are smaller than adults, one needs to normalize excretion by something to correct for size. Creatinine is made by muscle cells, so the amount scales roughly to lean body mass. If you divide total urine oxalate by total creatinine in the same sample you get a ratio of creatinine in = let us say – mg/gm creatinine. A typical adult will have perhaps 40 mg of creatinine per day in the urine with 1.5 gm of creatinine, or 40/1.5 = 26.6 mg/gm; so the value in your child at about 100 seems high. But children are really not small adults, so one needs to compare that value against pediatric normals. Your physician does this and interprets the result. Regards, Fred Coe
High oxalic acid is not the same as high oxalic acid with creatinine, right? What does this indicate…the acid with creatinine? Thank you for replying!
Hi Dawn, I believe I answered this in your prior question. Regards, Fred Coe
My husband had his left kidney blocked by a stone. His eFGR was at 18. Isnthis something to be eon ended about? He’s a type 1 diabetic and there was talk that his right kidney had failed already. Thank you
Hi Paula, With only one kidney working well, obstructing the good one causes a very serious acute kidney failure. I am sure your urologist has already seen to proper drainage on the obstructed side and his eGFR is back up to normal. Prevention of more stones is crucial, and rapid treatment of any other stone events likewise. Uric acid stones are common in diabetics, and always immediately curable, so be sure about the stone type and about prevention. Regards, Fred Coe
Thank you. He’s in stage 3 B CKF already. I’ve placed a call regarding the type. Our care isn’t that’s great because it the VA and they’re extremely busy.
Sorry for the typos. I can’t see the screen!
I went from stage 4 kidney failure in a 7 day span, it was 25 gfr too 31 gfr. Is it normal to fluctuate somewhat and if so, what would cause that that to happen?
Hi SUsan, These are serious numbers. Be sure your physician knows why your kidney function is reduced and is taking all possible care of you in regard to it. Fluctuations in kidney function can occur from diet or drugs. Your physician will know in your specific case. I want to emphasise the importance of your receiving skilled renal care. Regards, Fred Coe
Hi my name is Deborah…I have had two kidney stones sent off for the stand bloodwork that came back…this is the 3rd time my lipase has been elevated and the stones came back inconclusive because they contained cellular material. Please advise me on the next steps I should take!
Thanks,
Deborah Helms
Hi Deborah, Your physicians need to be sure you form kidney stones, and that your pain is not arising from your pancreas (lipase). If stones, this is a good introduction to prevention. Regards, Fred Coe
Hi,
My sister in law has a stone of 11 mm and gfr 10 which improved to 18 in 15 days after PNC now a doctor is suggesting removal while other is saying gfr has improved so this kidney can be saved please suggest. Patient is not diabetic and hypertensive.
Hi Yogesh, Given a gfr of 10 it means that neither kidney functions well. The two stones could not cause such dangerous kidney disease unless they obstructed both kidneys. Alternatively she may have a cause of stones that also causes kidney failure. This is a very urgent and potentially dangerous situation, and only her physicians can really figure it all out. But certainly one can say any obstruction needs to be repaired. A GFR of 10 is near to needing dialysis. Regards, Fred Coe
Hi
My husband has high creatinine level and rare oxalate and blood in his urine, is that a sign of kidney stone? Or something else might be the reason ?
Hi Donya, high creatinine and oxalate crystals may mean primary hyperoxaluria, a very dangerous cause of kidney failure. His physicians need to be sure it is not the cause of his kidney failure. Please mention this to them. Regards, Fred Coe
My 3 years boy baby had blood in urine all the reports were normal doctor said they dont know the reason she told only urine citrate was low
I cannot tell you how much this article means to me, even if I still feel a little helpless. I am a 34 year old female who has had a history of chronic stones since I was 22. I have had one lithotripsy but the rest have passed. The past 5 years my GFR has been quickly decreasing and started well into the 110-112 range to now 86-84. Despite this, my creatinine levels are “within normal range” and since my GFR is still above 60, my primary care and urologist are not concerned. I know they are just going to wait until it drops to actually try and consider preventative measures. I eat very healthy, exercise regularly and take care of myself. I wish other physicians saw the correlation and actually were proactive instead of reactive. I was just told chronic stones “just happen” and since I am still within normal ranges I am fine. Yet according to the kidney foundation I have a GFR rate of someone in their 60’s.
Hi Melissa, Falling eGFR is not ideal and the cause matters. Stones are themselves a problem for kidneys, they do not ‘just happen’ and need prevention. Here is a good place to start. Be sure about even slight obstruction from stones, and about your blood pressure. Perhaps a nephrologist might be helpful. I have no great enthusiasm for waiting to see what happens. Regards, Fred Coe
I am a 41 year old female and I experienced my first kidney stone episode last May. I had a 5mm stone I was trying to pass which is what landed me in the ER. From the visit and a follow up with a urologist it was found that I had 3 other stones all in my left kidney and they were quite large. Too large for lithotripsy. After 4 lithotripsies, a ureteroscopy and a 5 day hospital stay from a kidney obstruction (worse pain I ever felt), it was finally determined I was stone free. 3 months later at my follow up X-ray and ultrasound I was advised I had a couple new stones also in my left kidney, but they are too small at this point for active treatment. I’ve gotten no explanation on the reason I am developing stones so fast or so many of them. I also suffer from high blood pressure and have for years.. the last year however, I have not been able to get it down into a “normal” range even with medication. My GFR has never been tested as far as I know. At this point though I’m wondering if it would be beneficial of seeking out a nephrologist. Am I at higher risk of kidney disease? Should I be concerned ?
Hi Hether, I guess the stones that were too large for lithotripsy were treated by lithotripsy and then with ureteroscopy – which is an excellent approach. Then I guess there were new stones. One question: was the ‘stone free’ using a CT after surgery or a routine flat plate? If the latter you may not have been stone free and these new ones may not be new. You do indeed need prevention, and here is a good place to start reading about how. Your high blood pressure may respond to treatment for stones as the two treatments are much alike. Your eGFR (estimated GFR) was certainly tested in that serum creatinine is part of almost all blood panels. Your physicians know. There is a higher risk of kidney disease and high blood pressure, so prevention and treatment of blood pressure are very important, and you are right to ask and to seek such. Regards, Fred Coe
Hello. My father is being investigated for kidney disease. His GFR is 15. His CC is 333 and his urea is 20. He and my mother are going away for 2 weeks and I am incredibly concerned. His nephrologist has said he can go and we will do further investigation when he gets back. What would your advice be? Do I trust the nephrologist or my nurse instincts. Any help would be gracefully received. Regards. Jo
Hi Joanne, Your father has very significant kidney disease. I suspect his nephrologist is correct and his trip will do no harm. So long as serum potassium and bicarbonate are not too high or low, respectively, and kidney function has been stable over time, a wait is not necessarily a risk. I would trust him/her. Fred
i brother have stone in his kidney now only he remove it and then my question is does it effect kidney function after removing
Hi Hari, usually stone surgery does not affect kidney function. If the stone is obstructing, removing it will improve function. Regards, Fred Coe
Hi,
I have a long history of stones (18 years), no high blood pressure, but I am overweight. Recently I had a total of 8 stones removed, some that were small enough that I could have passed them, and some I could not. My eGFR has been steadily declining for over a year, but my PCP never mentioned that it could have anything to do with the stones. My urologist has scheduled further testing in an attempt to figure out what is causing the stones and how to prevent them. Is it possible that my kidney function could improve if I am no longer plagued by stones? Or is stopping decline the best I can hope for?
Hi Katie, Is is possible your urine oxalate excretion is high?? I would presume it has been measured repeatedly, but just in case. Of course, your urologist will make sure about any obstruction from stones. Are you possibly diabetic? Does your urine contain an excess of albumin? Your physicians need to look into all this, and find ways to halt further progression. Regards, Fred Coe
Is have stone in my right kidney of 3mm . Is it risky and does it affect to my kidney
Hi Shivam, if the stone is not obstructing, causing severe pain or bleeding, or infection, one can leave it be. But you might want to find out why you made the stone to prevent more, and also to reduce growth of the stone you have. Regards, Fred Coe
Hi i had a stag horn kidney stone about 5yrs ago. I had it removed but they couldnt get 1 piece out. Since then ive had alot of uti infections and the past year im getting alot of pain in my back and are tired all the time. I do have a xray yearly to make sure it hasnt grown
Hi Charmaine, Possibly the stone fragment is infected and promoting UTI episodes. Your physicians can tell, and if it is perhaps it is time to remove what is left. Regards, Fred Coe
I have had kidney stones (calcium) for several years and have had them removed multiple times. My urinalysis always shows the albumin/creatinine ratio is high. 409 this last time. All my other kidney functions are fine. I am not diabetic or have high blood pressure. My urologist and primary care doctors don’t seem to be too concerned. Is it “normal” to have that high of a result with kidney stones??
Hi Stacy, That is a high ratio but could reflect blood in the urine from stones. Check of the urine was screened by dipstick for blood or not. If not, get the test done on a sample that is clearly negative for blood. If in that urine you have so high a urine albumin something is wrong and it is not at all normal. I bet it is simply blood but be sure! Regards, Fred Coe
Let me tell you this you’re urologist and Doctor don’t seem that worried about it because they are not they make money out of your pain. I just passed a 2 inch by 3/4 of an inch kidney stone yesterday by myself with the help of two prescriptions Diclofenac and tamsulosin also Azo max strength and a friend of mine gave me some kind of muscle relaxer. I drank as much water as I could stomach. not to mention apple cider vinegar the night before and lots of lemon juice the previous day’s. And then I started to push from my kidneys. Like the worst feeling that you had to go pee ever. And that didn’t work so I jumped in a bath 3″ deep hot water then that I started out in cold and I noticed that my kidneys started to tense up tighten up. So I got out of the bath and I drink some more water and I let some of the urine flow. Then I drank a whole bunch more water. and I noticed my heart was beating hard and that my head was starting to feel funny and then I ran my hands under hot water and I noticed that the pressure started to come and I thought back to giving birth to my son. I remembered my mom saying something about the tips of her fingers going numb from burning them in the hot water was so hot that I got used to the hot but thinking back to my son think learn I remember the nurses telling me to breathe to push but to breathe and they said “pressure! pressure!! Breathe! breathe! No honey don’t hold your breath you’ll pass out! push! come on you got this, push! Breathe honey, good job! keep pushing! pressure! pressure! breathe! THERE WE GO!!!” Thinking back to that while having that kidney stone pass helps me a lot and I prayed to God that I wouldn’t get through it. So I just reminded myself to breathe and to push in to breathe and I was looking at myself in the mirror and I saw my eye go sideways and I realized that when I thought I was going to pass out before it was because I was in so much pain that may I was going sideways so my vision was blurry but I was holding my breath and if I had not holding my breath and just went through and just kept pushing through that pain then possibly would have been able to pass the stones sooner. I took my life into my own hands and I hope that I can continue to be strong and to be brave and to not let my fear stop me from pushing the rest of the stones out!! that was the biggest thing is cuz I was scared I was afraid of the pain I was afraid of what the kitty Stone could do to me but honestly it pushing it out it’s a lot less damaging than leaving it in so keeping my fingers in hot water and elevating my blood temperature raise my blood pressure without having that much actual pressure building in my heart or my brain and I just pushed the stones out I cannot believe it that stone is the same size as my thumb and I pushed it out by myself without the help of medical professionals. that urologist told me that I was imagining things and that there was nothing to worry about and that he got the stones out of my kidney and that the small fragments that were left would pass on their own.. judging off the size of the kidney stones I’m saying that they were never going to pass and I know that he saw them while he was in there with that camera and I know that he did not tell me about them and he did not want to use dye to help a CT scan see more clearly.. I was probably really close to having a heart attack or a stroke or dying probably of kidney failure or a heart attack or stroke.. taking my life into my own hands was probably the greatest thing I ever did.. I’m sitting here wondering if I should do that doctor for not telling me that he saw all those stones in my kidney. I really could have died and I’m only 25 years old and I told him that I felt like I was going to have a heart attack or something and he said that I was too young for that to happen. and he said last words were come back and see me if they keep bothering you..
Hi Jazzmin, Stone passage is horrid as you describe. Unlike delivery pushing will not help, but whatever you did by way of pain control is fine. I gather you have ureteroscopy and your physician removed stones or perhaps pulverized them into dust using a laser. As for retained stones, I would ask her/him was is in your kidneys and perhaps have a post operative ultra low dose CT to count what is there as a baseline for prevention. Prevention of more stones is crucial to stave off more attacks. Here is a good place to start. Regards, Fred Coe
My kidney gfr was found to be 51 by chance as i was being tested for autoimmune diseases. Kidney stones were discovered on a lung ct scan but deemed unobstructive. I was diagnosed with sjogrens syndrome, lupus, and anca related Vasculitis. Sudden severe pain sent me to hospital one night. Gfr at 47. Ct scan showed kidney stone obstruction. Had 4 stones removed and gfr jumped back to 74. Doctors tell me Sjogrens causes renal tubular acidosis and that my kidneys weren’t really damaged just impaired by the acidosis. My bloodwork was mostly normal other than high chloride and low albumin consistently. My question is should i take potassium citrate or sodium bicarbonate to balance or reduce the chloride? And will apple cider vinegar dissolve almost purely calcium phosphate stones?
Hi Steve, Your stones are almost purely calcium phosphate, blood chloride is high, CO2 was not mentioned but is probably a bit low, urine pH is high – the stones tell you that – and RTA from Sjogren is a fine idea. Yes, potassium citrate is good if it will raise urine citrate – surely very low – and not raise urine pH so much that calcium phosphate supersaturation actually rises. So 24 hour urines are crucial for monitoring. Your condition requires expert medical management given vasculitis and reduced kidney function. A nephrologist will special training or experience with sjogren is ideal here. Regards, Fred Coe
HI I was diagnosed with a proximal ureter stone and some small stones , at that time my creatnine level was 1.54, I got Cytoscopy with DJ stent treatment done , then I got lythotripsy done then got stent remove, but my doctor never said about createnine level and kidney damage. Should I worry or can I trust him , he said I am young its not big problem , but wherever I am reading it says 1.54 creatnin is not good.
Hi Kumar, You are right. Get the test repeated. Kidney function may have fallen because of surgery, and should be normal by now. If not, get a nephrologist to take a look. Do not fail to do this as there are real dangers when kidney function falls in a stone former. Regards, Fred Coe
Hi,
I have recently been diagnosed with having a calculus of size 9mm, in lower left calyx of my kidney. Over the past 2 months my E-GFR has declined from 61 to 42 only. But a year back it was normal at 94. I am 60 and have high blood pressure since past 10 years. Apart from that all my reports are mostly within normal range.
Is the presence of stone causing reduced kidney function ? Will the removal of stones improve my kidney function ? Which stone removing procedure would be better in my case ?
Thanks in advance.
Harry
Addendum:
My Blood pressure is within control, as I take daily medicines for that. About 4 months I did have urinary infection, for which I was prescribed antibiotics (It got cured after taking the medicines).
Hi George (It may be Harry), the decline in gfr is worrisome. I would be concerned about primary hyperoxaluria that can present with stones in later life and cause kidney disease. Be sure your physicians have considered this possibility. Another possibility is primary hyperparathyroidism, but it is not so likely to cause kidney function loss. Obstruction of a kidney will do all this, but I cannot imagine that it would go unnoticed. Even so, be sure your physicians are satisfied it is not present. Finally, I am sure your physician has inspected all of your meds as causes of the reduced function, an essential step. I would be concerned, very much so. Regards, Fred Coe
I just had a really fun trip to the hospital because of what was found a kidney stone. I would not like to repeat this. I am 50, in excellent shape. Hight Weight proportional. Nearly obsessive about my diet, exercise regularly. Don’t eat red meat. Blood pressure is normal. I have been taking Creatine for about a year. Plus I have recently added Spinach to my diet. I know spinach is massively high in oxalates. What are you quick thoughts on Creatine & Spinach relative to Kidney Stones?
Hi Dan, my quick thought is just like yours. But having had a stone I would check out my serum and 24 hour urine results to be sure there is nothing lurking. The oxalate should be gone – you certainly are no longer oxalate loading. As for creatine, a quick search in PubMed under ‘Creatine supplements AND kidney stones’ turned up no relevant papers. Regards, Fred Coe
Hello, I am 50 y. o Caucasian F. I have had small kidney stones here and there on and off since age 20. Have passed them all no issues and have gone years with no stone formation. However in the last 3 years I have formed 2 stones that were 6 to 7 mm and needed to be removed. The last stone dropped my egfrs to 88.. and 102. Creatine . 78 bun 15 albumin 4.5..blood pressure 112/68. Should I expect my egfr to raise up again into the 90s now that the stone has just been removed? And how long generally speaking will it take to raise back into the 90s
Hi Lisa, eGFR can fall like this and will rebound. But find out what is causing your stones and begin a prevention program. Long term stones can cause a lot of harm. Regards, Fred Coe
Hey , im 32 female , i have slight high bp issues due to anxiety i take pills for that recently i had my egfr creatinin checked creatinine was normal 0.58 (blood test) but my egfr is 122 is it hyper-filtration, if yes what could be the cause ? My propranolol for anxiety? Or what im not over weight no albumin in urine the rest is all normal
Thanks
Hi Hadiya, Your eGFR is not unreasonable and hyperfiltration is not proven by this value, Propranolol does not increase single nephron GFR – hyperfiltration. You do not say if you are a stone former, but treatment is more or less the same if so or not. I hope you are taking your BP at home, before eating, and doing what you can with aerobic exercise and reduced diet sodium, as these will help maintain a normal pressure. Regards, Fred Coe
Hello. I’ve had what has felt like kidney pain for about 2 yrs in both kidneys but more intense in my right. Kidney stones are prominent in my family. Last year my eGFR was 90 with all other levels normal. About 6 months ago the kidney pain seemed to become more frequent. About a month ago my eGFR dropped and has teetered from 49-60(s) since with repeated blood tests. High creatinine, high BUN high triglycerides. But I don’t consume anything to present such results. I’m currently experiencing my first Kidney Stone diagnosed as R ureterolithiasis. It has been the most painful thing I’ve experienced and I have been through severe appendicitis with appendectomy. Based on my eGFR dropping prior to the kidney stone presenting itself- could this be signs of true Chronic Kidney Disease or just side effects of the kidney stone forming itself? Also, does ureterolithiasis simply indicate a stone in the ureter or that its actually stuck in the ureter?
Hi Andre, Your eGFR could have fallen because of a stone obstructing one ureter, and if so it should rise after the stone is passed or removed. If it does not rise and you have no signs of obstruction your physicians need to figure out the cause and help improve matters. Regards, Fred Coe