FLUIDS

How much and what? We have already written a lot about this, but everyone has specific questions. This is the place to ask them.

82 Responses to “FLUIDS”

  1. Karen Kolba,MD

    Dear Dr Coe,
    The studies showing a change from high CT papillary density to nearly normal after a year of increased fluid intake is remarkable. Since the plaque is unlikely to change (ever), have you (or anyone) documented just how fast the change in papillary density happens? You suggested it might be a matter of weeks. This would be high motivation for us stone-formers.
    Also, has anyone documented less or smaller stone formation in patients who showed the decrease in papillary density? References appreciated.

    Reply
    • Fredric L Coe, MD

      Hi Dr Kolba, Thanks for being interested in this matter. I am but no one else I know! I have no data beside what is in the article. Frankly I think the high density is from high papillary calcium concentrations – not crystals – but how to prove that?? Plaque certainly will not change in a year with fluids- our repeat URS cases show it is very stable over even a decade. No one has done a shorter interval hydration study like the one in the article. Warm regards, Fred

      Reply
  2. Richard T.

    I have a recurrent problem with bladder stones related to chronic foley catheter usage. Are kidney stones and bladder stones two different conditions, or can your Kidney stone information and recommendations be used to treat bladder stones also? Thank you!

    Reply
    • Fredric L Coe, MD

      Hi Richard, They are different. But often abnormal urine chemistries play a role in bladder stones. Your physician will want to analyze the stones and see if there are any prevention options. Likewise she/he will want 24 hour stone urine chemistries for the same reason. Crystals are the same whereever they are and follow well known physical laws. Regards, Fred Coe

      Reply
  3. Kenneth Mantei

    Had a stone recently, 5th I think in the last 30 years. Second one I had to have surgically removed. All have been Calcium Oxalate Stones. This is the first time thought it sent me to the ER, so this is the first time I have taken it far more seriously. After a fee 24 hour urine test I can say there are some issues
    Urine Calcium: 400-510
    Calcium/Creatinine: 300+
    Urine PH: High 6.5-6.8
    Other good factors
    Citrate 700-800, Oxalate 20-25, Urine Volume 3-3.25ml. Urine Sodium around 150.

    My doc has me going low sodium (staying under 2000mg/day), and made changes to my diet. I am a 1g or protein per pound of body weight guy as I am a weight lifter. So i have dropped my protein down to 120-150 instead of 200+ grams per day. I normally eat a low fat, low processed food diet. I drink 170-200 ounces of water per day. I get 1000-1500mg of calcium from my food.

    Your website has been so incredibly helpful. Full of such detailed information. Is there anything else I can be doing to decrease my risk of forming another stone? Of getting my urine calcium down under the 250 level?

    Reply
  4. Sally Rishel

    Reading through your site there is no mention of medications adding to the formation of kidney stones. I’m 70 yrs old and since being diagnosed with RA 10 yrs ago have been taking Enbrel, Methotrexate, Celebrex, occasional steroid shots and now Lisinopril as HCT lead to raised uric acid levels and “Gouty Arthritis”. I have developed continuous kidney stones – had lithotripsy, ureteroscopy and 3 trips to the ER. Potassium Citrate was prescribed by a Nephrologist but caused extreme, unbearable body & leg cramps within a week of starting the script. Been a life long Water drinker – have an occasional tea and that’s it. Have stopped RA meds a couple of times and stone formation has slowed. I agree diet and water consumption is important – but it is hard to believe that medications can’t also be part of mix.

    Reply
    • Fredric L Coe, MD

      Hi Sally, You do not say what the stones are made of. The HCT will raise serum uric acid and can cause gout. Given continuous stones, their crystal composition is crucial and likewise for sleuthing which drugs might matter. Regards, Fred Coe

      Reply
  5. DeeDee B

    I have a friend who has (1) stone in left kidney in the crick and (1) stone in the right kidney in the crick. They have talked to a dietitian but their Dr will not give them any meds or prevention help. Says eat calcium foods, follow a low oxalate diet, push fluids. The stones are 8 mm and 9mm and may need to be surgically removed. They have been dealing with stones since 2014. Then in 2019 they ended up in the hospital for 4 days from sepsis from a infected kidney stone & UTI. They almost died. I have said to them that they need a new Dr. They also have a cyst on their left kidney besides. Nothing seems to help my friend get rid of the one’s they have or prevent more.

    Reply
    • Fredric L Coe, MD

      Hi DeeDee, stone prevention is a process. Here is my best by way of an introduction. See if she/he finds it useful. I do not know what the crick of a kidney is, but if the stones are not obstructing, or causing pain, bleeding or infection removal is elective. Regards, Fred Coe

      Reply

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