My Question

Tell me what you want next on this site; that is my question.

I have been writing this site – with the able help of my co-authors – since July 2014, and have reached what I might call a kind of plateau. Much of what I came to say about the most common kinds of kidney stone patients is said. Because the main work is done for the moment I have come with my question to you.

The readership of the site has grown from 50 people in the first month to a present running average of 55,000 – 65,000 people monthly, depending on the season, and many of the visitors read quite a bit each. People find the site valuable, and I am happy for that.

But, what next? I can guess, I can plan, and I can write.

I can also ask.

You might question why I chose Wedding Dance Outdoors by Pieter Bruegel the Elder. The picture is wonderful, so my reasons may not matter all that much.

Up Till 2017

Because I set out to create a definitive site, not a mere collection of opinions, I built a three layer cake.

Primary articles rest on peer reviewed literature and have links in them – some say too many, some say not enough – to scientific papers on PubMed. Secondary articles elaborate on and explain the primary ones in less technical detail. They link back to the primary articles rather than to PubMed. Public articles are for patients and their families. They show how science gives us useful ways to prevent stones. They have fewer links, and those are mainly to secondary articles.

Since 2017 to now – July 2018

Since I first wrote this article I created the Kidney Stone guide Book, and new topic listings for the whole site. Some of what people asked for I have done. Here is the table of all of it. Done means just that. Part means I know I need some components. Some means I have examples and can add more.

Going Forward

As I did in 2016, I am asking again for your suggestions. Please leave them as comments. Since I have added a lot this past year, perhaps your topic is already here. If so it will be a link or at least an entry in the table.

156 Responses to “A QUESTION TO MY READERS”

  1. Lisa Russo

    Not sure if i am writing in the right place but i have a question for Dr Coe
    Diagnosed with RTA in my early 20’s, now 57. Chronic kidney stones. Previously was taking potassium citrate. Just recently, by a new physician, was told to stop taking potassium citrate because my urine is very basic. Also urine citrate level is low. Currently taking magox and vitamin D. Stones are calicium/ phosphate and a small amount of oxalate. Waiting on 24 hour urine results from litholink.
    Confused about diet recommendations i have read. According to what i have read , some of the food/fluid recommendations will actually cause further increase in urine ph. Because my urine ph is already high , i am confused as to what i should be eating/drinking and what i should be avoiding.

    • Fredric L Coe, MD

      Hi Lisa, Very complex. A lot depends on how your urine pH actually behaves. Does it even come down, even without alkali treatment?? As you give alkali citrate and pH both rise. In RTA urine pH is never low (below 6) and often is so high without alkali that one treats with potassium citrate to get citrate into the urine. In more common calcium phosphate stone formers – whose urine citrate is low for the urine pH – one follows the SS for calcium phosphate. Citrate lowers is, it rises with pH and one aims for the lowest SS. Your physician is educated for this and has to figure out the best way. You can get genetic testing for RTA and insurance pays. If you have RTA nothing will lower urine pH and one just treats to raise citrate. Regards, Fred Coe


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