Testing, Evaluation, and Diagnosis

Every stone former needs fasting serum and 24 hour urine testing. Likewise important, kidney stone analysis and review of images – CT scans especially.

Medical evaluation is what physicians do. They integrate the testing with the history of stones and everything that can promote stones in any one patient.

Diagnosis is also what physicians do. It is the final synthesis and directs treatment.

The lovely painting by Jan Steen (1625-1679) hangs in Apsley House, London.

I have used it also for the page on systemic causes of stones because I like it a lot.

Testing

24-Hour Urine Collections: Why and how – The basis for prevention, never omit them

How to Use Urine Supersaturations – What a given value means in terms of kidney stone risk

How to read your kidney stone lab report 1; Calcium stones

How to read your kidney stone lab report 1; Uric acid stones

My Lab Report – A nifty self help guide

Kidney stone types – Full review of stone compositions and their meaning

Kidney stone analysis: How Bad is It?

Analyse every kidney stone – Evidence that stone type can change so treatment needs to change

Evaluation

Middle Age and Kidney Stones? Why Now? – A primer of special needs for these late comers

How to Count Kidney Stones – Prevention means fewer new stones; how do we know if we can’t count right?

Chapter 3: Coping with confusion – What to do when everything seems just confusing

How to be a successful kidney stone patient – Lists and hints to get the most out of your physician visits

Putting it all together – Full guide from first stone through follow up of your prevention

The five steps to kidney stone prevention – Step by step instructions on how to get evaluated

Treat the patient not just the stones – Stone formers are a risk for bone and kidney disease, and hypertension

Art of stone prevention – My personal style of stone prevention practice

Chapter 1: Personalized kidney stone prevention – Truly each patient is unique

Case 1: A stone former – How you integrate clinical history and labs to determine treatment

Case 2: A calcium oxalate stone former – A surprise lurked in this otherwise ‘easy’ case

CT papillary density may predict new stones – Any physician can make this measurement

Diagnosis

Chapter 4: Who are you? – What are the main diagnosed causes of stones?

Idiopathic calcium oxalate stone formers – Calcium oxalate stones, systemic diseases have been excluded

Idiopathic calcium phosphate stone formers –Calcium phosphate stones, systemic diseases have been excluded

Chapter 8: Uric Acid Stones – Any uric acid in stones means this applies to you

Chapter 9: CYSTINURIA: An Introduction for Patients – Special treatment, inherited renal transport disorder

Chapter 7: Primary hyperparathyroidismNot rare, diagnosed from blood and urine tests, curable

Distal Renal Tubular Acidosis – Rare disease, diagnosed from blood and urine tests

Chapter 10: Bariatric surgery and kidney stones – Obesity surgeries cause stones; special treatment needed

Medullary sponge kidney – Uncommon, over diagnosed, special treatment problems

Case 4: Medullary sponge kidney – For 24 years I missed the diagnosis

Case 5: Severe dietary hyperoxaluria – Massive hyperoxaluria reverted to normal with simple diet change

Chapter 11: Ileostomy and Kidney Stones – How ileostomy causes stones and how to prevent them

 

4 Responses to “Testing, Evaluation, and Diagnosis”

  1. Lisa

    Dr. Coe,

    Thank you for the wonderful article and information. Through my regular GP visit after multiple abnormal urinalysis an ultrasound and CT were ordered which showed 3 stones. 18mm, 11mm and 3 mm. I was referred to two urologists one recommendation was PCNL the other ureteroscopy x3. I scheduled the latter to take place over three consecutive weeks. I have no symptoms from the stones and the pain of either procedure and potential down time is concerning. Do you have a recommendation for which direction to go? Thank you, Lisa

    Reply
  2. Christina

    Thank you for all of your published articles. They have been very helpful. I am a 45 yr old woman with an unremarkable health history and my first diagnosis of kidney stones. 2 detected on CT. Largest is 5mm. Neither has begun to pass but I’m experiencing mild back pain unrelated to musculoskeletal issues. I was prescribed Flomax but am nervous to take it. I would like to move the stones and pass them, but am uncertain the best immediate course. Can you point me towards the best article for advice?

    Reply

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