Primary Care

Nephrolithiasis

Questions discussed in this category

What is your approach to using calcium containing medications for patients with recurrent nephrolithiasis and hyperoxaluria?

2 Answers available

How do you approach prevention of kidney stones in patients with an ileal diversion and recurrent nephrolithiasis?

2 Answers available

What is your approach to weight loss interventions for patients with recurrent nephrolithiasis and obesity?

1 Answer available

Are there instances when you recommend oral phosphate for patients with recurrent nephrolithiasis?

1 Answer available

Is there a kidney stone size for which you refer your patients with recurrent nephrolithiasis to urology?

1 Answer available

What is your approach to the management of patients with recurrent nephrolithiasis who continue to have elevated stone risk parameters in the setting of dietary factors despite receiving education from a dedicated stone clinic dietician?

1 Answer available

Do you recommend repeat kidney stone composition testing for a patient with recurrent nephrolithiasis who passed an additional stone but previously already had stone composition testing performed?

2 Answers available

Would you add an additional alkali medication for patients with recurrent uric acid nephrolithiasis who are on high doses of potassium citrate and continue to have acidic urine?

1 Answer available

Would you recommend a SGLT2i for a non-diabetic patient with recurrent uric acid or calcium phosphate nephrolithiasis?

Anderegg et al., PMID 39747681

1 Answer available

Do you advise your patients with cystinuria to perform home urine pH testing?

1 Answer available

Are there instances when you obtain an abdominal X-ray over an ultrasound or CT scan for kidney stone surveillance in a patient with recurrent calcium based nephrolithiasis?

2 Answers available

What is your approach to management of patients with recurrent nephrolithiasis and osteoporosis who are receiving teriparatide?

1 Answer available

Do you make any changes to surveillance imaging frequency, 24 hour urine stone risk collection frequency, and stone preventative medication approaches for patients with recurrent nephrolithiasis who become pregnant?

2 Answers available

What is your fluid intake target for patients with nephrocalcinosis and no history of kidney stones?

1 Answer available

Do you recommend patients consume dairy products over taking calcium carbonate with meals if they have recurrent calcium based nephrolithiasis and persistent hyperoxaluria?

1 Answer available

Do you recommend restricting alcohol use in patients with recurrent nephrolithiasis?

1 Answer available

Would you start stone preventative medications such as potassium citrate and thiazide diuretics for patients with recurrent calcium based nephrolithiasis and abnormal 24 hour urine chemistries if they no longer have calculi on most recent imaging testing?

3 Answers available

Do you routinely transition patients with recurrent calcium based kidney stones off of hydrochlorothiazide and onto chlorthalidone or indapamide for optimal control of hypercalciuria?

3 Answers available

Do you recommend a patient with recurrent nephrolithiasis who is performing a 24 hour urine collection add a urine preservative or keep the specimen refrigerated?

2 Answers available

How often do you check renal function panels for patients with recurrent nephrolithiasis?

1 Answer available

Would you start potassium citrate in a patient with recurrent nephrolithiasis of unknown stone composition who has hypocitraturia and alkaline urine pH?

2 Answers available

Is there a maximum dose of potassium citrate you would use for patients with recurrent calcium oxalate nephrolithiasis and hypocitraturia?

1 Answer available

What is your approach to managing patients with recurrent calcium oxalate nephrolithiasis since childhood who are found to be gene carriers for mutations in genes associated with primary hyperoxaluria?

1 Answer available

Is there a serum potassium level for when you would recommend discontinuing potassium citrate in a patient with recurrent nephrolithiasis, hypocitraturia, and hyperkalemia?

1 Answer available

Do you recommend CT or ultrasound imaging testing when monitoring a patient with nephrocalcinosis?

1 Answer available

Do you recommend checking a serum phosphorus level in patients with recurrent nephrolithiasis?

1 Answer available

How do you approach increasing urinary citrate levels in a patient with recurrent calcium nephrolithiasis who has hypocitraturia, non-acidic urine, and normal serum bicarbonate levels?

How do you approach increasing urinary citrate levels in a patient with recurrent calcium nephrolithiasis who has hypocitraturia non-acidic urine?

1 Answer available

Do you recommend Moonstone supplements for patients with recurrent calcium oxalate nephrolithiasis who have hypocitraturia and mild hyperkalemia for which potassium citrate is contraindicated?

2 Answers available

Does vitamin D supplementation in primary hyperparathyroidism increase the risk of kidney stones?

Is this seen more with high dose vitamin D supplementation?

1 Answer available

Do you recommend adding Moonstone supplements for patients with recurrent calcium oxalate nephrolithiasis who are on potassium citrate but continue to have hypocitraturia?

3 Answers available

Do you recommend dosing potassium citrate three times or two times daily for patients with recurrent calcium oxalate nephrolithiasis and hypocitraturia?

1 Answer available

What are your management strategies for patients with recurrent nephrolithiasis and hypercalciuria who develop hypercalcemia after thiazide initiation?

1 Answer available

What is your approach to managing acidic urine in patients with recurrent uric acid nephrolithiasis who have normal urinary citrate levels?

2 Answers available

Do you recommend genetic testing for patients incidentally found to have nephrocalcinosis on imaging?

1 Answer available

Do you have patients with recurrent nephrolithiasis target a certain urine volume or rather consume fluids as needed for goal of having consistent clear urine?

1 Answer available

Do you transition patients with recurrent nephrolithiasis and hypercalciuria off of hydrochlorothiazide in favor of an alternative thiazide diuretic?

1 Answer available

Do you alternate CT stone scans and renal ultrasounds for stone monitoring in your patients with recurrent nephrolithiasis with the goal of limiting radiation exposure?

1 Answer available

Do you use potassium phosphate for patients with recurrent nephrolithiasis to acidify the urine and prevent certain types of stones?

1 Answer available

Do you prefer still over carbonated water for your patients with recurrent nephrolithiasis who have chronically low urine volumes?

1 Answer available

Would you recommend cinacalcet for patients with recurrent nephrolithiasis who have hypercalciuria despite thiazide diuretic use and who also have an elevated PTH level without localizing parathyroid adenoma on imaging?

1 Answer available

Do you recommend using methionine to acidify the urine in patients with alkaline urine and recurrent calcium phosphate nephrolithiasis?

1 Answer available

Are there instances when you recommend using sevelamer for patients with recurrent calcium phosphate nephrolithiasis?

1 Answer available

Would you recommend against starting SGLT2 inhibitors in patients with a history of struvite nephrolithiasis who also have proteinuria and chronic kidney disease?

1 Answer available

Do you reduce the potassium citrate dose for patients with recurrent calcium oxalate nephrolithiasis who are started on the medication but experience persistently elevated urinary pH levels above 7.0?

1 Answer available

Do you avoid potassium citrate due to concerns with increasing the urine pH in patients with recurrent struvite nephrolithiasis who also have hypocitraturia?

1 Answer available

Do you have patients with recurrent calcium oxalate kidney stones stop taking supplements containing vitamin C if their 24 hour urine oxalate excretion is normal?

2 Answers available

What is your approach to managing patients with recurrent nephrolithiasis and nephrocalcinosis in the setting of hypoparathyroidism?

1 Answer available

For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?

2 Answers available

Do you recommend initiating a potassium sparing diuretic in patients with recurrent nephrolithiasis who have hypercalciuria but do not tolerate thiazide diuretics?

1 Answer available

Do you recommend stopping triamterene in patients with recurrent kidney stones who have stone composition results consistent with calcium based stone disease?

1 Answer available

What is your approach for patients with recurrent nephrolithiasis who require daily use of acetazolamide for management of an unrelated chronic condition?

1 Answer available

How long do you wait to repeat a 24 hour urine stone risk study after stopping topiramate in patient with recurrent calcium based kidney stones attributed to the medication?

1 Answer available

Is there a role for 24 hour urine stone risk profiles in your patients with known recurrent struvite kidney stones?

1 Answer available

What advice do you offer to patients with recurrent nephrolithiasis who are on a tube feeding diet and seeking stone prevention guidance?

2 Answers available

What is your approach to patients with recurrent nephrolithiasis and hypercalciuria who take daily calcium supplements?

1 Answer available

Do you take any special approaches with patients with recurrent nephrolithiasis who first developed stones prior to adulthood but have negative kidney stone disorder genetic test findings?

1 Answer available

What is your approach to patients with recurrent nephrolithiasis and hypercalciuria who are unable to tolerate thiazide diuretics due to hyperglycemia?

1 Answer available

How do you decide between CT and ultrasound imaging tests for surveillance imaging for patients with recurrent nephrolithiasis?

1 Answer available

Do you periodically check a urine culture for patients without dysuria but who have a history of struvite kidney stones and urinary tract infections with urease producing organisms?

1 Answer available

Do you routinely perform in-office urine microscopy for your patients with recurrent nephrolithiasis?

1 Answer available

What are some considerations to make when managing patients with recurrent nephrolithiasis who are found to have nephrocalcinosis on imaging?

2 Answers available

Do you recommend obtaining a DEXA scan for patients with recurrent nephrolithiasis and hypercalciuria of unknown etiology?

2 Answers available

Do you routinely prescribe acetazolamide for patients with cystinuria who do not have significant urinary alkalinization or are intolerant to citrate therapy?

1 Answer available

What is your approach to recurrent uric acid stone formers who have a persistently acidic urine pH and are unable to tolerate potassium citrate?

1 Answer available

Do you have your patients with recurrent nephrolithiasis stop supplements such as turmeric?

1 Answer available

What is your approach to management of recurrent nephrolithiasis in patients with mixed composition uric acid and calcium phosphate stones?

3 Answers available

Would you prescribe a thiazide diuretic for patients with recurrent nephrolithiasis attributed to hypercalciuria in the setting of excess dietary sodium or animal protein intake who fail or are unwilling to adhere to recommended dietary changes?

1 Answer available

What approaches do you take for your patients with nephrolithiasis who undergo intermittent fasting for cultural, religious, or personal reasons?

1 Answer available

What is the current recommendation for using thiazide diuretics in patients with calcium oxalate stone disease, given the negative results of the NOSTONE trial?

4 Answers available

Does your treatment strategy differ when managing patients with recurrent calcium oxalate monohydrate versus calcium oxalate dihydrate stones?

2 Answers available

How do you advise patients with recurrent nephrolithiasis who also have chronic mild hyponatremia for which they limit daily fluid intake?

1 Answer available

Are there patients with recurrent nephrolithiasis for who you recommend magnesium supplementation to reduce stone risk?

1 Answer available

How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?

3 Answers available

Are there any special considerations when treating patients with recurrent nephrolithiasis who also have medullary sponge kidney?

1 Answer available

How do you manage unintended hypercalciuria that results from an increase in dietary calcium intake as recommended to patients with recurrent calcium oxalate nephrolithiasis attributed to enteric hyperoxaluria?

1 Answer available

What is your approach to managing patients with recurrent nephrolithiasis who have 24 hour urine chemistry results that demonstrate low risk for stone formation but continue to experience stone events?

1 Answer available

Are there any instances when you use vitamin B6 to prevent kidney stones in patients with recurrent calcium oxalate nephrolithiasis who do not have primary hyperoxaluria?

1 Answer available

What is your approach to managing patients with recurrent ammonium urate kidney stones?

1 Answer available

For patients with nephrolithiasis and hypercalciuria attributed to a parathyroid adenoma, how long after a partial parathyroidectomy do you assess for improvement in 24-hour urine calcium levels?

2 Answers available

How do you manage vitamin D dosing in patients with nephrolithiasis and hypercalciuria who require supplemental vitamin D for treating other medical conditions?

1 Answer available

Would you wait a period of time before collecting a 24 hour urine stone risk study in a patient with nephrolithiasis who recently underwent a urologic stone removal procedure?

1 Answer available

Do you avoid losartan in patients with hypertension and uric acid nephrolithiasis due to the drugs uricosuric effects?

1 Answer available

Do you recommend obtaining 24 hour urine ammonium levels in patients with recurrent uric acid nephrolithiasis?

1 Answer available

Do you recommend dietary changes to your patients with recurrent kidney stone disease who consume coffee and low oxalate teas daily?

3 Answers available

How would you manage a patient with recurrent calcium phosphate nephrolithiasis who has hypercalciuria, hypocitraturia, and a urine pH greater than 6.3?

1 Answer available

How long do you continue a thiazide diuretic in a patient with nephrolithiasis and hypercalciuria who achieves normalization of urinary calcium excretion following therapy initiation?

2 Answers available

How often do you monitor labs such as complete blood count, liver function panel, and urine protein in a patient with cystinuria receiving tiopronin?

1 Answer available

What is your preferred therapy to raise urinary citrate in a patient with recurrent calcium based stone disease and hypocitraturia?

1 Answer available

What is your approach to elevated urine uric acid levels in a recurrent calcium based stone former?

2 Answers available

Do you recommend obtaining one or two 24-hour urine stone risk profile(s) when evaluating patients with nephrolithiasis?

Parks et al., PMID 11912373

3 Answers available

How do you advise your kidney stone patients about optimal daily fluid intake?

1 Answer available

How frequently do you obtain 24 hour urine stone risk profiles in your patients with kidney stone disease who pass less than one stone per year?

1 Answer available

In which patients do you obtain genetic testing for further evaluation of kidney stone disease?

1 Answer available

What dietary advice do you provide your patients with calcium oxalate nephrolithiasis?

1 Answer available

Papers discussed in this category

N Engl J Med, 2023 Mar 02

Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence.

Clinical journal of the American Society of Nephrology : CJASN, 2017-08-07

Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones.

The New England journal of medicine, 1980-02-21

The importance of circulating 1,25-dihydroxyvitamin D in the pathogenesis of hypercalciuria and renal-stone formation in primary hyperparathyroidism.

The New England journal of medicine, 2018 Sep 13

Primary Hyperparathyroidism.

Primary Care

Nephrolithiasis

Questions discussed in this category

Papers discussed in this category

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