Internal Medicine

Nephrolithiasis

Questions discussed in this category

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

Do you recommend obtaining both a parathyroid ultrasound and a parathyroid nuclear medicine scan when evaluating a patient with recurrent calcium based nephrolithiasis who is found to have an elevated PTH level, hypercalcemia, and hypercalciuria?

1 Answer available

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

1 Answer 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

What are your top takeaways from ASN 2024?

1 Answer available

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

1 Answer available

Do you recommend non-bypass bariatric surgeries over intestinal bypass procedures for kidney transplant-eligible candidates to prevent oxalate nephropathy, given the higher risk of kidney oxalate deposition with intestinal bypass?

2 Answers 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

Do you recommend starting pyridoxine in a patient with ESKD secondary to primary hyperoxaluria type 1 who is also on lumasiran for plasma oxalate reduction?

1 Answer 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

Do you recommend parathyroid adenoma resection or ablation for patients with primary hyperparathyroidism and recurrent nephrolithiasis who are found to have a single gland adenoma on parathyroid ultrasound and nuclear medicine imaging?

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

Are there instances when you would recommend obtaining a 24 hour urine protein measurement in place of spot urine protein studies in patients with acute kidney injury and proteinuria?

2 Answers 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

Do you recommend parathyroid imaging testing for patients with recurrent nephrolithiasis who are incidentally found to have an elevated PTH but who do not have hypercalciuria, hypercalcemia, hypovitaminosis D, or chronic kidney disease?

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

How often do you monitor plasma oxalate levels for patients with ESKD secondary to primary hyperoxaluria who are on hemodialysis and receiving lumasiran?

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 consider Randall's plaque as a form of nephrocalcinosis necessitating genetic testing for monogenic kidney stone disorders?

2 Answers 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

Do you recommend sending an autoimmune work up for patients with recurrent nephrolithiasis and 24 hour urine chemistries consistent with distal renal tubular acidosis?

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

What is your approach to differentiating primary from secondary hyperparathyroidism in recurrent kidney stone formers who also have chronic kidney disease, an elevated PTH, and hypercalcemia?

1 Answer 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 plasma oxalate target when treating patients with lumasiran for end stage kidney disease secondary to primary hyperoxaluria type 1?

1 Answer available

Do you routinely check a TSH level in patients with recurrent kidney stones who have hypercalciuria of unknown cause?

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

How has the introduction of lumasiran affected the need for combined liver and kidney transplantation in patients with ESKD related to primary hyperoxaluria type 1?

2 Answers available

What are your management strategies for patients with nephrolithiasis and hypercalciuria who have a severe sulfa drug allergy and are unable to tolerate thiazide diuretics?

1 Answer available

Are there other therapies such as SGLT2 inhibitors or alpha lipoic acid that you are offering your patients with cystinuria who continue to have active stone disease despite conservative therapy and thiol-based agents?

1 Answer available

Is there a role for cinacalcet suppression testing when evaluating patients for suspected primary hyperparathyroidism who also have recurrent calcium containing kidney stone disease?

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

In which patients with nephrocalcinosis and an incomplete distal RTA would you consider further testing for medullary sponge kidney?

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

What are your management strategies for patients with recurrent uric acid nephrolithiasis and chronic kidney disease who have persistent hypocitraturia and acidic urine pH?

2 Answers 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 kidney stone disease and chronic kidney disease, is there an eGFR threshold at which you no longer recommend pursing 24 hour urine stone risk studies?

2 Answers 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

What are your top takeaways from ASN 2023?

2 Answers available

What is your approach between choosing lumasiran or nedosiran for patients with primary hyperoxaluria type 1?

2 Answers available

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

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

What is your preferred method for diagnosing adenine phosphoribosyltransferase (APRT) deficiency in a patient with recurrent kidney stones and abnormal crystalluria?

2 Answers 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 use 24 hour urine stone risk profiles for purposes other than managing nephrolithiasis?

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

When would you recommend adding peritoneal dialysis to a patient with oxalosis who is already receiving hemodialysis?

1 Answer available

What is your approach to the medical management of struvite kidney stones?

1 Answer 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.

American journal of nephrology, 2014

Oxalate quantification in hemodialysate to assess dialysis adequacy for primary hyperoxaluria.

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

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

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Feb 13

Isolated kidney transplantation under lumasiran therapy in primary hyperoxaluria type 1: a report of five cases.

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.

Kidney360, 2022 Aug 25

Bariatric Surgery Decreases Barriers for Kidney Transplant: Are There Other Weight-Loss Options?

The New England journal of medicine, 2024 Oct 26

Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans.

Atencion primaria, 1997 Sep 30

[The existing differences between adolescent girls served on a first visit in a family planning center in 2 time periods].

The New England journal of medicine, 2024 Oct 25

Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.

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