Stones: Evaluation and Medical Management: Difference between revisions

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 === Extensive Diagnostic Evaluation ===
-* '''Includes one or two 24-hour urine collections'''
+* '''<span style="color:#ff0000">Consists of one or two 24-hour urine collections obtained on a random diet[https://pubmed.ncbi.nlm.nih.gov/24857648/ ★]</span>'''
+**'''<span style="color:#ff0000">24-hour urine collections analyzed at minimum for (9): [https://pubmed.ncbi.nlm.nih.gov/24857648/ ★]</span>'''
+***'''<span style="color:#ff0000">Volume</span>'''
+***'''<span style="color:#ff0000">pH</span>'''
+***'''<span style="color:#ff0000">Creatinine</span>'''
+***'''<span style="color:#ff0000">Sodium</span>'''
+***'''<span style="color:#ff0000">Potassium</span>'''
+***'''<span style="color:#ff0000">Calcium</span>'''
+***'''<span style="color:#ff0000">Oxalate</span>'''
+***'''<span style="color:#ff0000">Uric acid</span>'''
+***'''<span style="color:#ff0000">Citrate</span>'''
 *'''Indications for a metabolic stone evaluation'''
-*'''<span style="color:#ff0000">AUA (7):</span>'''
+**'''<span style="color:#ff0000">AUA (7):[https://pubmed.ncbi.nlm.nih.gov/24857648/ ★]</span>'''
-*#'''<span style="color:#ff0000">Recurrent stone formers</span>'''
+**#'''<span style="color:#ff0000">Recurrent stone formers</span>'''
-*#'''<span style="color:#ff0000">Family history of stone disease</span>'''
+**#'''<span style="color:#ff0000">Family history of stone disease</span>'''
-*#'''<span style="color:#ff0000">Malabsorptive intestinal disease or resection</span>'''
+**#'''<span style="color:#ff0000">Solitary kidney</span>'''
-*#'''<span style="color:#ff0000">Recurrent UTIs</span>'''
+**#'''<span style="color:#ff0000">Malabsorptive intestinal disease or resection</span>'''
-*#'''<span style="color:#ff0000">Obesity</span>'''
+**#'''<span style="color:#ff0000">Obesity</span>'''
-*#'''<span style="color:#ff0000">Medical conditions predisposing to stones (e.g., RTA Type 1, primary hyperparathyroidism, gout, diabetes mellitus type)</span>'''
+**#'''<span style="color:#ff0000">Recurrent UTIs</span>'''
-*#'''<span style="color:#ff0000">Solitary kidney</span>'''
+**#'''<span style="color:#ff0000">Medical conditions predisposing to stones (e.g., RTA Type 1, primary hyperparathyroidism, gout, diabetes mellitus type)</span>'''
-*Included in other lists
+**Included in other lists
-*# Pathological skeletal fractures
+**# Pathological skeletal fractures
-*# Osteoporosis
+**# Osteoporosis
-*# Infirm health (unable to tolerate repeat stone episodes)
+**# Infirm health (unable to tolerate repeat stone episodes)
-*# Anatomic abnormalities
+**# Anatomic abnormalities
-*# Stones composed of cystine, uric acid, and struvite
+**# Stones composed of cystine, uric acid, and struvite
-*# Children should generally be evaluated because of concerns about renal damage and long-term sequelae of stone recurrence
+**# Children should generally be evaluated because of concerns about renal damage and long-term sequelae of stone recurrence
 * '''Significant aberrations in total creatinine excretion from estimated volumes (males 20-25mg/kg and females 15-20mg/kg in 24 hours) imply incomplete collection, overcollection, greater than expected muscle mass, or less than expected muscle mass'''
 ** For abnormally collected 24 hour urine collections, can divide metabolite excretion by creatinine excretion to compare collections