Stones: Evaluation and Medical Management: Difference between revisions

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 **#'''<span style="color:#ff0000">Primary hyperparathyroidism</span>'''
 **#'''<span style="color:#ff0000">Malabsorptive gastrointestinal states</span>''' due to bowel resection, bariatric surgery or bowel or pancreatic disease
-**##Chronic diarrhea that could be caused by inflammatory bowel disease (Crohn disease, ulcerative colitis) or irritable bowel syndrome
+**##'''Chronic diarrhea that could be caused by inflammatory bowel disease (Crohn disease, ulcerative colitis) or irritable bowel syndrome'''
 **## Gout may predispose the patient to hyperuricosuria or gouty diathesis with either uric acid calculi or calcium oxalate stone formers
-**## Surgical history should be obtained focusing particularly on bariatric surgery and surgeries of the intestinal tract.
+**## '''Surgical history should be obtained focusing particularly on bariatric surgery and surgeries of the intestinal tract.'''
-**###Roux-en-Y-gastric bypass surgery may significantly increase the overall risk for stone formation
+**###'''Roux-en-Y-gastric bypass surgery may significantly increase the overall risk for stone formation'''
 **###'''In contrast to gastric bypass surgery, restrictive bariatric surgeries such as gastric sleeve or gastric band do not seem to increase the risk for kidney stones'''
 **'''<span style="color:#ff0000">Dietary history</span>'''
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 *#Sulfate can be added to assess the volume of protein loading from animal meat
-* The accuracy of a 24-hour urine collection should be assessed prior to interpretation of results.
+* '''Assess adequacy of 24-hour urine collection, prior to interpretation of results'''
-**'''To assess the adequacy of collection, 24-hour urinary creatinine excretion, taking into account patient gender and body weight,''' as well as patient recall of the start and end times of his or her collection, '''should be considered'''
+**'''To assess the adequacy of collection, 24-hour urinary creatinine excretion should be considered, taking into account patient gender and body weight (males 20-25mg/kg and females 15-20mg/kg in 24 hours),''' as well as patient recall of the start and end times of his or her collection
-***'''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'''
+***'''Significant aberrations in total creatinine excretion from estimated volumes 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
 *'''Markers of protein intake, such as urine urea nitrogen or urinary sulfate, are reflective of animal protein intake and can be used to assess dietary adherence'''.