Stones: Evaluation and Medical Management: Difference between revisions
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*# 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 | ||
==== | ==== 24-hour urine collections</span> ==== | ||
*Can be used to inform and monitor treatment protocols | *Can be used to inform and monitor treatment protocols | ||
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*#Sulfate can be added to assess the volume of protein loading from animal meat | *#Sulfate can be added to assess the volume of protein loading from animal meat | ||
* '''Assess adequacy of 24-hour urine collection, prior to interpretation of results''' | * '''<span style="color:#ff0000">Assess adequacy of 24-hour urine collection, prior to interpretation of results''' | ||
**'''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 | **'''<span style="color:#ff0000">To assess the adequacy of collection, 24-hour urinary creatinine excretion should be considered</span>, 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 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 | **** For abnormally collected 24 hour urine collections, can divide metabolite excretion by creatinine excretion to compare collections | ||
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*If a patient with calcium urolithiasis uses calcium supplements, 24-hour urine samples should be collected on and off the supplement. | *If a patient with calcium urolithiasis uses calcium supplements, 24-hour urine samples should be collected on and off the supplement. | ||
**If urinary supersaturation of the calcium salt in question increases during the period of supplement use, the supplement should be discontinued. | **If urinary supersaturation of the calcium salt in question increases during the period of supplement use, the supplement should be discontinued. | ||
== Diet Therapies == | == Diet Therapies == | ||
* '''General diet therapies to reduce risk of stone recurrence (6)''' | * '''General diet therapies to reduce risk of stone recurrence (6)''' | ||