EMERGENCY
RESPONSE LEVEL
Notes to visitors
Metabolic Evaluation
Metabolic evaluation may prevent stone recurrence, is economically sound yet vastly underused.
In first time stone formers conservative therapy with dietary advice is cost-effective. In recurrent stone formers however, medical therapy significantly reduces recurrence and is cost effective.
- Basic metabolic evaluation (for every stone former)
- Medical history including dietary intake
- Urine test: urinalysis and urine pH
- Blood test: RFT, calcium, uric acid level
- Stone analysis
- Comprehensive metabolic evaluation (for high risk stone former)
- Indications
Recurrent stone former
Young stone formers (under 30)
>1 significant stone at presentation
Stone type: Non-calcium urinary tract stones (infection stones, uric acid stones, cystine stone)
Predisposing medication conditions: Gout, DM, obesity, hyperparathyroidism, GI disease
Strong family history
- In addition to basic metabolic work-up, 24-hour urine analysis is necessary to identify predisposing factors for recurrent kidney stones.
- 24 hour urine analysis usually includes the assessment of:
total volume, urine pH, creatinine, sodium, calcium , oxalate, uric acid and citrate
- Indications