Basics of stone disease: 
The prevalence of kidney stone is between 15-20% in males and 5-10% in females. The sad part of this disease is its higher recurrence rate, 40% in the first 2 years, 55% in 5-7 yrs, 75% in 1-10 years and 100% in 15-20 years. The peak age distribution is between 18-45 yrs of age. People who have had renal stones once in their life time would never want to experience it again due to the severity of pain. Repeated kidney stone can affect the kidney function and can cause renal impairment. 

Causes of renal stones

The causes includes 
a. Low urine volume
b. High urine calcium
c. High oxalate in urine
d. High uric acid
e. Low citrate in urine
f. High dietary sodium and protein intake
g. Chronic metabolic acidosis

Why should I see an Endocrinologist:

If you have an acute episode of stone it is advisable to consult Urologist. The treatment for acute episode is hydration, pain control and urological procedure like lithotripsy to remove the stone if indicated. 

The role of an Endocrinologist is to PREVENT ANOTHER STONE. We will order simple blood test to check your calcium and if indicated PTH ( parathyroid hormone). Basic kidney test with electrolytes to see for kidney disease, metabolic acidosis etc. After the acute episode we will also recommend collection of 24 hr urine to check for oxalate, calcium, urate, phosphate, sodium etc. Two 24 hr urine collection is preferred

We will analyze the result of the urine test and recommend life style intervention, diet changes and medications if needed. For example if you have higher calcium excretion in the urine (hypercalciuria) treatment with Hydrocholorothiazide type of medication ( blood pressure medication) could help. 

This metabolic evaluation can help prevent another kidney stone. 

Dr Sruti Chandrasekaran
AB ( Internal medicine), AB ( Endocrinology, Diabetology and Metabolism)
Consultant Endocrinologist
Vikas Clinic
Chennai 42

Doctor Dr. Sruti Chandrasekaran, 2012083010:26:17

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