Page 249 - Urological Health

Preventing stones and managing them once

you get them

Dr. Sero Andonian
Urologist
Assistant Professor of Surgery, Division of Urology, McGill University, Montreal, QC, Canada
Dr. Mohamed Elkoushy
Urologist
Division of Urology, McGill University, Montreal, QC, Canada

“An ounce of prevention is better than a pound of cure”

If you have had kidney stones, you are at an increased risk of getting them again (50% within 5 years
and 90% in your lifetime). It’s important to find out why kidney stones have formed so that you can
prevent them from happening again.
According to the recent Canadian Urological Association Guidelines, if you have kidney stones, you
should have the following tests: stone analysis, urinalysis and blood testing.

You will be asked to strain the urine using filters to catch stones that are passed spontaneously. These
stone fragments are analyzed to determine their composition and the type of stone. A small sample
of voided urine is also obtained for urinalysis, which is important to determine the pH of the urine or
the level of acidity or alkalinity of urine.
Furthermore, red blood cells, white blood cells, glucose, or protein provide a snapshot of your urine
at a particular time point – this is a valuable screening tool for urinary tract infections, kidney disease,
and other conditions, such as diabetes.

Blood tests are done to measure serum electrolytes, such as sodium, potassium, chloride, bicarbonate,
calcium and phosphorus, in addition to serum creatinine and uric acid.

Stone analysis, urinalysis and blood tests form the limited metabolic
stone evaluation of all patients who present with kidney stones.

If this is your first experience with kidney stones, your doctor will likely advise you to follow dietary
recommendations (listed later).
Your doctor will need to conduct a detailed metabolic stone evaluation if you’ve had recurrent or
multiple bilateral kidney stones, single or abnormally shaped or located kidneys, strong family history
of kidney stones, recurrent bone fractures or osteoporosis, recurrent urinary tract infections, renal
impairment, and history of gout or inflammatory bowel disease, such as Crohn’s or ulcerative colitis,
non-calcium containing stone types, such as uric acid and cystine stones.

250