Ever had a Kidney Stone Risk Panel? Is mine as bad as I think?

Discussion in 'Vitamins & Labs' started by Marquis Mark, Dec 27, 2016.

  1.  
    Marquis Mark

    Marquis Mark Well-Known Member

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    Hi All,

    Just got the attached Kidney Stone Risk Panel back. Yikes! Doesn't look too good and the endocrinologist who ordered it has left Kaiser so not sure who can interpret it for me.

    Previously, when I was taking 3,000/day/calcium, my lab result was very high on a Calcium Urine test. So I dropped it to 1,500/day (generally not taken with food), While the calcium urine is now normal most of the other stuff looks pretty scary. Wish I'd taken this test prior to surgery for comparison's sake.

    I take about 400 day mag citrate and 400/day mag glycanate. I drink a lot of Crystal Light lemonade.

    Do my results mean I'm forming a boulder? Is there anything I should be doing? I really don't want kidney stones...

    M
     

    Attached Files:

  2.  
    DSRIGGS

    DSRIGGS Yes, that is chocolate covered bacon

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    Honestly I didn't know there was such a thing so I don't have anything to offer up. All I know is that I do the Jarrow Bone UP at 2,000 mg a day and a fair amount of it with food, but I should up it to 3,000. The Jarrow Bone Up doesn't cause the bloat and constipated feeling Citrate does me. I am not taking Citrate again unless I find out the Bone Up doesn't work.

    Hopefully somebody else has input on the panel, for you. Best wishes.

    I know I have 4 stones (3 at 4MM and 1 at 3 MM if I remember right) it is just a matter of when they are going to decide to ove
     
  3.  
    Munchkin

    Munchkin Full of Fairy Dust

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    It's a new one for me! So of course, google is my friend. Looks like this test is not indicated unless the patient has already had 2 kidney stones. From what I can see, many people have numbers that are 'off' but they never get stones.
     
  4.  
    k9ophile

    k9ophile Well-Known Member

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    I can't imagine why you wouldn't want kidney stones. You get to meet new people when you go to the ER for a CT scan and drugs. You get to strain your pee. Good times.
     
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  5.  
    DSRIGGS

    DSRIGGS Yes, that is chocolate covered bacon

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    And if lucky a stent!
     
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  6.  
    Marquis Mark

    Marquis Mark Well-Known Member

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    God, I hope you're right about never getting stones. I've never had a stone, but the endo I've been working with (he just retired) pretty much gave me any test I asked for. This was one of them. I wanted to see where I was and, if possible, take steps to avoid getting stones. I guess an ultrasound would be able to rule out if I had any, right?

    In the meantime, other than avoiding Oxalate producing foods not really sure what to do...
     
    Last edited: Dec 28, 2016
  7.  
    Clematis

    Clematis Well-Known Member

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    Do everything you can to prevent stones.

    Ultrasound is very very bad at identifying stones and their size. KUB Xray is a bit better but not very good. CT is the best way to see if you have stones and their size and location.

    I've had 4 calcium oxalate stones since July and another is still in there and starting to ache. (And one 2 years ago and 3 in the late 70s).

    You should see a urologist, Mark. These numbers, if correct, aren't good. (This was from a 24 hr urine collection?) Stone formation is a complex matter involving many different substances coupled with fluid intake. But ALL your numbers are bad. Maybe you are a lucky one who will never produce stones. For reference, NONE of mine values are off and yet clearly something is amiss as I produce copious stones.

    Most people's stones are calcium oxalate stones and your panel shows you could develop those. You, however, also have elevated uric acid so could produce uric acid stones as well. (Uric acid reduction needs a prescription medicine.) You can do a few things on your own to reduce the chance of formation of the calcium stones.

    Here's what I was told to do: Drink LOTS of water all the time, especially before bed so you are compelled to get up to pee in the middle of the night, then drink another glass. (The theory is that stones form more readily at night because the particulates can settle in the kidneys when you spend 8 hours not peeing.) Increase consumption of potassium citrate to prevent stones. Even though my citric acid level is ok, I drink 20oz of Crystal Light Lemonade as it has a very high level of potassium citrate. http://kidneystones.uchicago.edu/price-of-potassium-citrate/ I recently started taking a daily Jarrow potassium citrate tablet. After reading recent research that hydroxycitric acid may be even better than potassium citrate in preventing stones, I take one of these too: https://www.amazon.com/gp/product/B000I4DOOW/ref=oh_aui_detailpage_o02_s00?ie=UTF8&psc=1

    A strict oxalate diet is pretty much sticking to animal protein, which I guess we should be doing anyway but, well, DAMN, who wants to do that? If you study up on oxalates, you'll see that the problem is that all the oxalate charts are different. (The method of measuring oxalates in foods varies as well as the fact that oxalate content varies depending on the variety of the vegetable and the time of year it is harvested. I can find the article -- perhaps on University of Chicago urology sites? -- that discusses this phenomena.) I don;t follow the oxalate diet although I will take a calcium pill with something I know is high in oxalates to counteract it. Spinach by all charts is a killer (as high as 800mg when a low oxalate diet suggests less than 50 a day) so I took my calcium with it when I was served a little during the holidays.

    FYI: my numbers are, normal range in parens:
    calcium 195 (100-300)
    citric acid 437 (320-940)
    oxalate 18 (4-31)
    sodium 63 (40-220)
    uric acid 299 (250-750)

    PS: the third stone this year was a doozy, got stuck for weeks and I finally had to have lithotripsy under general anesthesia to have it removed. The fourth stone, weirdly, just fell out with zero pain. I woke one morning and as I was peeing felt a "bubble" come out. Having had stones, I knew this feeling and sure enough there was a 3mm stone in the toilet. I was astonished as my first and second stones this summer were 3mm and I just about died from pain, yet this passed without me feeling anything. (I never even knew it was possible to pass a painless stone.) My point: perhaps you have passed small stones without pain. If so, lucky you!
     
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  8.  
    Larra

    Larra Well-Known Member

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    Lots of good info here already. I'll just add that while ultrasound is the best test for gallstone, it's not a good test for kidney stones. A plain x-ray is actually pretty good, as 90% of kidney stones contain calcium and therefore will show up on a good old-fashioned x-ray. Of course, that also means that 10% won't show up, and if your stones are of the uric acid variety and not calcium, well...
     
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  9.  
    Marquis Mark

    Marquis Mark Well-Known Member

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    Thanks Clematis and all,

    As I'm reading what I should/shouldn't eat/do and add that to my vitamin should/shouldn'ts, I think I'd rather shoot myself in the face and get this over with.

    The list of oxalate foods is long but, from what I can quickly surmise, the main things I especially need to cut are potato products, nuts (inc peanut butter - damn, just bought three jars on sale), bran flakes and chocolate. Was never big on buckwheat groats, spinach or rhubarb.

    The scariest part is my usual urine output (I've had a few 24-urine tests, inc this one) is at least 3 liters/day and I always take a 20-ounce water bottle to bed which I sip through the night. In addition I always wake up at least twice a night to tinkle. I also drink a few glasses of Crystal Light lemonade a day. I drink too much diet soda so, perhaps, I need to increase water and reduce that, but I'm not sure what the evidence is for that. It's 99.9% water.

    Perhaps I need to re-increase my calcium to 3,000/day (although, when I did, my 24-urine calcium level was well above range. Now, at 1,500/day, it's normal). In addition to the 1,500, I eat a lot of cheese, milk and Greek yogurt. BTW, more than 1,500/day constipates me. Maybe I can carry around some smaller cal cit tablets (200s) and pop them whenever I eat a high oxylate meal. At that low a dose, it shouldn't interfere with my other vits.

    Just emailed the urologist.
     
    Last edited: Dec 28, 2016
  10.  
    Marquis Mark

    Marquis Mark Well-Known Member

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    I drink about a quart of Crystal Light lemonade a day now. How much Potassium Citrate should I be taking. The pills I have are 275 mg citrate which equals 99 mg of actual potassium or about 2.5 mEQ each. And when do you take the pills? Should I avoid taking any particular supplements at the same time? It's going to be a while until I can see the urologist.
     
  11.  
    Clematis

    Clematis Well-Known Member

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    Geez Mark I don't know what to tell you about potassium citrate dosage. Your urine citrate is at 170 and it should be >320. And yet you've been drinking all that crystal light at 21.7 mEq/liter.

    Take your calcium pills when you eat oxalate foods. Perhaps you might want to lower your sodium intake as well?

    Keep in mind that kidney stones aren't just from low citrate or high oxalates or high sodium or low fluid intake -- there is some way it all comes together in each individual to cause stones or not cause stones. Medical science does not have the definitive answers on kidney stones. (Except for total output volume, all my numbers were "good" and yet I'm a stone producer. You're just the opposite... so far.)

    This is from the first link I provided in post #7 [READ THE COMMENTS UNDER THE DOCTOR'S ESSAY. PEOPLE TALK ABOUT THEIR DOSAGES AND HE RESPONDS SO THAT MAY HELP YOU.]:

    Not All Patients Need Potassium Citrate Or Any Other Alkali
    This post is for those who have been told by their physicians to use alkali. Nothing I have written here should induce anyone to begin alkali unless their physician has prescribed or recommended it. Stone formation is complicated. Sometimes alkali can worsen stones, or even become a danger. Potassium can itself be dangerous if kidney function is below normal. Sodium loads are a problem for people with high blood pressure, heart disease, and other illnesses. Do not use sodium or potassium alkali or even high volumes of Crystal Light unless the physician who is treating your stones recommends you do so.

    And...

    How To Put It All Together
    Compromise is the best policy, and I offer a general scheme which patients and physicians can use, if they wish, with their personal alterations. Be sure and check that your combinations provide the dosages your physician wants you to have.

    Make a List of Equivalent Dosages
    Each potassium citrate pill is 10 mEq; 2 are 20 mEq of alkali. Each liter of Crystal Light is just over 20 mEq of alkali. Each OTC 10 grain (650 mg) sodium bicarbonate tablet is 7.7 mEq of alkali so 3 make 23 mEq.

    Make A Day’s Menu
    Consider dividing the day’s alkali into 3 parts: Beverages; sodium bicarbonate; potassium citrate pills.

    To Replace 2 Potassium Citrate Pills
    If we only need 2 10 mEq potassium citrate pills (20 mEq), substitute 1 liter of Crystal Light (20 mEq). It is part of the day’s fluids, but also like a medication, so spread its use out over the day and, if possible, night.

    To Replace 4 Potassium Citrate Pills
    If we need 4 pills (40 mEq) consider 1 liter of Crystal Light and three sodium bicarbonate pills (20 mEq). The beverage and individual pills can be spread out through the day.

    To Replace 6 Potassium Citrate Pills
    If we need 6 pills (60 mEq), consider 2 liters of Crystal light (40 mEq) and three sodium bicarbonate pills (20 mEq) likewise spread out through the day. Reserve the potassium citrate pills for when you tire of the beverage or if the extra sodium is raising blood pressure or urine calcium.
     
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  12.  
    Spiky Bugger

    Spiky Bugger Well-Known Member

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    Mark,

    You might want to consider REAL citrus...like from REAL lemons. Crystal Light is a magic chemical brew...

    Ingredients: Citric Acid, Potassium Citrate, Sodium Citrate, Aspartame+, Magnesium Oxide, Maltodextrin, Contains Less than 2% of Natural Flavor, Acesulfame Potassium, Soy Lecithin, Artificial Color, Yellow 5, BHA (Preserves Freshness). +Phenylketonurics: Contains Phenylalanine.

    I was told 4 oz of LEMON JUICE daily and don't know how to judge if the above ingredients are close to that.

    Sue
     
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  13.  
    Spiky Bugger

    Spiky Bugger Well-Known Member

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  14.  
    southernlady

    southernlady Administrator Staff Member

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    I was gonna ask... why Crystal Light? Why not, homemade lemonade made with real honest to goodness lemons.
     
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  15.  
    Clematis

    Clematis Well-Known Member

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    Because there is far more potassium citrate in Crystal Light than in real lemon juice @southernlady@southernlady as explained in the University of Chicago links.
     

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