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similarities & diffs in management of Ca2+ oxalate & uric acid kidney stones

Ca2+ =
1) increase fluid intake
2) reduce urinary Ca
3) reduce urinary oxalate
4) increase natural inhibitors of crystal formation-citrate, Mg

Uric acid = DITTO + low purine diet && maintain alkaline urine (>6pH)


what type of fluids should be emphasized and which reduced?

good = black tea, coffee, milk, beer, wine

bad= grapefruit, apple, cranberry juice, soft drinks


explain how using certain quantitative urine tests can help guide Dr in managing kidney stones

24-h urine analysis = ddx: abortive hypercalciuria = should still take calcium


how can Ca supplements be made safer for patients with a Hx of kidney stones?

--supplementation = should be taken with a meal so it can bind to the dietary oxalate
--citrate forms of Ca &/or Mg may increase benefits


what is the role of Mg, Vit B6, Vit C in the formation of kidney stones?

--Mg = low = more stones
--Vit B6 = increase oxalate formation from normal body metabolism, reduce stone formation
--Vit C = increase urinary oxalate. not sure if high dosing actually helps. Pt should be tested w/ 24-h urinary oxalate while high dosing Vit C