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Urology/CArbonate apatite kidney stones

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Question
Hi I have 100% carbonate apatite stones with no infection I've had 2 surgerys so far I take 1060 mg it potassium citrate and also take chlotothiadone 12.5 my which now just increases to 25 mg which the labco company recommended over lasix or hydrochozide
All my labs always come back normal I have never had an infection or family history of these
I have no rta or hyperthyroid problems of any sort again all labs normal but I keep getting these stones
I drink 2 liters plus a day of fluid
My urologist doesn't know what to do
I had ct scan which has five 1 mm stones hense the recent increase to 25 mg of the water pill
Any advise would be appreciated
I also follow the low animal protein etc
Thanks in advance for your help

Answer
Erica:

I can't accept that all the labs are "normal".  Even if I did, there is a long distance sometimes between "normal" and "optimal" in a stone former.  You have carbonate apatite stones (calcium phosphate) which almost always are caused by underlying metabolic problems.

I would want to see your actual laboratory numbers for the following:

Blood: calcium, parathyroid hormone, phosphorus, uric acid.

24 hour urine: volume, pH, calcium, oxalate, magnesium, uric acid, sodium, phosphate, and citrate.  with this information, I may be able to advise you.

I can tell you that how much your drink is not the issue in urinary volume; it's how much urine do you make in 24 hours!  It should be 2 liters or more of urine so even your 2 liters a day of fluid intake may not be sufficient for you.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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