Comprehensive Metabolic Stone Evaluation

Most stones are preventable once we understand your unique risk factors. Our evaluation looks for the imbalances that drive stones — and then we fix them.

Blood Work

  • Metabolic panel (kidney function, electrolytes)
  • Calcium, uric acid (and others as indicated)
  • Parathyroid testing when appropriate

48-Hour Urine Collection

  • Volume, pH, citrate
  • Calcium, oxalate, uric acid
  • Sodium, creatinine, other stone promoters/inhibitors

What we do with the results: Create a targeted prevention plan. We can almost always prescribe a medication to reduce stones — most commonly potassium citrate, a potent inhibitor that raises urinary citrate and alkalinizes urine to prevent crystals from forming.

How We Diagnose Stones

Ultrasound (US)

  • Radiation-free, quick, and office-friendly
  • Great for screening and follow-up

Computed Tomography (CT)

  • Highest accuracy for stone size and location
  • Guides decisions on medical vs surgical management

Treatment Options (When You Have a Stone)

Medical Expulsive Therapy (MET)

  • For stones <5 mm likely to pass on their own
  • Prescription medication to relax the ureter and ease passage
  • Pain control + hydration plan, close follow-up

ESWL (Shock Wave Lithotripsy)

  • Non-invasive; no incisions
  • Breaks stones into sand-like fragments to pass naturally
  • Performed pain-free under general anesthesia in our ASC

URS + Thulium Laser & Stent

  • Flexible ureteroscopy reaches the stone through natural passages
  • Modern thulium laser precisely dusts the stone
  • Temporary stent supports drainage and healing
  • Done in our state-of-the-art Ambulatory Surgery Centers

Which Option Is Best?

  • Depends on stone size, location, density, and your goals
  • We tailor care to minimize pain, downtime, and recurrence

Common Causes of Kidney Stones

  • Low fluid intake (concentrated urine)
  • High sodium diet
  • Low urinary citrate (a natural inhibitor)
  • High oxalate or uric acid in urine
  • Genetics and family history
  • Metabolic conditions (e.g., gout, hyperparathyroidism)
  • Certain medications or supplements
  • Digestive diseases or bariatric surgery (malabsorption)
  • Obesity and insulin resistance

Diet & Fluid Recommendations

Fluids

  • Aim for urine output ≥ 2–2.5 liters/day (usually 2.5–3 L fluid intake)
  • Spread fluids throughout the day; add a glass at bedtime
  • Water first; consider citrus-infused water to boost citrate

Sodium

  • Limit sodium to ~1,500–2,000 mg/day
  • Avoid heavily processed/restaurant foods

Calcium & Oxalate

  • Do not over-restrict calcium; get normal dietary calcium with meals
  • Pair calcium foods with oxalate-rich foods to bind oxalate in the gut
  • Moderate high-oxalate items (spinach, nuts, beets, rhubarb, dark chocolate)

Protein & Citrate

  • Moderate animal protein; incorporate plant proteins
  • Add citrate-rich foods (lemons, limes, oranges)

Medications That Help Prevent Stones

  • Potassium citrate: boosts urinary citrate and raises pH — a potent stone inhibitor
  • Other options may include thiazides or allopurinol, depending on your 48-hour urine profile

We personalize therapy to your stone type and metabolic results, with periodic monitoring to keep you stone-free.

When to Call Us

  • Severe flank/abdominal pain, nausea, or vomiting
  • Fever or chills (possible infection)
  • Difficulty urinating or worsening blood in urine

We offer rapid access, same- or next-day surgical options, and comprehensive prevention plans.