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.

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