tag:blogger.com,1999:blog-4230162007222918868.post6286505088339868062..comments2023-09-19T05:50:03.130-04:00Comments on Renal Fellow Network: Kidney Stones - What's the diagnosis?Gearoid McMahonhttp://www.blogger.com/profile/08049723797363526138noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-4230162007222918868.post-75922087195373872312013-07-15T22:17:31.767-04:002013-07-15T22:17:31.767-04:00Very likely IBD, Crohn's disease, with chronic...Very likely IBD, Crohn's disease, with chronic diarrhea and enteric hyperoxaluria;<br />The missing hint could have been "chronic diarrhea"<br />Tx:<br />1. Fluid intake > 3 L per day<br />2. Ca with meals<br />3. K citrate<br />4. Low oxalate diet.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-89063969342751232172013-07-14T19:27:45.550-04:002013-07-14T19:27:45.550-04:00short bowel syndrome.
Relative increased absorptio...short bowel syndrome.<br />Relative increased absorption of oxalate (though absolute value not particularly high but relatively high given urine volume). <br />Needs urine alkalinization with potassium citrate to supplement citrate and prevent uric acid and calcium oxalate stones.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-51977141599303412422013-07-13T23:27:39.395-04:002013-07-13T23:27:39.395-04:00high ouput from ileostomy. Loss of volume, base a...high ouput from ileostomy. Loss of volume, base and sodium.Anonymoushttps://www.blogger.com/profile/05442574289622272334noreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-68618342112883837182013-07-12T14:32:00.871-04:002013-07-12T14:32:00.871-04:00gastrointestinal disorder as the main pathophysiol...gastrointestinal disorder as the main pathophysiology. <br /><br />Specific therapy for the malabsorptive disorder, such as a gluten-free diet for patients with sprue, is the first line of treat- ment of enteric hyperoxaluria. More generalized therapy for steatorrhea, such as a low-fat diet, cholestyramine, and adminis- tration of medium-chain triglycerides, may reduce fat malabsorp- tion as well as oxalate absorption and subsequent excretion. The low-oxalate diet and mealtime calcium carbonate prescribed for patients with dietary oxaluria are also helpful for these patients. The diarrhea associated with these disorders may result in low urine volumes, hypokalemia, hypocitraturia, and hypomagnes- uria. Patients should therefore be advised to increase their fluid intake and to take potassium citrate (in this case, the liquid, although unpalatable, is better absorbed than the tablets) as well as a magnesium supplement. Magnesium also serves as a urinary stone inhibitor and can be given as magnesium gluconate (0.5 to 1 g every 8 hours) or magnesium oxide (400 mg every 12 hours. <br /><br />From Comprenhesive clinical Nephrology. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-7311300504868613962013-07-12T14:29:55.586-04:002013-07-12T14:29:55.586-04:00This comment has been removed by a blog administrator.Anonymousnoreply@blogger.com