I am a 26 year old female. I have had a kidney stone in my right kidney for around eight months and now it is relatively large 22 mm. I have attached my report for your reference. I am suffering from recurrent kidney infections in the past couple years and had a stone in my left kidney when I was 15. I have attached my latest blood, urine and CT reports. I am concerned that I have CKD stage 1 from the GFR I calculated using the parameters in these reports. Could you please advise me on this? In general, does GFR improve after a stone is removed through lithotripsy or PCNL? I am scheduled for a lithotripsy in a week. Any information regarding if you think I have CKD and what prognosis will be very helpful?
Welcome to icliniq.com.
I saw all your reports and your clinical details (attachment removed to protect patient identity).
Your tendency for recurrent stone formation which needs to be evaluated.
You need not to worry about eGFR (estimated glomerular filtration rate) currently as creatinine is normal. Removal of stone will mostly increase GFR.
Most importantly after your lithotripsy please send the stone fragments which comes in urine for stone analysis. From that we will have a clear idea how to prevent their recurrence.
Secondly, some general measures which include drink at least 3-4 liters of water and restrict salt in your diet up to 2 g in total.
Do not take any calcium supplements and restrict or possibly avoid animal protein that is non-vegetarian food for some years.
Take lots of water particularly in evening so that you at least wake up twice in night to pass urine.
These all are general measures which really worked for many of my patients for future stone prevention.
Do some blood tests like serum calcium, phosphorus, uric acid, bicarbonate and magnesium from any reliable laboratory and send for review.
Revert back with the laboratory reports to a nephrologist online --> https://www.icliniq.com/ask-a-doctor-online/nephrologist
I have a follow-up question. In the meantime, I got one round of lithotripsy done - 2200 shockwaves. The Hounsfield value of my stone is 1250. I got an ultrasound (attached reports) done yesterday and my report says that I have significant hydronephrosis and that the stone is at the pelvic junction. How immediately do I need to resolve this? Is lithotripsy a good idea? In particular, if I do have to get PCNL done, is it fine to wait?
Welcome back to icliniq.com.
Do you have any complaint like pain or fever or burning sensation in urine?
It seems that stone has got partially fragmented and there is a blockage in the right side, which needs to be looked on. We advise to do gentle thumping on your right back with a fist every day and drink lots of water. It may help to dislodge the stone fragments.
Also, the second round of lithotripsy may be needed. Send a urine culture and sensitivity. If you get a high-grade fever or abdominal pain or vomiting, then immediately visit your nephrologist and consider PCNL (percutaneous nephrolithotomy). Thanks.
For further doubts consult a nephrologist online --> https://www.icliniq.com/ask-a-doctor-online/nephrologist
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