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BackTable / Urology / Podcast / Episode #131

No Stone Unturned: Kidney Stone Prevention

with Dr. Margaret Pearle

This week on BackTable Urology, Dr. Manoj Monga (UC San Diego) invites Dr. Margaret Pearle (UT Southwestern) to discuss kidney stone prevention with lifestyle changes and medical therapy.

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No Stone Unturned: Kidney Stone Prevention with Dr. Margaret Pearle on the BackTable Urology Podcast)
Ep 131 No Stone Unturned: Kidney Stone Prevention with Dr. Margaret Pearle
00:00 / 01:04

BackTable, LLC (Producer). (2023, October 25). Ep. 131 – No Stone Unturned: Kidney Stone Prevention [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Margaret Pearle discusses No Stone Unturned: Kidney Stone Prevention on the BackTable 131 Podcast

Dr. Margaret Pearle

Dr. Margaret Pearl is a Professor and Vice Chair of Urology at UT Southwestern Medical Center in Dallas, TX.

Dr. Manoj Monga discusses No Stone Unturned: Kidney Stone Prevention on the BackTable 131 Podcast

Dr. Manoj Monga

Dr. Manoj Monga is the chair of the urology department at UC San Diego in California.

Synopsis

First, the doctors reflect on Dr. Pearle and Dr. Yair Lotan’s paper from 2008 that predicted the impact of climate change on kidney stones. Dr Pearle then shares her recommendations for lifestyle changes to prevent kidney stones, such as increasing fluid intake and reducing sodium and animal protein intake. She also advises on reducing oxalate intake in diets and maintaining adequate calcium intake to ensure bone health.

Next, the doctors discuss strategies for treating and preventing stones with medical therapy. They explore the use of thiazides and potassium citrate for both calcium oxalate and calcium phosphate stones, as well as the importance of evaluating PTH levels and serum uric acid levels in these patients. They also discuss the role of dietary oxalate and bowel disease in determining when to order genetic testing. Additionally, they explore the nuances of treating hypercalciuria with thiazide holidays and the use of potassium citrate as a second line therapy. Potassium citrate is beneficial for alkalinization and citrate supplementation. There are different benefits when comparing the liquid formulation to the tablets.

Finally, they discuss the use of urinary pH and xanthine oxidase inhibitors, the importance of genetic testing, and the importance of fluid intake and potassium citrate for cystine stones.

Resources

Brikowski TH, Lotan Y, Pearle MS. Climate-related increase in the prevalence of urolithiasis in the United States. Proc Natl Acad Sci U S A. 2008 Jul 15;105(28):9841-6. doi: 10.1073/pnas.0709652105. Epub 2008 Jul 14. PMID: 18626008; PMCID: PMC2474527.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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