Re: question re calcium phosphate kidney stones / RTA

[Guest guest]

-Hi Barbara

I don't have kidney problems but my daughter and mother do. My

daughter was on bicitra for years (sodium citrate with other goodies

thrown in) and had routine renal ultrasounds. Since she's been on TPN

she's had extra acetate for her bicarb losses, sodium, calcium and

potassium to replace losses, low chloride since she doesn't waste that,

and low phosphate since hers runs high. We also monitor her serum

albumin since she wastes more of everything when she's dumping

protein. also has nephrogenic diabetes insipidus. She needs

tons of fluid because she doesn't concentrate well, but we have to walk

a fine line between giving her too much and triggering diuresis and too

little and getting her dehydrated. You might ask them to check urine

osmolality and blood osmolality at the same time. They should reflect

the same hydration status.

Wish I could give you better news about my mom. She's been on dialysis

for years. She had kidney stones that eventually destroyed her ureters

and the microscopic wasting of all sorts of stuff (started with Ca, Mg,

Na, and K, then added protein and blood) did her kidneys in. She's not

a candidate for transplant because she started getting routine blood

transfusions in 1975 and has way too many antibodies (except HIV and

hepB and C, thank the Lord)

If you had any specific questions I could try to answer them. As far

as the stones, I'm not sure what can be done once you have them. My

mom had surgery, scopes, lithotripsy, the whole 9 yards. I think the

main focus is on prevention and early detection. Treatment with

bibitra or polycitra is probably the best wat to do that. But boy that

stuff is the most awful tasting liquid around. And it takes a lot of

volume to get effects. Good luck.

Hope this helps!

Heidi

-- In , " Barbara Seaman "

wrote:

> Is there anyone in the group who has had calcium phosphate kidney

stones,

> especially in combination with renal tubular acidosis? What, if

anything,

> has been suggested to prevent further stone formation? I have another

> consult with a nephrologist coming up, but wanted some input from mito

> patients if possible.

>

> Also, is there anyone in the group who has a renal leak of

bicarbonate and

> calcium (high in urine) along with low citrate? These conditions

apparently

> predispose to the formation of calcium phosphate stones. I also leak

> potassium, but could not remember anyone in the group mentioning a

> bicarbonate and calcium leak before.

>

> Thanks.

> Barbara

[Guest guest]

Heidi, Very helpful, thanks. I will print and digest and may have more

questions later. A few weeks back I had surgery to remove two stones, one

blocking the right ureter, which turned out to be calcium phosphate.

Previous evaluations by nephrology found wasting of calcium, sodium bicarb,

and K, with low citrate, dilute and grossly alkaline urine, etc.

Nephrologist said this predisposed to stones of calcium phosphate which is

exactly what mine turned out to be when analyzed. I will read about bicitra

and polycitra.have wondered if someone shouldn't have put me on some form of

citrate, though half my K is citrate. What I found suggests that citrate can

prevent calcium oxalate stones but not calcium phosphate stones. So maybe

that is not the answer. Neph also said restricting calcium was not the

answer since that would increase oxalate excretion. Sheesh! This stuff is so

complicated. I know they checked urine osmolality but not sure blood

osmolality was checked at the same time. Would that require an arterial

draw? They did check serum pH. Dehydration is definitely an issue for

me..but I too wonder about overloading fluids and losing even more. I have

no idea how to tell when enough is enough. Most of the time my veins are

collapsed and the original neph was concerned about that. I am really hoping

the new nephrologist will have some idea of how to prevent further stones,

as this recent round in hospital/surgery had a dramatic effect on mito

status. Not keen on going through that again. I had a stroke-like episode

(garbled speech/profound weakness) while attempting to pass the largest

stone. Makes ER interesting when you can't talk. Anyway, thanks again.

Barbara

_____

From: [mailto: ] On Behalf

Of heidicoleman2002

Sent: Friday, April 29, 2005 6:02 PM

To:

Subject: Re: question re calcium phosphate kidney stones / RTA

-Hi Barbara

I don't have kidney problems but my daughter and mother do. My

daughter was on bicitra for years (sodium citrate with other goodies

thrown in) and had routine renal ultrasounds. Since she's been on TPN

she's had extra acetate for her bicarb losses, sodium, calcium and

potassium to replace losses, low chloride since she doesn't waste that,

and low phosphate since hers runs high. We also monitor her serum

albumin since she wastes more of everything when she's dumping

protein. also has nephrogenic diabetes insipidus. She needs

tons of fluid because she doesn't concentrate well, but we have to walk

a fine line between giving her too much and triggering diuresis and too

little and getting her dehydrated. You might ask them to check urine

osmolality and blood osmolality at the same time. They should reflect

the same hydration status.

Wish I could give you better news about my mom. She's been on dialysis

for years. She had kidney stones that eventually destroyed her ureters

and the microscopic wasting of all sorts of stuff (started with Ca, Mg,

Na, and K, then added protein and blood) did her kidneys in. She's not

a candidate for transplant because she started getting routine blood

transfusions in 1975 and has way too many antibodies (except HIV and

hepB and C, thank the Lord)

If you had any specific questions I could try to answer them. As far

as the stones, I'm not sure what can be done once you have them. My

mom had surgery, scopes, lithotripsy, the whole 9 yards. I think the

main focus is on prevention and early detection. Treatment with

bibitra or polycitra is probably the best wat to do that. But boy that

stuff is the most awful tasting liquid around. And it takes a lot of

volume to get effects. Good luck.

Hope this helps!

Heidi

-- In , " Barbara Seaman "

wrote:

> Is there anyone in the group who has had calcium phosphate kidney

stones,

> especially in combination with renal tubular acidosis? What, if

anything,

> has been suggested to prevent further stone formation? I have another

> consult with a nephrologist coming up, but wanted some input from mito

> patients if possible.

>

> Also, is there anyone in the group who has a renal leak of

bicarbonate and

> calcium (high in urine) along with low citrate? These conditions

apparently

> predispose to the formation of calcium phosphate stones. I also leak

> potassium, but could not remember anyone in the group mentioning a

> bicarbonate and calcium leak before.

>

> Thanks.

> Barbara

Medical advice, information, opinions, data and statements contained herein

are not necessarily those of the list moderators. The author of this e mail

is entirely responsible for its content. List members are reminded of their

responsibility to evaluate the content of the postings and consult with

their physicians regarding changes in their own treatment.

Personal attacks are not permitted on the list and anyone who sends one is

automatically moderated or removed depending on the severity of the attack.

_____

[Guest guest]

-As far as giving too much fluid, that's a big big problem. We keep

strict intake and output on . We weigh every diaper and

measure every drop that goes in and out. It seems like many mito kids

need to be positive by several hundred cc's but is OK if she

is 200cc either way. We total up I and O every 24 hours, at 8am

(it's the most accurate at that time, don't ask me why.) If she's

positive we do nothing. If she's negative by less than 200 we do

nothing. If she's negative 200-300 we replace cc:cc with normal

saline. If she's negative 301-500 we replace cc:cc with 1/2 normal

saline. If she's negative over 501 we replace 1/2cc:cc with 1/2

normal saline and notify metabolism. She can be wildly negative due

to stress (a long car ride, an immunization, etc) and we just watch

her closely. If she's still negative the next day then we wonder if

she's coming down with something and we draw labs. Nothing fancy,

just lytes, LFT's, CBC, cultures. 9 times out of 10 something will

show up. I know that we're not accounting for insensible losses but

she seems to do fine. We don't worry about GI losses either (from

draining g and j tubes), we just total them in.

Extra sugar caused a big problem. She spills sugar very easily and

if you spill sugar it takes K with it. If she loses K she loses Na

and then she doesn't keep the fluids. Low dextrose concentration in

her TPN and tolerating low blood glucoses (50-60) did the trick.

Alkaline urine invites bacteria, you might want to get a bottle of

test strips and test once or twice a week to screen for leukocytes

and nitrites.

Blood osmolality is a venous test.

As far as determining when " enough is enough " , we look for stable BP

and pulse, Na 138-139, K above 4, bicarb above 22, no sugar or

albumin in urine, intake within 200ml of output. She hasn't had any

stones but she gets scanned every 6 months.

My Mom has had stones since her teens, despite being on K and Mg

since then. One of those times she must have had a SLE but the

doctor diagnosed a conversion reaction... geesh.

Heidi

-- In , " Barbara Seaman "

wrote:

> Heidi, Very helpful, thanks. I will print and digest and may have

more

> questions later. A few weeks back I had surgery to remove two

stones, one

> blocking the right ureter, which turned out to be calcium phosphate.

> Previous evaluations by nephrology found wasting of calcium, sodium

bicarb,

> and K, with low citrate, dilute and grossly alkaline urine, etc.

> Nephrologist said this predisposed to stones of calcium phosphate

which is

> exactly what mine turned out to be when analyzed. I will read about

bicitra

> and polycitra.have wondered if someone shouldn't have put me on

some form of

> citrate, though half my K is citrate. What I found suggests that

citrate can

> prevent calcium oxalate stones but not calcium phosphate stones. So

maybe

> that is not the answer. Neph also said restricting calcium was not

the

> answer since that would increase oxalate excretion. Sheesh! This

stuff is so

> complicated. I know they checked urine osmolality but not sure blood

> osmolality was checked at the same time. Would that require an

arterial

> draw? They did check serum pH. Dehydration is definitely an issue

for

> me..but I too wonder about overloading fluids and losing even more.

I have

> no idea how to tell when enough is enough. Most of the time my

veins are

> collapsed and the original neph was concerned about that. I am

really hoping

> the new nephrologist will have some idea of how to prevent further

stones,

> as this recent round in hospital/surgery had a dramatic effect on

mito

> status. Not keen on going through that again. I had a stroke-like

episode

> (garbled speech/profound weakness) while attempting to pass the

largest

> stone. Makes ER interesting when you can't talk. Anyway, thanks

again.

>

>

>

> Barbara

>

>

>

> _____

>

> From: [mailto: ]

On Behalf

> Of heidicoleman2002

> Sent: Friday, April 29, 2005 6:02 PM

> To:

> Subject: Re: question re calcium phosphate kidney

stones / RTA

>

>

>

> -Hi Barbara

> I don't have kidney problems but my daughter and mother do. My

> daughter was on bicitra for years (sodium citrate with other

goodies

> thrown in) and had routine renal ultrasounds. Since she's been on

TPN

> she's had extra acetate for her bicarb losses, sodium, calcium and

> potassium to replace losses, low chloride since she doesn't waste

that,

> and low phosphate since hers runs high. We also monitor her serum

> albumin since she wastes more of everything when she's dumping

> protein. also has nephrogenic diabetes insipidus. She

needs

> tons of fluid because she doesn't concentrate well, but we have to

walk

> a fine line between giving her too much and triggering diuresis and

too

> little and getting her dehydrated. You might ask them to check

urine

> osmolality and blood osmolality at the same time. They should

reflect

> the same hydration status.

>

> Wish I could give you better news about my mom. She's been on

dialysis

> for years. She had kidney stones that eventually destroyed her

ureters

> and the microscopic wasting of all sorts of stuff (started with Ca,

Mg,

> Na, and K, then added protein and blood) did her kidneys in. She's

not

> a candidate for transplant because she started getting routine

blood

> transfusions in 1975 and has way too many antibodies (except HIV

and

> hepB and C, thank the Lord)

>

> If you had any specific questions I could try to answer them. As

far

> as the stones, I'm not sure what can be done once you have them.

My

> mom had surgery, scopes, lithotripsy, the whole 9 yards. I think

the

> main focus is on prevention and early detection. Treatment with

> bibitra or polycitra is probably the best wat to do that. But boy

that

> stuff is the most awful tasting liquid around. And it takes a lot

of

> volume to get effects. Good luck.

>

> Hope this helps!

> Heidi

>

>

> -- In , " Barbara Seaman "

> wrote:

> > Is there anyone in the group who has had calcium phosphate kidney

> stones,

> > especially in combination with renal tubular acidosis? What, if

> anything,

> > has been suggested to prevent further stone formation? I have

another

> > consult with a nephrologist coming up, but wanted some input from

mito

> > patients if possible.

> >

> > Also, is there anyone in the group who has a renal leak of

> bicarbonate and

> > calcium (high in urine) along with low citrate? These conditions

> apparently

> > predispose to the formation of calcium phosphate stones. I also

leak

> > potassium, but could not remember anyone in the group mentioning a

> > bicarbonate and calcium leak before.

> >

> > Thanks.

> > Barbara

>

>

>

>

>

> Medical advice, information, opinions, data and statements

contained herein

> are not necessarily those of the list moderators. The author of

this e mail

> is entirely responsible for its content. List members are reminded

of their

> responsibility to evaluate the content of the postings and consult

with

> their physicians regarding changes in their own treatment.

>

> Personal attacks are not permitted on the list and anyone who sends

one is

> automatically moderated or removed depending on the severity of the

attack.

>

>

>

>

>

> _____

>

>

[Guest guest]

Heidi, great info, thanks a lot for sharing these details.

Barbara

_____

From: [mailto: ] On Behalf

Of heidicoleman2002

Sent: Friday, April 29, 2005 7:51 PM

To:

Subject: Re: question re calcium phosphate kidney stones / RTA

-As far as giving too much fluid, that's a big big problem. We keep

strict intake and output on . We weigh every diaper and

measure every drop that goes in and out. It seems like many mito kids

need to be positive by several hundred cc's but is OK if she

is 200cc either way. We total up I and O every 24 hours, at 8am

(it's the most accurate at that time, don't ask me why.) If she's

positive we do nothing. If she's negative by less than 200 we do

nothing. If she's negative 200-300 we replace cc:cc with normal

saline. If she's negative 301-500 we replace cc:cc with 1/2 normal

saline. If she's negative over 501 we replace 1/2cc:cc with 1/2

normal saline and notify metabolism. She can be wildly negative due

to stress (a long car ride, an immunization, etc) and we just watch

her closely. If she's still negative the next day then we wonder if

she's coming down with something and we draw labs. Nothing fancy,

just lytes, LFT's, CBC, cultures. 9 times out of 10 something will

show up. I know that we're not accounting for insensible losses but

she seems to do fine. We don't worry about GI losses either (from

draining g and j tubes), we just total them in.

Extra sugar caused a big problem. She spills sugar very easily and

if you spill sugar it takes K with it. If she loses K she loses Na

and then she doesn't keep the fluids. Low dextrose concentration in

her TPN and tolerating low blood glucoses (50-60) did the trick.

Alkaline urine invites bacteria, you might want to get a bottle of

test strips and test once or twice a week to screen for leukocytes

and nitrites.

Blood osmolality is a venous test.

As far as determining when " enough is enough " , we look for stable BP

and pulse, Na 138-139, K above 4, bicarb above 22, no sugar or

albumin in urine, intake within 200ml of output. She hasn't had any

stones but she gets scanned every 6 months.

My Mom has had stones since her teens, despite being on K and Mg

since then. One of those times she must have had a SLE but the

doctor diagnosed a conversion reaction... geesh.

Heidi

-- In , " Barbara Seaman "

wrote:

> Heidi, Very helpful, thanks. I will print and digest and may have

more

> questions later. A few weeks back I had surgery to remove two

stones, one

> blocking the right ureter, which turned out to be calcium phosphate.

> Previous evaluations by nephrology found wasting of calcium, sodium

bicarb,

> and K, with low citrate, dilute and grossly alkaline urine, etc.

> Nephrologist said this predisposed to stones of calcium phosphate

which is

> exactly what mine turned out to be when analyzed. I will read about

bicitra

> and polycitra.have wondered if someone shouldn't have put me on

some form of

> citrate, though half my K is citrate. What I found suggests that

citrate can

> prevent calcium oxalate stones but not calcium phosphate stones. So

maybe

> that is not the answer. Neph also said restricting calcium was not

the

> answer since that would increase oxalate excretion. Sheesh! This

stuff is so

> complicated. I know they checked urine osmolality but not sure blood

> osmolality was checked at the same time. Would that require an

arterial

> draw? They did check serum pH. Dehydration is definitely an issue

for

> me..but I too wonder about overloading fluids and losing even more.

I have

> no idea how to tell when enough is enough. Most of the time my

veins are

> collapsed and the original neph was concerned about that. I am

really hoping

> the new nephrologist will have some idea of how to prevent further

stones,

> as this recent round in hospital/surgery had a dramatic effect on

mito

> status. Not keen on going through that again. I had a stroke-like

episode

> (garbled speech/profound weakness) while attempting to pass the

largest

> stone. Makes ER interesting when you can't talk. Anyway, thanks

again.

>

>

>

> Barbara

>

>

>

> _____

>

> From: [mailto: ]

On Behalf

> Of heidicoleman2002

> Sent: Friday, April 29, 2005 6:02 PM

> To:

> Subject: Re: question re calcium phosphate kidney

stones / RTA

>

>

>

> -Hi Barbara

> I don't have kidney problems but my daughter and mother do. My

> daughter was on bicitra for years (sodium citrate with other

goodies

> thrown in) and had routine renal ultrasounds. Since she's been on

TPN

> she's had extra acetate for her bicarb losses, sodium, calcium and

> potassium to replace losses, low chloride since she doesn't waste

that,

> and low phosphate since hers runs high. We also monitor her serum

> albumin since she wastes more of everything when she's dumping

> protein. also has nephrogenic diabetes insipidus. She

needs

> tons of fluid because she doesn't concentrate well, but we have to

walk

> a fine line between giving her too much and triggering diuresis and

too

> little and getting her dehydrated. You might ask them to check

urine

> osmolality and blood osmolality at the same time. They should

reflect

> the same hydration status.

>

> Wish I could give you better news about my mom. She's been on

dialysis

> for years. She had kidney stones that eventually destroyed her

ureters

> and the microscopic wasting of all sorts of stuff (started with Ca,

Mg,

> Na, and K, then added protein and blood) did her kidneys in. She's

not

> a candidate for transplant because she started getting routine

blood

> transfusions in 1975 and has way too many antibodies (except HIV

and

> hepB and C, thank the Lord)

>

> If you had any specific questions I could try to answer them. As

far

> as the stones, I'm not sure what can be done once you have them.

My

> mom had surgery, scopes, lithotripsy, the whole 9 yards. I think

the

> main focus is on prevention and early detection. Treatment with

> bibitra or polycitra is probably the best wat to do that. But boy

that

> stuff is the most awful tasting liquid around. And it takes a lot

of

> volume to get effects. Good luck.

>

> Hope this helps!

> Heidi

>

>

> -- In , " Barbara Seaman "

> wrote:

> > Is there anyone in the group who has had calcium phosphate kidney

> stones,

> > especially in combination with renal tubular acidosis? What, if

> anything,

> > has been suggested to prevent further stone formation? I have

another

> > consult with a nephrologist coming up, but wanted some input from

mito

> > patients if possible.

> >

> > Also, is there anyone in the group who has a renal leak of

> bicarbonate and

> > calcium (high in urine) along with low citrate? These conditions

> apparently

> > predispose to the formation of calcium phosphate stones. I also

leak

> > potassium, but could not remember anyone in the group mentioning a

> > bicarbonate and calcium leak before.

> >

> > Thanks.

> > Barbara

>

>

>

>

>

> Medical advice, information, opinions, data and statements

contained herein

> are not necessarily those of the list moderators. The author of

this e mail

> is entirely responsible for its content. List members are reminded

of their

> responsibility to evaluate the content of the postings and consult

with

> their physicians regarding changes in their own treatment.

>

> Personal attacks are not permitted on the list and anyone who sends

one is

> automatically moderated or removed depending on the severity of the

attack.

>

>

>

>

>

> _____

>

>

[Guest guest]

Have you tried journal searches for " calcium phophate " " kidney

stones " ? Here is something I found about them:

Calcium Phosphate Stones

Calcium phosphate stones do not occur as commonly as calcium oxalate

stones do. Therapy for calcium phosphate stones is similar to that of

calcium oxalate stones. The one exception is with regard to high

oxalate in the urine, which patients with calcium phosphate stones

don't have, and therefore does not have to be addressed. In addition,

in contradistinction to calcium oxalate stones, these stones thrive

not in acidic, but in basic conditions. Treatment is therefore

acidification of the urine. This can be achieved through cranberry

extract. A diet rich in whole grains has been shown to acidify urine,

and contains little of the phosphorous plentiful in animal protein.

Additionally, the bran in grains binds excess calcium before it

concentrates in the kidneys. We will guide our calcium phosphate

stone patients through a diet rich in whole unrefined grains,

assuming they are not sensitive to gluten.

(from http://www.drhoffman.com/page.cfm/552)

Cranberry juice seems to be the cure for all urinary tract ills, lol.

Take care,

RH

> > Is there anyone in the group who has had calcium phosphate kidney

> stones,

> > especially in combination with renal tubular acidosis? What, if

> anything,

> > has been suggested to prevent further stone formation? I have

another

> > consult with a nephrologist coming up, but wanted some input from

mito

> > patients if possible.

> >

> > Also, is there anyone in the group who has a renal leak of

> bicarbonate and

> > calcium (high in urine) along with low citrate? These conditions

> apparently

> > predispose to the formation of calcium phosphate stones. I also

leak

> > potassium, but could not remember anyone in the group mentioning a

> > bicarbonate and calcium leak before.

> >

> > Thanks.

> > Barbara

>

>

>

>

>

> Medical advice, information, opinions, data and statements

contained herein

> are not necessarily those of the list moderators. The author of

this e mail

> is entirely responsible for its content. List members are reminded

of their

> responsibility to evaluate the content of the postings and consult

with

> their physicians regarding changes in their own treatment.

>

> Personal attacks are not permitted on the list and anyone who sends

one is

> automatically moderated or removed depending on the severity of the

attack.

>

>

>

>

>

> _____

>

>

[Guest guest]

Thanks for taking the time to do some searches, RH. Much appreciated.

Unfortunately, I cannot eat gluten at all, rice being the only grain I can

eat and only in small amounts. GI cannot tolerate cranberry either. There

are 6 foods I can eat: chicken, turkey, rice, potato, egg, plain non-fat

yogurt. These limitations complicate any dietary manipulation considerably.

We might be able to administer " something " through my J-tube, but the

question is what. Yes, I have done journal searches on PubMed, as well as

general Google searches on urologychannel.com etc. Information I have seen

in recent PubMed abstracts would disagree with what drhoffman.com

recommends, in that taking citrate (acidification) has been shown to prevent

calcium oxalate stones, but does not prevent calcium phosphate stones. This

would fit with what my nephrologists have said in the past, but we'll see

what the new one recommends. I will also take a can of Advera to the

consult, in case he thinks my formula may be contributing unwelcome stuff re

the stones. He will also need to address the RTA again, as this is the cause

of the imbalances in the urine and the resulting stones.

Barbara

_____

From: [mailto: ] On Behalf

Of ohgminion

Sent: Saturday, April 30, 2005 8:23 AM

To:

Subject: Re: question re calcium phosphate kidney stones / RTA

Have you tried journal searches for " calcium phophate " " kidney

stones " ? Here is something I found about them:

Calcium Phosphate Stones

Calcium phosphate stones do not occur as commonly as calcium oxalate

stones do. Therapy for calcium phosphate stones is similar to that of

calcium oxalate stones. The one exception is with regard to high

oxalate in the urine, which patients with calcium phosphate stones

don't have, and therefore does not have to be addressed. In addition,

in contradistinction to calcium oxalate stones, these stones thrive

not in acidic, but in basic conditions. Treatment is therefore

acidification of the urine. This can be achieved through cranberry

extract. A diet rich in whole grains has been shown to acidify urine,

and contains little of the phosphorous plentiful in animal protein.

Additionally, the bran in grains binds excess calcium before it

concentrates in the kidneys. We will guide our calcium phosphate

stone patients through a diet rich in whole unrefined grains,

assuming they are not sensitive to gluten.

(from http://www.drhoffman.com/page.cfm/552)

Cranberry juice seems to be the cure for all urinary tract ills, lol.

Take care,

RH

> > Is there anyone in the group who has had calcium phosphate kidney

> stones,

> > especially in combination with renal tubular acidosis? What, if

> anything,

> > has been suggested to prevent further stone formation? I have

another

> > consult with a nephrologist coming up, but wanted some input from

mito

> > patients if possible.

> >

> > Also, is there anyone in the group who has a renal leak of

> bicarbonate and

> > calcium (high in urine) along with low citrate? These conditions

> apparently

> > predispose to the formation of calcium phosphate stones. I also

leak

> > potassium, but could not remember anyone in the group mentioning a

> > bicarbonate and calcium leak before.

> >

> > Thanks.

> > Barbara

>

>

>

>

>

> Medical advice, information, opinions, data and statements

contained herein

> are not necessarily those of the list moderators. The author of

this e mail

> is entirely responsible for its content. List members are reminded

of their

> responsibility to evaluate the content of the postings and consult

with

> their physicians regarding changes in their own treatment.

>

> Personal attacks are not permitted on the list and anyone who sends

one is

> automatically moderated or removed depending on the severity of the

attack.

>

>

>

>

>

> _____

>

>

[Guest guest]

Hmmm. Could you get an ultrasound every six months to look for

stones? Maybe they could treat them when small and you could avoid

pain from them.

The several things I saw said that renal tubule acidosis indicated

that calcium phosphate stones can be associated with that condition.

I also found this on the NIDDK website...

> In addition to limiting phosphorus in the child's diet, the doctor

> may recommend a phosphate binder. This medicine binds some of the

> phosphorus in the bowel so that it is excreted in the child's

> stool. Phosphate binders come in the form of chewable tablets,

> liquids, capsules, and pills. Some people can use over-the-counter

> antacid tablets as phosphate binders because they contain calcium.

> Your child's doctor, however, may prescribe a newer calcium-free

> binder if calcium buildup in the blood is a concern. The child

> should take the phosphate binder with meals and only according to

> the doctor's recommendations.

Take care,

RH

> > > Is there anyone in the group who has had calcium phosphate

kidney

> > stones,

> > > especially in combination with renal tubular acidosis? What, if

> > anything,

> > > has been suggested to prevent further stone formation? I have

> another

> > > consult with a nephrologist coming up, but wanted some input

from

> mito

> > > patients if possible.

> > >

> > > Also, is there anyone in the group who has a renal leak of

> > bicarbonate and

> > > calcium (high in urine) along with low citrate? These

conditions

> > apparently

> > > predispose to the formation of calcium phosphate stones. I also

> leak

> > > potassium, but could not remember anyone in the group

mentioning a

> > > bicarbonate and calcium leak before.

> > >

> > > Thanks.

> > > Barbara

> >

> >

> >

> >

> >

> > Medical advice, information, opinions, data and statements

> contained herein

> > are not necessarily those of the list moderators. The author of

> this e mail

> > is entirely responsible for its content. List members are

reminded

> of their

> > responsibility to evaluate the content of the postings and

consult

> with

> > their physicians regarding changes in their own treatment.

> >

> > Personal attacks are not permitted on the list and anyone who

sends

> one is

> > automatically moderated or removed depending on the severity of

the

> attack.

> >

> >

> >

> >

> >

> > _____

> >

> >

[Guest guest]

Yep, calcium phosphate stones are associated with RTA, so it all makes

sense. My particular imbalances in urine are also very typical of RTA. I

like your idea of having periodic ultrasounds. I'm hoping the neph will

recommend something like that-I may try to tactfully ask, depending on how

open he seems. The original urologist had recommended annual x-ray, but my

PCP didn't think that was necessary, so he didn't do it. The phosphorus

stuff you found from NIDDK is interesting..I do take K-Phos Neutral and have

for a year, but I know that the largest stone was there long before I

started that drug, so it may not contribute. However, I'm wondering if the

neph will want me off it...he may. Combined with creatine, the K-Phos

Neutral has definitely helped boost phosphocreatine as an alternate source

of ATP in muscle. So I'd hate to give it up, but..we'll see.

Anyway, thanks again. Your help always appreciated.

B

_____

From: [mailto: ] On Behalf

Of ohgminion

Sent: Saturday, April 30, 2005 12:59 PM

To:

Subject: Re: question re calcium phosphate kidney stones / RTA

Hmmm. Could you get an ultrasound every six months to look for

stones? Maybe they could treat them when small and you could avoid

pain from them.

The several things I saw said that renal tubule acidosis indicated

that calcium phosphate stones can be associated with that condition.

I also found this on the NIDDK website...

> In addition to limiting phosphorus in the child's diet, the doctor

> may recommend a phosphate binder. This medicine binds some of the

> phosphorus in the bowel so that it is excreted in the child's

> stool. Phosphate binders come in the form of chewable tablets,

> liquids, capsules, and pills. Some people can use over-the-counter

> antacid tablets as phosphate binders because they contain calcium.

> Your child's doctor, however, may prescribe a newer calcium-free

> binder if calcium buildup in the blood is a concern. The child

> should take the phosphate binder with meals and only according to

> the doctor's recommendations.

Take care,

RH

> > > Is there anyone in the group who has had calcium phosphate

kidney

> > stones,

> > > especially in combination with renal tubular acidosis? What, if

> > anything,

> > > has been suggested to prevent further stone formation? I have

> another

> > > consult with a nephrologist coming up, but wanted some input

from

> mito

> > > patients if possible.

> > >

> > > Also, is there anyone in the group who has a renal leak of

> > bicarbonate and

> > > calcium (high in urine) along with low citrate? These

conditions

> > apparently

> > > predispose to the formation of calcium phosphate stones. I also

> leak

> > > potassium, but could not remember anyone in the group

mentioning a

> > > bicarbonate and calcium leak before.

> > >

> > > Thanks.

> > > Barbara

> >

> >

> >

> >

> >

> > Medical advice, information, opinions, data and statements

> contained herein

> > are not necessarily those of the list moderators. The author of

> this e mail

> > is entirely responsible for its content. List members are

reminded

> of their

> > responsibility to evaluate the content of the postings and

consult

> with

> > their physicians regarding changes in their own treatment.

> >

> > Personal attacks are not permitted on the list and anyone who

sends

> one is

> > automatically moderated or removed depending on the severity of

the

> attack.

> >

> >

> >

> >

> >

> > _____

> >

> >