Physicians Use Clinic to Prevent Recurring Kidney Stones
Ann B. DeBellis
Recurring kidney stones are a problem for a number of people, especially those living in the Southeast’s hot, humid climate. Men who work outside may be more susceptible because of excess loss of fluids combined with inadequate fluid intake. Urology Centers of Alabama has a kidney stone prevention clinic where urologists help patients find answers to this problem.
Most people who suffer from recurring kidney stones have a genetic predisposition to the condition, according to urologist Rodney Dennis, MD, who developed the clinic. “These patients typically are predisposed to having recurrent stones, but there are certain things that can cause one patient to develop stones more than others,” Dennis says. “Those things can include diet, dehydration, how much they sweat, or medications they are taking. Medical problems such as hyperparathyroidism, gout, chronic diarrhea and several other inflammatory gastrointestinal (GI) problems, including GI surgeries, also can increase the risk.”
Dennis and the physicians at Urology Centers of Alabama use various methods to treat kidney stones, including shockwave lithotripsy, ureteroscopy, nephroureteroscopy, laser lithotripsy, ultrasonic lithotripsy, stone basket extraction, percutaneous nephrolithotomy, and double J stents. However, prevention of kidney stones is the goal for these urologists, and the prevention clinic is helping with that effort.
“All urologists are trained to treat kidney stones, but our goal in this clinic is to find a way to prevent a patient from ever having a new stone,” Dennis says. “Determining why a patient forms the stones can be a difficult process. It’s time consuming and takes a bit of detective work to get the background information needed to figure out how to prevent these stones. We do several things in the clinic that generally are not done for the usual, run-of-the-mill stone.”
Clinic patients complete a questionnaire that can be helpful in determining what dietary factors and medications might cause them to have an increased risk. Clinic staff also draws special blood work for these patients. “We use 24-hour urines that patients collect and send to the lab. We do a metabolic evaluation to help us figure out what’s going on in a patient’s body that could cause them to have kidney stones,” Dennis says.
Dennis also has developed a special electronic medical records template to use as an easy reference. “It helps me remember some of the complex associations between the labs we are seeing and some of the treatment and diagnostic options. The template is easily used by any physician and can help them find answers to diagnostic questions,” he says.
Dennis has focused on the kidney stone prevention clinic for about two years. “The clinic has matured over time and we change or add things depending on circumstances,” he says. “So far, 95 percent of our clinic patients have been able to avoid the development of new stones.”
Dennis is cautious about that success, because it is based on only two years’ worth of information. “Kidney stones definitely are a potentially lifelong problem, but I’ve been pleased with our results so far.”
Reducing health care costs is another goal for Dennis and the other physicians at Urology Centers of Alabama, and prevention of what is a chronic condition for many people can save money in the long run. They want to help as many people as they can, and their clinic generally accepts referrals from other physicians who call their office.
“A lot of patients will have recurrent kidney stones and it’s something they think they just have to live with,” Dennis says. “Because kidney stones are something that they have come to expect, they are excited when they realize there are things we can do to help them avoid the problem.”