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Have Lower Pole Renal Calculus. Suggest Medication

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Posted on Tue, 18 Sep 2012
Question: Dear Doctor,
I have been diagnosed with left lower pole renal calculus (0.58 cms). Please kindly suggest me the medication or practice that I have to adhere.
After diagnonis, I have been taking adequate water 3.5 to 4 liters of water.
doctor
Answered by Dr. V. Sasanka (2 hours later)
Dear Mr XXXXXXX
Hi,
I do not know under what circumstances the scan was taken (e.g. did you go because you had pain?) but usually a 0.58cm calculus should not be bothering you too much. It is unlikely to be the cause of pain, located as it is in it's present location within the kidney. It can drop from the kidney into the ureter and can then cause some pain, but what we find is most people do manage to pass stones less than 6mm without too much discomfort.
Having said that, if you are keen on getting rid of the stone, the options available are
1) ESWL - shock wave lithotripsy focusing only on the calculus provided you can be off blood thinners which you might have been after the stroke. Before doing this procedure, you might have to get a few more specialized tests done like IVU or CT scan of KUB to localize the stone, and find out how hard it is ( a hard stone located low in the kidney might be more difficult to clear)
2) Laser with Holmium:YAG which is an endoscopic procedure which is relatively more demanding technically, but in view of the small size of the stone, should not be too much of a problem.
You can also try and see if you can take more fluid as a routine, because once a stone former, always a higher risk of future stone formation. Try to reduce salt in your diet. Avoid a high oxalate diet like one containing too many greens leafy vegetables, dry fruits. these are only recommendations and do not necessarily mean they will stop stone formation in the future completely.
Hope this answers all your questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. V. Sasanka (42 minutes later)
Dear Dr.Sasanka,

Thanks for your answer. The scan report was resultant of my early Medical Check Up.
Your mail gave me bit of confidence. As I was frightened by the stone size.

Further to it, should I stop or reduce intake of dry fruits.
current in take: 3 dates, 5-10 pieces of dry grapes and 2 apricots and 1 fig a day.
walnuts 4 pcs, almonds 2 pcs and pista 2 pcs /day.

please advice which of the above should be avoided or should I reduce the quantity.

Many thanks for your quick reply.

kind regards, XXXXXXX Prasad
doctor
Answered by Dr. V. Sasanka (38 minutes later)
Hi again,
As I said earlier, complete elimination of dry fruits does not mean a complete withdrawal of the chances of formation of urinary stones in the future. These dry fruits have a relatively higher concentration of oxalates, and thus pose a higher risk of stone formation, and there is no standard recommendation that you can have 'x' amount of this fruit, and 'y' amount of the other. If you can cut down and have them only occasionally,( there is no proven benefit or need for taking them all together at the same time) - well and good. If you cannot, you can always try and see if your improved fluid intake is countering the higher risk of oxalate stone formation. the fluids need not be only water - butter milk, coconut water, juices also help.
You can include milk in your diet liberally. Lot of misconceptions exist regarding milk. The present recommendations are to take about 2 glasses of milk per day. The calcium in the milk will bind to the oxalate in the stomach and intestines and prevent it from getting absorbed. Avoid calcium tablets.
Also see if you restrict salt in diet. It does help in reducing the chance of stone formation in the future.
Trust this has more than answered your question.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. V. Sasanka

Urologist

Practicing since :1995

Answered : 529 Questions

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Have Lower Pole Renal Calculus. Suggest Medication

Dear Mr XXXXXXX
Hi,
I do not know under what circumstances the scan was taken (e.g. did you go because you had pain?) but usually a 0.58cm calculus should not be bothering you too much. It is unlikely to be the cause of pain, located as it is in it's present location within the kidney. It can drop from the kidney into the ureter and can then cause some pain, but what we find is most people do manage to pass stones less than 6mm without too much discomfort.
Having said that, if you are keen on getting rid of the stone, the options available are
1) ESWL - shock wave lithotripsy focusing only on the calculus provided you can be off blood thinners which you might have been after the stroke. Before doing this procedure, you might have to get a few more specialized tests done like IVU or CT scan of KUB to localize the stone, and find out how hard it is ( a hard stone located low in the kidney might be more difficult to clear)
2) Laser with Holmium:YAG which is an endoscopic procedure which is relatively more demanding technically, but in view of the small size of the stone, should not be too much of a problem.
You can also try and see if you can take more fluid as a routine, because once a stone former, always a higher risk of future stone formation. Try to reduce salt in your diet. Avoid a high oxalate diet like one containing too many greens leafy vegetables, dry fruits. these are only recommendations and do not necessarily mean they will stop stone formation in the future completely.
Hope this answers all your questions.
Regards.