Kidney Stones
Conditions We Treat
Kidney Stones
Recurrent kidney stone formers need metabolic evaluation, not just urology. We identify the underlying cause and prevent future stones.
What are kidney stones?
Kidney stones are hard deposits of minerals and salts that form inside the kidneys. They develop when urine becomes concentrated, allowing minerals to crystallize and stick together. Stones can range from a grain of sand to a golf ball. Small stones often pass on their own; larger stones may require urological intervention.
The most common type is calcium oxalate stones, accounting for roughly 80% of cases. Other types include uric acid stones (associated with gout and metabolic syndrome), struvite stones (associated with urinary tract infections), and cystine stones (caused by a rare genetic disorder). Each type has a different cause and requires a different prevention strategy.
A single kidney stone episode may be managed by a urologist. But patients who form stones repeatedly — or who form stones at a young age, or who have a family history of stones, or who have only one kidney — need a metabolic evaluation by a nephrologist to identify the underlying cause and prevent recurrence.
Stone Types
How we approach kidney stones
24-hour urine metabolic evaluation
A 24-hour urine collection measures calcium, oxalate, uric acid, citrate, sodium, and pH — identifying the specific metabolic abnormality driving stone formation. This is the foundation of prevention.
Stone composition analysis
When a stone is recovered, we analyze its composition. Calcium oxalate, uric acid, struvite, and cystine stones each have different causes and require different prevention strategies.
Dietary and fluid counseling
Increasing fluid intake to produce more than 2.5 liters of urine per day is the single most effective prevention strategy. Dietary modifications depend on stone type — low oxalate for calcium oxalate stones, low purine for uric acid stones.
Medical therapy
Thiazide diuretics reduce urinary calcium. Potassium citrate alkalinizes the urine and prevents uric acid and cystine stones. Allopurinol reduces uric acid production. We select medications based on the metabolic evaluation.
Frequently asked questions
Why do I keep forming kidney stones?
Recurrent stone formation indicates an underlying metabolic abnormality — excess urinary calcium, oxalate, or uric acid; insufficient citrate; or abnormal urine pH. A 24-hour urine metabolic evaluation identifies the specific problem and guides prevention.
Do I need to see a nephrologist for kidney stones?
A single stone episode can be managed by a urologist. But recurrent stone formers, patients who form stones at a young age, those with a family history of stones, and those with only one kidney should see a nephrologist for metabolic evaluation and prevention.
What is the most effective way to prevent kidney stones?
Increasing fluid intake to produce more than 2.5 liters of urine per day is the most effective single intervention. Beyond that, prevention depends on stone type — dietary modification and medications are tailored to the metabolic evaluation results.
Can kidney stones damage the kidneys permanently?
Yes. Recurrent stones can cause scarring, obstruction, and progressive kidney damage. Patients with recurrent stones, staghorn calculi, or stones in a solitary kidney are at particular risk and benefit most from nephrology management.
Related conditions
Recurrent kidney stones have a cause. We find it.
Our nephrologists perform metabolic stone evaluations and build prevention plans. Accepting new patients in Newport Beach.