A 2-mm calculus was removed by basket extraction. Pathologic examination reported the stone to be
calcium oxalate.
If S.R. continues to form calcium oxalate stones, what recommendations would the physician
make for S.R.?
What will be an ideal response?
• Obtain a 24-hour urine collection for stone protocol to identify the cause of the stone, such as high
urinary calcium or elevated urinary uric acid levels.
• Check parathyroid hormone (PTH) level. PTH allows for the release of calcium into the blood.
In cases of stone formation, too much calcium is released into the blood that is filtered by the
kidneys, and it precipitates to form stones. Further investigation would be needed to rule out
hypercalciuria and hypercalcemia as well as hyperparathyroidism.
• Refer her to a nephrologist or urologist.
• Refer her to a registered dietitian for diet modification, based on the discovery of calcium oxalate
stones.
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