How Doctors Diagnose Kidney Stones
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Kidney stones are made of minerals and other substances that can be found in the urine that can be identified with testing. Types of kidney stones include calcium stones (both calcium-oxalate and calcium phosphate stones), uric acid stones, struvite stones, and cystine stones.
Notably, a urinalysis test and urine culture can also tell doctors whether you also have an infection, which is a potentially life-threatening complication in combination with a kidney stone, says Seth K. Bechis, MD, an associate professor of urology at UC San Diego Health in California. If urine is trapped behind an obstructing stone in the ureter, urine can become infected. This scenario can cause an infection of the kidney tissue or spread to the bloodstream.
Doctors may perform the following urine tests in kidney stone diagnosis:
Urinalysis With Microscopy For this test, urine is analyzed under a microscope to look for crystals made of minerals that are associated with specific types of kidney stones, says Hashmi. For example, uric acid crystals may be found in the urine of someone with uric acid stones. Calcium oxalate crystals in the urine may indicate a calcium oxalate stone.
A urinalysis with microscopy can also help doctors find evidence of bleeding or infection, says Dr. Maalouf.
24-Hour Urine Collection Doctors often perform a 24-hour urine collection, says Maalouf. This means patients need to collect all of their urine in a container over a 24-hour period. Some doctors recommend two of these tests over two consecutive days.
From this urine sample, doctors can tell whether people are predisposed to stone formation. “We call it a stone risk profile,” says Maalouf.
The test measures levels of calcium, oxalate, and uric acid, which are found in certain types of kidney stones, says Anil Agarwal, MD, a clinical professor of nephrology at the University of California San Francisco School of Medicine.
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