Should you have your kidney stone analyzed?

The following is designed to entertain and inform, not provide medical advice. Always consult your doctor before starting any treatment.

Welcome back to the Kidney Stone Diet podcast, the show about reducing your kidney stone risk and living your best life. I'm your host and fellow student, Jeff Sarris.

And I'm Jill Harris, your kidney stone prevention nurse.

And, again…

I forgot, we haven't–well, we've talked about non-dairy products a bunch and how you can get calcium and things like that. Have you tried the Miyoko's Mozzarella?

Do you know that brand?

I don't care about mozzarella.

Oh, yeah?

I don't know why. I just don't. Well, it's just boring to me.

If I'm going to use cheese, which–which I do, but I always watch my salt, because I follow Kidney Stone Diet goals, because my family has kidney stones, I usually, first of all, let me just say this. Jeff's like, "Oh, Jesus. How could she make a whole show about this stupid question I'm asking?

Shut up, Jeff, I'm going to tell you."

[laughter]

So, mozzarella cheese, you would think I'm Italian, I love it, but I mean at the end of the day, folks, it just doesn't have that much flavor. To me, cheddar cheese is delicious. I don't eat it, I have cholesterol issues, genetically.

I don't want the extra salt. People are like, "I love cheddar, that's how I'm going to get my calcium." I'm like, "I'm sure you do love cheddar, it's just fat and salt! Of course you do." Plus it's a pretty color orange.

Yeah.

So, mozzarella to me is boring. If I'm going to put any cheese on any of my food, it's going to be parmesan. Parmigiano, baby!

I love it! It's very salty, so I just use a little bit. But so mozzarella, I'm, you know, no.

I don't waste my–I don't waste my caloric or salt budget on mozzarella. So tell me what's great about it, though, because my–my patients love mozzarella cheese.

Oh, yeah. I mean, it's really interesting. So, I'm not typically into sort of the vegan products.

So, but this is a vegan cheese. A lot of times, they have a lot of junk in them. This one–

Well, and a lot of salt.

Yeah, so that is the challenge. This isn't low-salt by any means, but I was shocked by the taste, and it uses a cashew milk base. So, obviously, cashews, nuts, oxalates, just all of that, it's not–you're not gorging on it, but it's something that I've never encountered a cheese, an–a cheese alternative, that tastes this similar.

It's really fascinating.

Wow, that's–that's cool. That's cool because, you know, they've been making these non-dairy cheeses for a very long time, pretty long time. And the first one was probably, I don't know, made out of almonds, and they all were not that great.

But, you know, vegans are like, "It's all I got, so I'm going to have it." And so much salt, a lot of my vegan patients had no idea how much salt they were eating, right? But, you know, they've–just these non-dairy cheeses have gotten better and better and better. So, that's–that's awesome to know.

Yeah, and it's interesting, it comes in like a–a wheel kind of thing, like a small wheel, or it's a pourable cheese if you're making like pizza or something, which I thought was an interesting idea. So, they instead of trying to make it solid and have it melt, you pour it and then when it bakes, it actually gives like a melted kind of cheese vibe to it.

It's really interesting. This isn't an ad for Miyoko's, I was just–I was curious if you tried it.

Very cool. We're not going to support them because of cashew and its salt, so no. Of course, I've not–used it, yet, no, right.

Yeah.

But, yeah, I just thought it was interesting and–

It is interesting.

Yeah, I was just curious. But anyway, we should probably get into this week's question.

All right.

This is from Laura.

Laura. Laura, Laura, Jeff–

Hi, this is Laura calling from Portland, Maine. I have medullary sponge kidney and renal tubular acidosis. The diet plan has really helped a lot, just more feeling empowered that I can do something.

But my question is, I just passed another stone this morning and every time I do, the urologist wants to analyze it. And it has always been 100% calcium phosphate. So my question is, why do they continue to analyze it?

I'm wondering if they're looking for infection or if you know. So it just seems like, you know, I want to get medicine because I don't want to get a–a kidney infection, which I often do, but in order to give me antibiotics, they always seem to need to analyze the stone and run a test. So, I guess it seems like that's maybe a new protocol now.

Just wondering. Thanks so much. Bye-bye.

Well, I love that question. Number one, we've never had it. And she has two pre-condition–two, pre-existing conditions that can have somebody definitely more prone to kidney stones: MSK, which is medullary sponge kidney, where the kidneys are like, you know, the crystals and solutes that are in there are hard to just come out because the kidneys are actually like spongy and they get stuck in these little pockets.

And the other thing is RTA, where the kidneys have a hard time getting rid of excess acid. So, and that's pretty rare. Most of you who are listening are not going to have RTA, so don't worry about it.

And most of you don't have MSK. And quite frankly, MSK is misdiagnosed lots of times, too. But there are a lot of people that do have MSK, okay?

So, and imaging would show that. Your urologist would know that. So, let's see, she's asking, Laura's asking, why in God's name–this is my version of what Laura's saying.

Laura said it very adorably and sweet, but my crass way is going to be: why the hell are they keep analyzing these stones, Jill? They're always calcium phosphate, why? Is this new protocol?

It's not! Actually, your doctor is A+ on the ball. Every stone should be analyzed.

Most docs don't even send the stones for analysis. And a lot of docs will say, " you had a calcium oxalate the first time, we don't need to–you make calcium oxalate stones." But Laura, your doctor is really on the ball because even though you have always had calcium phosphate stones, your next one may be a combination!

So, the doctor wants to make sure, and is he looking for an infection in there? Is there? Could be.

Would it–would it–would it be he's going to put you on a different antibiotic? There's many reasons, which is ask your doctor why the analysis is important. But every stone should be analyzed, absolutely.

Your doctor is doing what the gold standard is, so you're with a good doctor. Because stones can switch. There's other people that will say, when I'm doing a medical intake on them, I ask, "What did the stone analysis say?" "Oh, the doctor just said I always get my calcium oxalate stones, so he's not going to send them anymore." And then a patient–the patient calls me back the next year, because they have their annual urine collection and we're going over it, and the doctor–the patient will say, "Well, you know what?

The doctor just happened to analyze this one, and it was a combination stone. So, it was calcium oxalate and a calcium phosphate stone." So, the doctor's paying attention to that going forward. So, even though you've had calcium phosphate stones every time, as you have said, could be that changes.

So, the doctor is doing what the doctor is supposed to do, and rarely do doctors do that, so it's impressive, actually. You're with a good doctor, it seems like. I only know what you've told me, but it seems like he's taking good care of you or she is taking good care of you.

And the other thing is, people will come to me and say, "Jill, I have MSK and my doctor said I'm just a stone maker." Oh, absolutely not! You are not doomed because you have sponge kidneys, you are not doomed. The diet will help.

I have so many patients that come to me with MSK, and they tell me exactly that, "My doctor said diet's not going to help." That would be hell no! Yes, diet will help. Let me just say this: even if the diet didn't help you with kidney stones, low salt, low added sugar, getting calcium for your bones, not overeating a side of beef every day, getting enough fluids, come on, folks!

It's just a healthy way to eat. Do you know how many of my patients get off blood pressure medications, their A1C has dropped, they're not on their diabetic medications anymore? They're off all kinds of meds.

Why, because I'm a genie? Jeff is king of the world? No!

Because they're eating well, because the kidney stone scared the crap out of them! And they're getting all their–they never want to go through a stone again, and all of a sudden they're starting to pay attention and be mindful of how they're eating. And guess what?

These medications are now going away, because they're lowering salt. Listen, Laura's like, "I didn't ask this, Jill." Shut up, Laura, hold on! Let me tell you this! [laughter] Let me tell you: I am–what makes me happy as a nurse, or here, what makes me unhappy: we are spending zillions of dollars a year helping people manage chronic illness.

So much of this can be taken away. These meds can be taken away in a lot of cases, and we could save a lot of money if people just ate better. But what happens is, and I hear this every day, " yeah, my cholesterol's high, but I'm on a med.

Oh, yeah, my blood pressure's high, but I'm on a med." You still have to lower your salt. Why wouldn't you want to get off that medication? Why wouldn't you want to get off the medication?

So people become very–they're just complacent because a medication is handling their disease. But, and people–people all day long also say this to me, "I just want to do everything natural. I'm going to take the pill." There's nothing more natural than having a diet change, eating real food, eating more fruits and vegetables, watching how much if you eat meat, how much of it you're eating every day, keep your saturated fats low, for those of you on keto and it doesn't bother you, God bless, you're rare, but getting enough fluids, all of these things, staving off bone disease by getting enough calcium, whether it's non-dairy or dairy.

These are all really important things, and just think how much money our healthcare system could save and we could save if we just changed our diet instead of relying on pills. And yes, it's a hell of a lot easier to take a pill than it is to change your diet. But you're really just masking your issues, folks.

So, what I love about Laura is that she said, "Look, I got these things, but the diet is helping." If Laura didn't do the diet, these things could be worse for her. Is there any guarantee with RTA and MSK that Laura has, is there any guarantee that she would, stop making stones even with the diet? No.

No. She may still make stones, but I promise you this: there is a guarantee of lowering the occurrence, lowering how big they get. There's that, because I have plenty of MSK patients for decades and they're like, "Yep, still no more new stones.

The ones I have not grown." So, it's just a great question and, yes, your doctor seems very much on the ball from what you've told me. Every stone you all make should be analyzed, because just because you've made one calcium oxalate stone doesn't mean that's what you always make. Many of my stone formers have combination stones and would never know that unless they had their stone analyzed.

And a lot of doctors don't analyze stones, so there's that. So, remind your doctor if you've had a surgery or you have passed one, if you have passed one, get them out of your underwear drawer and bring them to your doctor's office. Don't be saving them in a little jar, a lot of people do that.

Bring them to your doctor's office and get them analyzed. The end.

Well, yeah, and that's a great question just because that's something that, isn't necessarily a given for everyone across the board, and like you said, it's really good that the doctor is being proactive with this just to make sure that you know your results. You–you know what's happening within your own body.

Yes. Yes, I'm very happy with that doctor. A+.

So, thanks again for that question, Laura. If you're out there with a question for Jill, the number is 773-789-8763 and we'd love to feature your voice on a future episode. And if you want to dive deeper, you can always go over to kidneystonediet.com where you can find every–whoa, I just hit a button with my finger! [laughter]

That's the Morse code! That's so funny, I love it! That's tomorrow's show. [laughter]

So, anyway, if you want to dive deeper, you know always go to kidneystonediet.com where you can find everything from the Kidney Stone Prevention Meal Plans, the Kidney Stone Prevention Course, the group coaching calls with Jill, which is the steal of a lifetime, because you can work directly with Jill in a group setting and really get to–to the heart of what's going on with you and share with others, as well, who are experiencing something very similar.

And, yeah, it's just a very valuable service. People get so much out of it and I know Jill does, as well, being able to work with people at scale, because it's hard to do only privates, only one-on-ones, because you can only reach so many people that way.

I love it. Yeah.

So, you can find that and all the free resources at kidneystonediet.com. So, I think with that, we will wrap for this week. And thanks again for tuning in.

We'll see you next time.

Thanks, Laura! Great question!