What do these lab results mean?

This is episode 300, and for the very first time, we're going to look at a urine collection so you can better understand your results. Welcome back to the Kidney Stone Diet podcast, number episode number 300. I'm your host and fellow stone former Jeff Sarris.

It's it's crazy that it's that many. Feels like just yesterday.

Yeah.

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

It is very crazy. Like 300 is, especially weekly, I mean 300 is lots of weeks.

Lots of weeks, baby, lots of weeks.

But, yeah, we're we're doing something that we've never done before, now. So, we are going to, maybe pull back the curtain a little bit and show people what are these results on a urine collection and what does this actually mean? Because you're working with patients all the time.

Like, this is, you have direct consults with patients at kidneystonediet.com, and the very first thing they do is get a urine collection because this collection tells you what you need to know to help them.

My job is to make very complicated, sciency stuff simple. Because if we as patients don't understand our disease, and we as patients don't understand our results, we are never going to be compliant with treatment. And so, one of my specialties is taking very complex information and making it simple.

Not only simple, but very specific to each person I'm talking to. That matters to me as a nurse. That matters to me as a patient with my cancer stuff, and that matters to me just human to human.

So, my consults are breaking these results down in a very humanistic way, also bonding with each of you with all the obstacles, the dietary restrictions, the medical conditions you have, the food allergies, sorry, I've been sick, folks, all of the things so that you can say, "Oh my God, now I understand it better." Instead of, you know, when I was going through my cancer, you go into a doctor's office visit and they're doing their best.

Look, they have many patients they have to see. They open up results, they're like, "Bap, boop, bap, bap." Now, you're in the office and you're anxious cuz you're sick, first of all. So, your memory, all of it is kind of, and you're hearing words you've never heard before.

Or, the doctor barely goes over results, and if he or she does, you don't even have a copy in your hand so you can see it. So, when I do my urine consultations, the patient knows to have their result handy, and I'm going to take their hand and we're going to sit next to each other, well, on the phone anyway, and we're going over all of these things in a way that each person can understand it, so they can be compliant to the treatment plan.

All right, Jeff, now, so, this is Litholink, and that's a laboratory, and they do 24-hour urine collections. And so, it doesn't matter what laboratory you use. I like Litholink because their quality is bar none.

And also, I love their reporting process because, Jeff, do you have a pointer where you can point things out?

I have my mouse here, can you see that?

Yeah, that's great. So, can you go to the first thing? It says volume right there.

We're mostly going to go in order. Great. So, Litholink shows every time you do a test with Litholink, if you did one 10 years ago and you did one in May, they are going to put those results together, so you can see the healthcare person can see and you as the patient can see how am I doing over time.

My first test in 2019, I peed out 2.3 L. Look at me now! Look at me now in May of 2026, holy perzhole, 3.6 L.

I nearly feel filled up the whole darn jug. I'm amazing. So, this I can see this patient over time has increased their urine volume.

That is huge. Because the more, go ahead.

Oh, real quick real quick, for anyone who's listening, we would recommend going to the video version of this, cuz you can actually see a screenshot of a urine collection. I guess we haven't, clarified that, but yeah, if you're on audio only, head on over to YouTube and you can see exactly line by line as Jill goes through this urine collection.

So, the volume is how much, for people who've never seen a urine collection, never done a urine collection, and people, if you don't get one, you're going to keep making stones. You have to see why you're forming stones. There's many values on this test that you don't know is a problem, and you're just being told not to have spinach or drink more water or suck on a lemon.

There's so many values here. We're showing you 1/3 of the report, because otherwise you'd fall asleep. So, the volume, so we can tell the patient peed 2.3 L one time, 2.5 L, and now 3.6 L.

The goal is 2.5 to 3 L. She's doing an excellent job. Why does water matter so much?

Look at the next value. Calcium oxalate saturation: 1.65, 5.90, 5.40. Here's why water matters so much.

Patients will say, "I'll do your stupid diet, Jill, I ain't drinking no more." You will still make stones, even despite the dietary changes. Sometimes patients have values on this test that they can't change because they have medical conditions. It doesn't mean they will make as many stones as they used to if they didn't drink as much water, but they raise it, they can decrease their stone risk, and here's how.

Look at these numbers. Your calcium oxalate saturation, Jeff, if you make this smaller, I want them to see other values going down this row. If you go four across, folks, you can see calcium phosphate saturation.

And if you go two more across, you can see uric acid saturation. These saturations are very complicated, but I'm going to Jill it all up. These saturations are the most important values on this test.

Their ratio's telling the doctor your kidney stone risk for each kidney stone type: calcium oxalate stones, calcium phosphate stones, and uric acid stones. So, this is telling, thank you, Jeff, this is telling the doctor on the day of the collection, did this patient have a risk to make calcium oxalate stones, calcium phosphate stones, or uric acid stones?

And even though the patient has some less than happy results, and I'll explain that in a second, she's still at a very low risk for making any stone type on this day. And Litholink uses the stoplight analogy. Green is good, yellow is oh, red is holy perzhole.

So, the yellow, orange going into pinks, that means it's a problem. And also, Litholink bolds the numbers and makes them bigger, so the doctor can see all this at a glance, what is a problem. So, there's no escaping it, okay?

So, if we just zoom in and we'll forget about the calcium phosphate and uric acid saturation, just so you can understand the calcium oxalate saturation, which is most kidney stone formers, so if you make that a little bigger, Jeff, for older folks like me that need that, thank you. We can clearly see that her saturations have gone a lot lower.

So, what does this mean? This is telling, again, Jill version, this is very sciency, this is how saturated this patient's urine was with calcium oxalate crystals on the day of the collection. And because she drank more, look at how low her saturation is.

This means she has lowered her stone risk. By a couple, there's a couple reasons why this patient did. She lowered her stone risk because she drank a heck of a lot more, and it makes sense.

If you're drinking and peeing, drinking and peeing, drinking and peeing, those stone crystals are not sitting in your kidney. They're coming out in the toilet bowl. That's how important fluids are.

You must pee away those crystals. If you don't pee away those crystals, your urine is more saturated with them, and you have all these crystals bumping into each other like bumper cars. You have all these crystals sitting there, not moving into the toilet, sitting in your kidney.

So, they eventually will form stones over time. This is why fluids are so important. And Litholink says under 7 and 1/2 is where we want it to be, but you can see the gradient of green, meaning it's really green right now, which is super great, Litholink's saying this is the greenest it's ever been, really low risk.

You can see that the 5.9 in October of 2024 and in March of 2019, it was less green. And Litholink saying a higher risk, even though it's under the reference range. This is what I mean, folks, too.

People will say, "My doctor said everything's fine," but does the doctor know where this reference range really should be for a kidney stone former? It may be under the reference range, but unless a doctor really knows how to read these results, they're not being as specific. Lab results are a general range.

There are always specific ranges for the disease you're treating, the ideal ranges. So, ideally, we would love the calcium oxalate saturation to be under 3, and this patient now is under 3 simply just because of fluids. Okay?

Now, I want to show you one more thing, otherwise this video will be really long, and that's why people get consults. This is complicated. Okay, the other thing I want to show you is the calcium.

Calcium in the urine is now 112. You can think to yourself, "Boy, this broad needs to get a life. She's very happy about this." Even though I've been doing this for three decades almost, boy, I get so happy for patients because they're working so hard, and somebody needs to tell them that, and it makes a difference.

So, if you're just going over lab results and you really don't understand them, and you don't get as excited as I do, you're never going to be compliant with this stuff. You have to understand the greatness that this is. But I want you to know that this is a kid.

She's very young. She's worked so hard. She's not only working hard, but she's like 30 years old.

So, why does that matter? Because she's she has to go up against going out with friends all the time, going out to eat. They're drinking and eating, hooting and hollering, and she's like, "Hold the salt" to the server.

This takes extra, just like it takes extra for people my age who are also socializing, going out all the time, having to deal with going out. It's a different thing. We're not partying like we used to, but it's very hard to make these changes.

So, when I see results like this, God, it makes me so happy and so proud. So, Jeff, you see the 112? So, we see the calcium.

I want you to make everything little cuz I want to go to that the dietary factor of this. Remember the sodium? It was on another page.

Oh, yeah, to the other page? I'll do that right here.

Yes, please. And we're going to go back and forth for a second. Take your time, but I just want you to know we're going to Okay.

So, there's other things on here we don't have the time, folks, that's when you get a consult, you go over everything. But under dietary factors, the first value is sodium. In, thank you, Jeff, in May, she had her sodium down to 69.

Now, that's how many millimoles. Don't fall asleep, folks, cuz I said the word millimole. Hold on, hold on, hold on.

That's how many millimoles of sodium came out of her. In order to find out how much she ate in order to get that amount, we multiply that result by 23, and she ate about, you know, a little over 1,500, I think, milligrams of sodium. Now, the other time she did a urine collection, she was double.

She ate double the amount of sodium. So, you see that, folks? She really lowered that sodium, God bless her.

She did a great job on this urine collection. Jeff, go back to the calcium now, please. Thank you.

God bless, Jeff. I would be nothing without him. Okay, we see the calcium, it has gone down markedly.

This, so you hear me barking low salt, low salt, shut up, Jill, about low salt, I'm so sick of hearing about it, so what about it, why do we care? Because look at that calcium. Again, I'm putting this in my Jill way.

But look at how much less calcium is now in her urine. It's staying in her bone where it needs to be. She's not losing all this calcium.

Again, simply put, when we eat too much salt, the kidneys filter our blood. The kidneys don't want all that salt to go back to the body. So, the kidneys open their little door and say, "Okay, blood, I'm going to clean that for you.

I'll get rid of some of that sodium, cuz the body don't need all that sodium, the heart doesn't want it, everybody else doesn't want it. So, I'm going to clean the blood, take out that extra sodium, and I'll bring it into the urine in my kidney," okay? That's what the kidneys do crudely, folks.

But along with the sodium that's leaving that front door, calcium follows it. And that's why we want you to lower the sodium. So, there's three goals out of the Kidney Stone Diet: the sugar, the added sugar, the salt, and the meat protein.

And that is to help you get that calcium number on your urine down. So now, my beautiful friend here has less calcium crystals in that kidney of her hers. So, phosphate and oxalate, there's so much less calcium, okay?

So, that's why we care about salt. And this kid really did a great job. Her kidney stone risk is very, very low now.

It's more than half of what it was. It's like four times less. So, that calcium, had she not gotten urine collections, had she not worked so hard, had she not made the changes, she'd be losing calcium all the time, which would eventually, she'll always make kidney stones if she keeps that up, and she may be, which so many women are because we lose our estrogen and that protects us against bone loss later on in life, but she would have really had even more of a risk for osteoporosis.

So, you see how satisfying this is? And the patient, I know she was like, "Jesus, Jill," [LAUGHS] you know, "You're very You're more excited than me." But now I understand what you're saying, because we went over the report together. So, now, it's just not lower salt, what's that doing?

Increasing her fluids, and there's other things on this report, but that's not for us to talk about today. But by increasing her fluids, by lowering her sodium, just doing those two things, you can see how low her oxalate is, too, by the way, okay? The oxalate is right after the calcium, Ox24, oxalate in the urine.

She lowered her oxalate, too. So, when you do the Kidney Stone Diet, you follow those goals, your kidney stone risk can plummet. And I told her if she keeps this up, and she does annual urine collections, because, folks, when you don't do those annual urine collections, you forget about being accountable.

And, you know, the diet just wanes as diets do, and then these things get out of whack again, and your kidney stone risk comes back. So, you got to go get those annuals. Most doctors are not reminding you to do them.

It's your job to do it, so you can stay low risk. So, this young person really did a phenomenal job, and I want you guys to take her as a role model, because this lowered her stone risk significantly. Now, also, so she just did diet alone.

Some of you will do the diet and it makes a significant difference, but you still need help, and specifically, things like urine calcium, it still may need some help by a diuretic. But the mass of change you can do by diet alone is unbelievable. So, again, I told her, I was so proud of her, I told her we would do a video on this.

I said, "Honey, I don't know when it's going to come out, but I promise you, I'll do one for you." so just so exciting. It's why I get up every day. I tell you guys this is hard work, and it really is hard work, but God, man, it's just so worth it, right?

To feel good, to know that she took the impetus to make the change and really change her whole kidney stone history. If she keeps compliant, I'm hoping she never makes a stone again, and she had a significant history. So, guys, I promise you, I just wanted to do this video, just like let's do it for the 300th video, because it's something that we never do, and he didn't know this, but I didn't really know it either, but God, I just get so excited seeing things like this, because that's why I'm a nurse.

I understand what it's like as a person who's been very sick in her life to see results get better, and to know that the things that you're doing are really making a difference and it's not just falling into a vacuum somewhere. So, once again, I want to tell my patient, I'm super duper proud of you. Keep on trucking.

And for all of you who have never done a urine collection, I'm begging you, please get that done. That patient would have never known she had high urine calcium. She would have made stones for the rest of her life, and she was right on track for bone disease, so that's how important the Kidney Stone Diet goals can be for you: water, fluids, getting enough calcium, lowering oxalate, getting your added sugar down, eating less crap, and keeping meat protein in check, and you can just change your whole life.

And, Jeff, I promise this is it, to take somebody who's so young and help her instill habits that can help her maybe prevent diabetes, chronic inflammation, fatty liver, all the things later on, well, it's why I run out of my bed every single day.

Yeah, so if you want to work directly with Jill, head over to kidneystonediet.com where you can sign up for a private consult or if you're a member in the all-access pass, you get 25% off all private consults with Jill, and she will help you learn exactly what your urine collection is telling you and how to adjust to make sure you never make a kidney stone again.

That's a very popular service and it's 20% off, just so people know. It's 20% off privates, okay? You said 25.

I don't want to get an email.

Oh, did I? Oh, yeah, 20%.

Yeah, because that's the only time we discount. We don't discount privates anywhere except in the all-access. It's why a lot of people buy that all-access pass.

Plus, they get the meal plan and all the things. It's amazing. So, yes, happy 300, Jeff!

Thank you for everything you do for our community. People know that this community doesn't run as far as the IT and all the things that you do behind the background. And, so thank you from the bottom of my heart.

You're a major part of this business, as you know. And Dave, as well. He's never on camera, he's in the desert somewhere doing his nomad life, but, you know, we three are Kidney Stone Diet, and thank you for everything you guys do, and for our community.

Jeff's like, "You are not winning an Oscar, Jill, calm down." [LAUGHTER] But for our community, too, thanks for being a part. I see that you're writing a lot more comments in the YouTube short section, so thank you for that. We really like creating a community.

Kidney stone patients need help. They're not getting the right information, and so we're here to fill that fill that void in the medical community. So, thanks, guys.

Yeah, and with that, we'll wrap, and we'll see you in 301.

See you later, 301. My goodness. Bye.