The Case for Incremental Thinking About Kidney Stone Disease

From a patient’s perspective, you either have a kidney stone or you don’t. Detecting a stone represents an all-or-nothing event, foreshadowing what may come to pass (or not pass). In comparison, evaluating risk of a recurrent stone is a continuous, often iterative, process. Evaluating stone risk typically includes measuring a panel of 24-hour urine chemistries, which may predict a patient’s risk for a future stone. Based on the results of a urine chemistry profile, the clinician may prescribe dietary or medical interventions to lower that risk, reanalyze ensuing urine chemistry, and repeat the cycle as necessary.