What is metabolic kidney stone management?

Written by: Dr Mehdi Mirzazadeh
Published: | Updated: 20/05/2024
Edited by: Carlota Pano

Metabolic kidney stone management involves identifying and addressing the underlying metabolic factors that contribute to the formation of kidney stones, aiming to prevent their recurrence.


Here, Dr Mehdi Mirzazadeh, renowned consultant chemical pathologist and metabolic specialist, provides an expert insight into metabolic kidney stone management.



What are the common metabolic factors associated with kidney stone formation?


Kidney stones are often a result of imbalances in urine composition.


Common metabolic factors associated with kidney stone formation include:

  • Hypercalciuria: Elevated levels of calcium in the urine increase the risk of calcium-based kidney stone formation.
  • Hyperoxaluria: Elevated levels of oxalate in the urine can amalgamate with calcium, leading to the formation of calcium oxalate stones, which are the most common type of kidney stone.
  • Hyperuricosuria: Increased excretion of uric acid in the urine raises the risk of uric acid stone formation.
  • Hypocitraturia: Low levels of citrate in the urine reduce its ability to prevent the formation of calcium-containing kidney stones, as citrate acts as a natural inhibitor of stone formation.


Can genetic factors contribute to metabolic kidney stone formation?


Genetic factors can play a role in kidney stone formation. In some cases, patients may inherit genetic conditions that affect the absorption, excretion, or metabolism of minerals and salts, increasing their susceptibility to kidney stone formation. Genetic testing may be recommended in cases where there is a strong family history of kidney stones or when other risk factors suggest a possible genetic component.


Why is metabolic evaluation important for patients with kidney stones?


Unlike traditional approaches that focus solely on treating symptoms or removing existing stones, metabolic kidney stone management aims to prevent stone formation by targeting specific metabolic abnormalities.


Metabolic evaluation plays a central role in this management approach. By analysing urine and blood samples, specialists can identify metabolic abnormalities unique to each patient and develop personalised treatment plans.


What tests are involved in a metabolic evaluation for kidney stones?


A metabolic evaluation for kidney stones typically involves several tests to assess various aspects of urine composition and metabolic function.


Common tests include:

  • 24-hour urine collection: This test requires collecting all urine produced over a 24-hour period. The collected urine is then analysed to measure levels of varying substances, including calcium, oxalate, uric acid, citrate, and creatinine. These measurements provide valuable information about urinary parameters and metabolic imbalances.
  • Blood tests: Blood tests may be conducted to assess kidney function and identify metabolic abnormalities that could contribute to kidney stone formation.
  • Imaging studies: While not directly part of the metabolic evaluation, imaging studies such as X-rays, ultrasounds, or CT scans may be performed to assess the size, location, and number of existing kidney stones. Imaging can also help identify any structural abnormalities that may contribute to stone formation.


Are there medications that can help manage metabolic kidney stones?


Medications are often prescribed as part of a comprehensive treatment plan tailored to each patient's specific metabolic profile. These medications can help manage metabolic kidney stones by addressing underlying metabolic abnormalities and reducing the risk of stone formation.


Common medications include:

  • Thiazide diuretics: Thiazide diuretics work by increasing the reabsorption of calcium in the kidneys, thereby reducing the amount of calcium excreted in the urine. This can help lower urinary calcium levels and decrease the risk of calcium-based kidney stone formation.
  • Potassium citrate: Potassium citrate supplementation can help increase urinary citrate levels. By raising citrate levels, potassium citrate can help prevent the formation of calcium-containing kidney stones and may also help dissolve existing stones.


How frequently should I undergo follow-up evaluations to monitor my progress and adjust my treatment plan if necessary?


The frequency of follow-up evaluations may vary depending on individual factors and treatment response. Typically, follow-up evaluations are recommended every 6 to 12 months to assess urinary parameters and ensure the effectiveness of preventive measures. During follow-up appointments, the specialist may review the patient’s metabolic profile, assess stone recurrence risk, and make recommendations for ongoing management.


The ultimate goal of metabolic kidney stone management is to prevent the recurrence of kidney stones, improve overall kidney health, and enhance the quality of life for patients at risk.



If you would like to know more about metabolic kidney stone management, schedule an appointment with Dr Mehdi Mirzazadeh via his Top Doctors profile today.

By Dr Mehdi Mirzazadeh

Dr Mehdi Mirzazadeh is a distinguished consultant in metabolic medicine and chemical pathology based in Epsom. His areas of expertise include metabolic bone disorders such as osteoporosis, metabolic stone management, lipidology, including high cholesterol and triglycerides, medical weight loss, novel biological agents, and interpretation of complex blood tests. His specialist interest is in rare metabolic disorders.

Dr Mirzazadeh is highly qualified, with an MSc in Clinical Biochemistry from King’s College London and an MD from the University of Tehran, ECFMG certificate from United States and also has a BA in Sociology from Azad University. Furthermore, Dr Mirzazadeh holds esteemed fellowship to the Royal College of Pathologists, as well as membership to the Royal College of Physicians.

With a focus on personalised care and evidence-based practice, Dr Mirzazadeh is dedicated to helping patients achieve optimal metabolic health and wellbeing. His extensive training includes higher specialist training in the prestigious Oxford deanery, after which he also undertook collaborative subspecialty training at Cambridge and University College London Hospitals.

His centre of practice is personalised care with an approach to tailoring treatments to individual needs and health goal. He has access to cutting-edge technology to accurately assess metabolic health, including radiological tests like Trabecular Bone Score for bone health, complex omics, including genomics to make diagnosis and direct management in rare and potentially genetic metabolic disorders in addition to complex biochemical tests. He emphasises on a comprehensive approach that considers lifestyle factors, nutrition, and overall well-being. He has publication in and committed to evidence-based practice using proven methods backed by scientific research. He focuses on strategies for sustainable improvements and ongoing support of patients with metabolic diseases with stress on the importance of early intervention and proactive measures to prevent metabolic disorders.bHe incorporates various modalities for a well-rounded treatment approach for a patient and has a dedication to listening to patients' concerns and involving them in decision-making. He has expertise in addressing metabolic issues through lifestyle modifications, including diet and exercise and has had successful diagnosis and management outcomes in cases where the diagnosis was difficult or not obvious.

Currently, Dr Mirzazadeh serves as the clinical lead for metabolic bone disorders at Epsom and St Helier University Hospitals NHS Trust, where he is also the laboratory director for the South West Thames newborn screening services. He is actively involved in teaching undergraduate and supervising postgraduate trainees and holds an honorary senior lecturer post at St George's University of London.

In his additional capacity as an assessor for the national clinical biochemistry quality assurance services, namely, NEQAS, Dr Mirzazadeh leverages his specialist expertise to evaluate specialist advice provided by laboratories around the UK on blood tests concerning calcium and sodium metabolism, vitamin deficiencies, and hormonal imbalances.

He works with GMC in assessing the doctors qualified abroad for the right knowledge and skills to practise in the UK.

View Profile

Overall assessment of their patients

  • Related procedures
  • Skin infections
    Kidney transplantation
    Prostate cancer
    Human papillomavirus (HPV)
    Preventive cardiology
    Diabetes diet
    Brain tumour
    Testicular cancer
    Metabolic syndrome
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.