Talk:Kidney stone disease

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Good article Kidney stone disease has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
August 27, 2011 Good article nominee Listed

See also section[edit]

Per WP:SEEALSO. It mentions that terms already in the article are not needed in a see also section. And terms that only tangentially apply should not appear. Doc James (talk · contribs · email) 17:48, 12 January 2011 (UTC)

It states only that including a link under "See also" is a matter of judgment and common sense, and that an annotation can be included if the connection is unclear. I have seen numerous instances where editors preferred to keep a duplicate link in the "See also" section, so that guideline is not an absolute. Links may be excluded if it would make the article too long, but the current list does not appear excessive. That being said, I'm sure we can find a satisfactory compromise.—RJH (talk) 19:24, 12 January 2011 (UTC)
Many of them where tangential at best. Listing which medical specialty every disease fall under would not be vary useful. The rest of them are already in the article. Per WP:DUE is do not see why cysteinuria a rare genetic condition was mentioned here when it is already mentioned under causes in the text. Why is IVP mentioned when it is no longer a commonly used method of diagnosis and is already discussed under diagnosis. I am happy to discuss each one by one and to work on improving this article but I do not think in general creating lists of terms adds to Wikipedia.Doc James (talk · contribs · email) 19:31, 12 January 2011 (UTC)
Okay, here are the links from the section you deleted that are not duplicated in the article:
I would say that general medical professions dealing with the kidneys and urinary tract may be of interest to the readers of this article, so I don't see a problem in including those. It would appear to fall under the common sense clause. I guess you consider urinary retention covered by the bladder stone article? (Although perhaps a casual reader like me might not know that.)—RJH (talk) 19:46, 12 January 2011 (UTC)
Moved List of kidney stone formers to the history section. Urinary retention may be cause by bladder stones but that would be exceedingly rare. The most common cause is prostate problems. We have 23,000 medical articles. Listing in a see also section which specialties each fall into I do not think is a good idea. We have categories for that thus I consider these already covered under categories.Doc James (talk · contribs · email) 19:55, 12 January 2011 (UTC)
Shrug. So be it.—RJH (talk)

Kidney stone flushing[edit]

In the novel 'East of Eden' I read this: "Right here?" he asked, and exerted a little pressure on the small of her back. "No? Here? Does this hurt?" So. Well, I think you just need a kidney flushing." He left yellow, green, and red pills to be taken in sequence. The pills did good work.

I am wondering what type of substance those pills would be. I searched for 'kidney flushing' but didn't find an article on it. Google showed me things like -blocked link- and http://curezone.com/cleanse/kidney/default.asp . Kidney flushing in that case involves drinking things like green tea, lemon juice, olive oil and so on. But only liquids. I still don't know what solid 'kidney flushing' pills would of contained.

Someone with medical knowledge could help here. Even if 'kidney flushing' is a pseudoscience at best, the process still deserves a mention in the article, if not it's own one.

From personal experience, a strong pain killer will sometimes stop the spasms of uninary colic and allow the stone to pass. That suggests that at least one component to the 'medical cocktail' mentioned would be such a pain killer. 50.124.139.7 (talk) 04:52, 3 April 2014 (UTC)

J1812 (talk) 19:32, 9 March 2011 (UTC)

Perhaps a diuretic?—RJH (talk) 19:48, 9 March 2011 (UTC)
It's covered under expulsion therapy and also under the medical management, in the past sentence.Wzrd1 (talk) 03:56, 20 October 2011 (UTC)

GA Review[edit]

This review is transcluded from Talk:Kidney stone/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Doc James (talk · contribs · email) 06:38, 18 June 2011 (UTC)

Will provide a few comments over the next few days:

  • Typically we do not use patient ( here it is used about 15 times ).
I have eliminated all instances of the term "patient". DiverDave (talk) 06:15, 19 June 2011 (UTC)
  • There are a bunch of words that are technical and need to be either linked or simplified ie "Postrenal azotemia and hydronephrosis" and "renal colic" for example
I have provided links for all technical terms, including postrenal azotemia, hydronephrosis, and renal colic. DiverDave (talk) 06:15, 19 June 2011 (UTC)
  • Units should be both in SI and American ( yes there are still lots who use those other units sigh )
I have added conversion templates where applicable. DiverDave (talk) 06:15, 19 June 2011 (UTC)
  • The section on cause mixes cause and pathophysiology. IMO would be best to separate the two. Molecular mechanisms would be under patho. What proportion is due to genetics, diet, meds, lifestyle etc would be under cause.
I have reorganized text and created a ==Pathophysiology== section. DiverDave (talk) 06:15, 19 June 2011 (UTC)
  • Classification may be best as a subheading under diagnosis.
This issue has been addressed. DiverDave (talk) 00:49, 21 June 2011 (UTC)
  • Some of the textbooks need ISBNs added
All books have ISBN except McNutt (there is no ISBN for this source published in 1893) and Litwin (this is not really a textbook, but rather a 716 page report). DiverDave (talk) 00:49, 21 June 2011 (UTC)
  • The section on managements seems to be a mix of preventative measures and treatment measures. The Preventative stuff (diuretics, urine alkalization) should be move to that section. Some of the stuff (urine alkalization) does not have any refs.
This issue has been addressed. DiverDave (talk) 00:49, 21 June 2011 (UTC)
  • The section on signs and symptoms starts with "Signs of urolithiasis include oliguria". I have seen many kidney stones in my carrier and not one person presented complaining of oliguria. I see flank pain radiating to the groin. It would be good if this section presented the most common symptoms first (also what percentage of kidney stones present with each symtom?)
This issue has been addressed. DiverDave (talk) 00:49, 21 June 2011 (UTC)

Will add more as time goes on. Doc James (talk · contribs · email) 06:38, 18 June 2011 (UTC)

I have replaced primary research studies with review articles and textbook refs in all instances where practical. DiverDave (talk) 21:30, 27 July 2011 (UTC)

What's the status of this review? The writer seems to have addressed everything so I trust more comments are forthcoming soon. Wizardman Operation Big Bear 20:00, 7 July 2011 (UTC)

Away. Will check the rest of the article next week. The issue of primary research studies has not been fully addressed. With a topic of this importance plenty of review articles exist. Not sure if DriverDave is still working on this? So right now the article is on hold.--Doc James (talk · contribs · email) 00:09, 8 July 2011 (UTC)

It looks like we may have some copyright violations that need to be cleaned up. I spot-checked just one source, and here's what I found:

Text
"The majority of indwelling ureteral stents can be removed during an office visit under topical anesthesia after resolution of the urolithiasis.[86]"
Source
"The majority of indwelling ureteral stents can be removed in the office with topical anesthesia using a flexible cytoscope and grasper."
Copyvio has been addressed; text now reads: "Most ureteral stents can be removed during an office visit under topical anesthesia after resolution of the urolithiasis." DiverDave (talk) 03:52, 23 July 2011 (UTC)

What I'd originally meant to say is this: The citations are a little odd. Normally, if you're citing a book only once, then you cite it just like anything else, without using shortened footnotes. Also, if you're supplying an ISBN, there's not really any need for the links to books.google.com, but if you want to, then you might want to read WP:CITE#Linking_to_Google_Books_pages on how to shorten the links. WhatamIdoing (talk) 01:04, 23 July 2011 (UTC)

I have just corrected this situation. Thanks for clarifying this point; I find the Notes and References sections to be the most difficult parts to get correctly formatted. DiverDave (talk) 13:53, 23 July 2011 (UTC)
Great will continue with the review in a couple of days.--Doc James (talk · contribs · email) 21:30, 30 July 2011 (UTC)
Sorry about the delay. Will look again tomorrow and continue. Doc James (talk · contribs · email) 05:14, 11 August 2011 (UTC)

There are still some none review articles used as references and some of the references are more than 10 years old such as this PMID 7504361 and this PMID 9818798 Wondering if we could use more uptodate sources?Doc James (talk · contribs · email) 05:43, 11 August 2011 (UTC)

Neither of these are signs or symptoms "Postrenal azotemia and hydronephrosis can be observed following the obstruction of urine flow through one or both ureters.[4]" but would be more reasonable classificed as complications.Doc James (talk · contribs · email) 05:54, 11 August 2011 (UTC)

Would it be appropriate to include the character of pain to the symptoms section (as in stabbing, radiating, etc)? As there is a graphic illustrating the referred pain locations, it would seem potentially appropriate. On the other hand, there is the risk of a wikipedia self-diagnosis. Thoughts?Wzrd1 (talk) 04:08, 19 October 2011 (UTC)

Progress[edit]

This article has been under review now for 65 days. If there are outstanding problems then best to fail the nomination now. Jezhotwells (talk) 22:19, 22 August 2011 (UTC)

All the concerns above seem to be addressed. The one tweak above can be reworded but it's find as is for GA. Since further reminders have gone unheeded, I'm closing the review. Wizardman Operation Big Bear 04:37, 27 August 2011 (UTC)

Error with convert function[edit]

I think there is a problem with the "convert" function. When I was browsing this entry I noticed the statement "consumed 1,000 milligrams (15 gr) of supplemental calcium". When I went to correct the fact that 1,000mg is equal to 1gr, I noticed this was created by the command (bracket-bracket)convert|1000|mg|gr(bracket-bracket). Seems to be an error with this function, no? — Preceding unsigned comment added by Talbotron22 (talkcontribs) 03:03, 20 June 2011 (UTC)

"gr", at least in this case, is grains, not grams. I don't know whether that was intended or not, though. RobinHood70 talk 03:19, 20 June 2011 (UTC)
Excellent observation, RobinHood70! The conversion from milligrams to grains ("...women who consumed 1,000 milligrams (15 grains) of supplemental calcium") was indeed intentional, although most of us do not think in terms of the grain unit. Other available options for mass units would have been either 0.564 drams, or 0.0353 ounces. Both of these numbers are even more awkward than 15 grains, IMHO. It may ultimately be best to simply leave the units in milligrams.... DiverDave (talk) 04:20, 20 June 2011 (UTC)
I'll second the leaving units in metric. Wow! I had nearly forgotten Grain units! Many, many ages ago, we'd administer 1/4 grain of morphine. 16 milligrams is FAR more uniform than 1/4 grain.Wzrd1 (talk) 04:00, 20 October 2011 (UTC)

Fluoridation of drinking water[edit]

I've removed the statement that water flouridation may cause kidney stones purely on the basis of the source that's given. It cites what purports to be a publication of the National Academy of Sciences; however, the copy that is linked to is hosted on [1], and I challenge anyone to go look at that site and then come back here and claim it can be relied upon to report the NAS's words faithfully. If someone can link to the same paper hosted somewhere reliable, or has a paper copy and can swear the linked version hasn't been altered, go ahead and put it back in. GideonF (talk) 09:08, 7 September 2011 (UTC)

I have restored the source, though this time from the National Academy of Sciences website. Though the the linked version at the previous website is indeed unaltered, I certainly agree that the actionpa.org website cannot be considered a reliable source. Unforntunately, that is the only place I could find the full pdf file. DiverDave (talk) 12:20, 7 September 2011 (UTC)
Thanks.GideonF (talk) 15:28, 7 September 2011 (UTC)

Imaging caption - (L) rather than (R)?[edit]

"Axial CT scan of abdomen without contrast, showing a 3mm stone (marked by an arrow) in the right proximal ureter"

Isn't this the (L) proximal ureter? The opposite stide is marked (R) on the film. — Preceding unsigned comment added by 123.211.54.84 (talk) 12:47, 18 October 2011 (UTC)

Normally, I'd dismiss such a comment, except that it DOES appear to be on the left side. If the liver is what I'm seeing on the left side of the image and to be honest, it IS looking a lot like liver... Any radiologist types out there to comment?Wzrd1 (talk) 04:04, 20 October 2011 (UTC)
It is the left yes sorry. I added a better quality picture without fixing the side of the stone in the text. No liver in that slice just some bowel with intra luminal stool on the right. Note the little R... --Doc James (talk · contribs · email) 04:54, 20 October 2011 (UTC)

Radiolucent stones[edit]

In the ultrasound paragraph under imaging, there is a sentence that reads "Radiolucent stones, which do not appear on CT scans, may show up on ultrasound imaging studies". This is incorrect, no? All stones (except for those rare drug residue stones) - even radiolucent ones - are visible on CT. That's what makes CT so much more useful than plain film. If we couldn't see radiolucent stones on CT, we might as well just get KUBs on everyone and call it a day.

Here's an old article from the early days of CT that confirms it: http://www.ajronline.org/content/142/3/545.full.pdf+html

And a newer one: http://radiology.rsna.org/content/250/3/813.full — Preceding unsigned comment added by 72.95.157.14 (talk) 14:34, 21 October 2011 (UTC)

Mechanical horse[edit]

There is a picture captioned "1935 mechanical horse used against ureteral stones". Such a bizarre contraption surely deserves a line or two in the article explaining what it is all about? Putney Bridge (talk) 22:43, 15 December 2011 (UTC)

10 months ago i had a large kidney stone which was stuck in my tube ,stopping everything from working as they should ,and i got a mass build up so i had a tube coming out of my side and drained into a pouch ,i had it for 4 weeks ,then i ad a operation ,it all got removed which i was relieved .anyway following up appointment i ad to go for X-rays ,then i was asked to return to speak to my doctor of which he informed me i have got another stone ,but my doctor told me that for it to reaccur it was very unlikely once i had one that big ,and if one did occur it would not be prob 5 years on plus .and it not been a year yet since my first stone ,could u explain why this as occured .thankyou M Commons — Preceding unsigned comment added by 86.15.199.212 (talk) 21:48, 29 January 2012 (UTC)

Is it in the other kidney? Regards, RJH (talk) 22:50, 29 January 2012 (UTC)

Frequency of occurrence[edit]

I notice that frequency of occurrence is given only for the first three types of stones. The last category ("Other") lumps together several types of stones, all considered rare. I think it would be helpful to put a number on this, if it can be done. Also, Type 1 (calcium stones) are 80% of cases in the U.S. For the other types, no country or region is specified. This seems inconsistent. ChrisWinter (talk) 23:16, 30 January 2012 (UTC)

If you can find reliable sources for the suggested information, that would be helpful. Thanks. Regards, RJH (talk) 23:43, 30 January 2012 (UTC)


Need Your Opinion[edit]

Hello Editors I added a subsection of ayurvedic treatment in the kidney stone page. I also wanted to add a list of medicines under this subtopic, like: Pashanbhed Gana ,Varunadi Kwath. Needed your opinion regarding this. If medicines cannot be added to the page we can atleast add some core ingredients of these medicines. Barkhadhamechai (talk) 09:39, 27 February 2012 (UTC)

File:Urether stone loosener mechanical horse.jpg Nominated for Deletion[edit]

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Well that's a shame. It's a great pic, in a retro type of way. Regards, RJH (talk) 19:06, 22 March 2012 (UTC)

Causes: Refined Sugars and High Fructose Corn Syrup.[edit]

Under causes "high fructose corn syrup" mentioned as a cause, but the citation references a study that focuses solely on pure fructose consumption not fructose and glucose. It also seems redundant to mention high fructose corn syrup and refined sugars since refined sugars covers high fructose corn syrup. — Preceding unsigned comment added by Miso beno (talkcontribs) 14:51, 13 April 2012 (UTC)

Male and female urinary systems and symptoms of kidney stones[edit]

Males and females have different urinary systems, the man's is longer, does this mean the man suffers more? Although I understand the woman's is wider... Or at least... her urinary system is tied to the uterus, well I dont really know, I'm no expert in anatomy...Undead Herle King (talk) 02:22, 19 April 2012 (UTC)

Ok, I know this is no place for questions, but the article should address if there is any meaningful difference between the male and female experience through this ailment as tests have proven by quantifying pain the same way they have quantified pain to determine women ahs a higher tolerance to painUndead Herle King (talk) 02:24, 19 April 2012 (UTC)


2012 review article[edit]

Sakhaee, K (2012 Jun). "Kidney stones 2012: pathogenesis, diagnosis, and management". The Journal of clinical endocrinology and metabolism. 97 (6): 1847–60. PMID 22466339.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help) Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 04:12, 25 July 2012 (UTC)

What's an "orgasim"?[edit]

"male orgasim can decrease formation of stones."
Is that like an orgasm, but for a nucular age? Also, how exactly does it decrease formation of stones, and whose stones does it decrease the formation of? Male or female stones? Was this tested on laboratory mice? If so, was it controlled for presence (or absence of) cadmium in the post-sex cigarettes, or did the mice light up a cig as well? If so, who provided them with such small cigarettes, and has it been attempted to use nicotine addiction in rats as a form of deratization? Or did the smoker mice and rats running around the fields, as well as the human settlements, prove too much of a fire hazard?
I believe that this article would benefit greatly from further examination of these questions.--92.36.132.101 (talk) 04:33, 18 February 2013 (UTC)

No one ever sat down and gave you the talk, now did they? Charles35 (talk) 05:03, 18 February 2013 (UTC)

Possible error[edit]

Too busy/lazy to look into this, but is there not a contradiction here?:

"On the other hand, high dietary intake of potassium appears to reduce the risk of stone formation because potassium promotes the urinary excretion of citrate, an inhibitor of urinary crystal formation. High dietary intake of magnesium also appears to reduce the risk of stone formation somewhat, because like citrate, magnesium is also an inhibitor of urinary crystal formation.[6]"

Shmaristotle (talk) 01:52, 9 September 2013 (UTC)

PH or acid-alkaline balance relative to calcium oxalate chart entry[edit]

Currently the table entry for calcium oxalate stones says under the column "circumstances" i.e., that they form, "when urine is alkaline (ph>5.5)". Med.nyu.edu asserts in relation to citrate "... it makes the urine less acidic, which inhibits the development of both calcium oxylate and uric acid stones." So, it seems there's some bad information somewhere. Either Wikipedia is correct,that calcium oxalate stones form when urine pH is > 5.5, or med.nyu.edu is correct, that alkaline urine inhibits formation of calcium oxalate stones, but it doesn't seem that both sites can be correct, unless there's some other language problem such as misreading the header meaning of "circumstances."

Here's another reference, nlm.nih.gov says, "Acidic urine is associated with xanthine, cystine, uric acid, and calcium oxalate stones. Alkaline urine is associated with calcium carbonate, calcium phosphate, and magnesium phosphate stones." Gzuufy (talk) 17:19, 7 December 2013 (UTC)

The 'kidney stone belt'?[edit]

There is quite a bit of detail in the article about the geographic distribution with specific mention of the 'Middle East', which is helpful, but there is also mention of the 'kidney stone belt' in the 'southern US' which is quite vague. Please elaborate. 50.124.139.7 (talk) 05:08, 3 April 2014 (UTC)

Dubious -- "When a stone causes no symptoms, watchful waiting is a valid option."[edit]

I think we should change it to: "When a stone causes minor symptoms, watchful waiting is a valid option."

If there are "no symptoms" then the doctor and patient don't know there's something to watch at all. Totoro33 (talk) 02:50, 3 July 2014 (UTC)

One picks up stones on CT all the time. These do not need treatment unless they cause symptoms. You tell the person about it and say that at some point they may develop pain but then again may not. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:47, 3 July 2014 (UTC)
Okay, I guess that makes sense, except that I'd consider a stone on CT to be a "symptom." However, I'm not a doctor, so I could be misunderstanding the word symptom. Thanks. Totoro33 (talk) 15:01, 3 July 2014 (UTC)
Maybe we could say something like, "When a stone causes no perceived symptoms, watchful waiting is a valid option."Totoro33 (talk) 15:05, 3 July 2014 (UTC)
"symptom" is what the person experiences. A stone on a CT is a radiological finding not a symptom. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:51, 3 July 2014 (UTC)
Thanks for the clarification... Totoro33 (talk) 00:39, 4 July 2014 (UTC)

Contradiction?[edit]

"Prevention

...

Dietary measures

...

* Increasing intake of citrate-rich drinks such as lemonade and orange juice

...

* Limiting vitamin C intake to less than 1,000 mg (1.0 g) per day

..."

Is there a contradiction? Citrate-rich drinks are also vitamin-C-rich.

That is what the source says [2] Doc James (talk · contribs · email) 16:21, 4 November 2014 (UTC)

No benefit from expulsive therapy[edit]

[3] Doc James (talk · contribs · email) 11:57, 23 May 2015 (UTC)

Roller Coaster Could Help People Pass Kidney Stones[edit]

Does this deserve a mention? JuanTamad (talk) 09:19, 16 July 2017 (UTC)

External links modified[edit]

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Potassium argument illogical[edit]

Article states: "High dietary intake of potassium appears to reduce the risk of stone formation because potassium promotes the urinary excretion of citrate, an inhibitor of calcium crystal formation." This seems illogical. If the effect of K is to increase excretion and hence lower citrate levels, how does this reduce stone formation? Removing an inhibitor would presumably increase it. Carusus (talk) 21:24, 24 August 2017 (UTC)

Review of prophylaxis[edit]

doi:10.2215/​CJN.11201016 CJASN. JFW | T@lk 08:20, 9 October 2017 (UTC)

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