Expert on the importance of the 24-hour urine test in patients with stones

In this video, Joseph Song, MD, discusses the importance of the 24-hour urine test in evaluating patients with stones. Song is a urologist with Georgia Urology.

In your experience, what are the most promising recent advancements in terms of long-term preventive strategies, especially for patients who have already experienced multiple stones? Are there specific dietary or pharmacologic approaches that show promise?

There's a lot out there. For me, it's the increased utilization of 24-hour urines. I see more of my colleagues using them. Certainly, anybody who is a recurrent stone former, or of a young age when they develop their first stone, they automatically get a 24-hour urine test. One other thing that's been useful is the amount of nutritional information out there. We have more limited time with patients, but it's very helpful for me to be able to say "look, your 24-hour urine shows that you have very high oxalate"; we do some of the testing to make sure they don't have primary hyperoxaluria or some other, you know, underlying issue, but then I can direct them towards online resources that can really list diets and different foods and even recipes. It becomes a lot more involved, and it's something that patients can take that information they get in the office, but then expand it to a broader field. In addition to that, I also see more patients who have undergone bariatric surgery, especially patients who have bypasses or things like that, where they may have some issues with fat absorption, and that's driving kidney stones for that population of patients. And I see a bigger recognition that patients who have undergone bariatric intervention may be at increased risk for stones. A lot of them come in, and lead with, "I formed stones, but I had a gastric bypass." And that allows us to drill in a bit more quickly on something that's putting them at risk.

This transcription was edited for clarity.