Stone Urinalysis Report Sample (Page 2 of 4) in pdf

RTE: US!AFS

SEQ: W93U

DIANON

SYSTEMS

F I N A L

840 Research Parkway, Oklahoma City, OK 73104-3699

VOICE (800) 634-9330 FAX (405) 290-4046

AH3500000

Page 2 of 4

Stone Urinalysis Report

Specimen:

Collection:

01/13/13

Bar Code:

006100000

WR93U01

Received:

01/15/13

Completed:

01/15/13

Report Date:

01/15/13

SAMPLE, PHYSICIAN, MD

Patient Information

DIANON SYSTEMS

Patient Name

SAMPLE, PATIENT

840 RESEARCH PARKWAY

Social Sec. No.

***-**-0000

Phone #

(000) 000-0000

OKLAHOMA CITY, OK 73104

Date of Birth:

07/00/1900

Age:

55 Yrs

Chart #:

Recommendations

Hypercalciuria

Medical condition causing Hypercalciuria:

•

Hyperparathyroidism

Milk-Alkali-Syndrome

Metastatic Malignant Neoplasms

Leukemia

•

Hyperthyroidism

Immobilization Syndrome

Idiopathic Infantile Hypercalcemia

Lymphoma

•

Sarcoidosis

Vitamin D Intoxication

Multiple Myeloma

Adrenal Insufficiency

When the above conditions do not exist, Hypercalciuria is considered ‘Idiopathic’.

Nonspecific therapy for idiopathic stone disease may include the following options:

• Increasing urine output to over 2 liters per day.

• A low protein diet. Excess protein intake may result in transient metabolic acidosis. Calcium is released from bone in response to this acid load.

• Moderate sodium intake of less than 3000 milligrams per day.

• Strict calcium restriction should be avoided.

Based on the effectiveness of the above measures or the patient’s condition and history determining the cause of idiopathic hypercalciuria may be warranted.

Differential Diagnosis and Management of Hypercalciuria

Diagnostic Presentation

24 Hr. Urine On

Serum

Condition

Treatment Options

Monitoring

Random Diet*

Restricted Diet**

Low Oxalate

SERUM

Absorptive

Low Sodium Diet (<1000 mg/day)

** Electrolytes

Elevated

Hypercalcuria

Moderate Calcium (600-800 mg/day)

& Uric Acid

Calcium

Type I

Thiazides

URINE

Sodium Cellulose Phosphate

Citrate, Calcium,

Restricted

Orthoposphates

Sodium, Oxalate

Diet

Normal

SERUM

Absorptive

** Electrolytes

Low Oxalate

Hypercalcuria

& Uric Acid

Low Sodium Diet (<1000 mg/day)

Normal Calcium

Elevated

Type II

URINE

on Diet Restriction

Moderate Calcium (600-800 mg/day)

Calcium

Citrate, Calcium,

Thiazides, If no response to diet

Sodium, Oxalate

SERUM

** Electrolytes

Normal Calcium

Renal Calcium

Thiazides

& Uric Acid

Elevated PTH

Leak

URINE

Citrate, Calcium

Absorptive

SERUM

Elevated

Hypercalcuria

Calcium

Phosphate

Calcium

Low Phosphate

Type III

URINE

Supplements

Calcium, Phosphorus

Elevated

Elevated Calcium

Hyperpara-

Phosphorus

Surgery

None

Elevated PTH

thyroidism

SERUM

Electrolytes

Low Potassium

Renal Tubular

Calcium, Citrate

Citrate Therapy

Elevated

Low Bicarbonate

Acidosis

URINE

Calcium

High Chloride

Electrolytes

Bicarbonate

Low

SERUM

Absorptive

Citrate

Potassium Bicarb.

Diet & Citrate

Citrate, Calcium

Hypercalcuria

& Chloride are

Therapy or Thiazides

Sodium, Oxalate

with

usually normal

& Citrate Therapy

URINE

Hypocitraturia

Electrolytes

* It has been suggested that two collections will increase detection of abnormal urine values.

** 24 Hour urine collection after one week on a low calcium (<400 mg/day), low sodium (<100 mEg/day) and low oxalate diet.

*** Thiazide Treatment may result in electrolyte imbalance, increase uric acid production, and urine citrate depletion.

To confirm diagnosis of the above conditions, Pak et al. recommend evaluation of the patient using a calcium loading protocol

Stone Urinalysis Report Sample Page 2

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