Stone Urinalysis Report Sample (Page 3 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 3 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

Elevated Urinary Oxalate (Hyperoxaluria)

Urinary oxalate is an important risk factor for recurrent calcium oxalate nephrolithaisis. More than urinary calcium concentration, small

Increases in urinary oxalate markedly increase the risk of crystallization. Endogenous metabolism of glycine accounts for the majority of

Urinary oxalate. Only 10-15% is derived from dietary oxalate.

There are three mechanisms to account for Hyperoxaluria:

•

Inborn errors of metabolism – primary Hyperoxaluria is a rare genetic disorder, which usually presents in childhood with

significant elevation in urinary oxalate >60 mg/day.

•

Increased oxalate precursors – excessive Vitamin C ingestion greater than 1 gram/day.

•

Increased dietary intake and intestinal absorption – excessive intake of oxalate rich foods such as chocolate, dark green leafy

vegetables, nuts, citrus, tea, cocoa, and pepper. Inflammatory bowel disease, chronic diarrheal states, chronic pancreatitis, and

low calcium diet

(400 mg/day) may increase oxalate absorption.

Treatment of Hyperoxaluria:

•

Decrease intake of oxalate rich foods

•

Decrease Vitamin C consumption

•

Control diarrhea and fat malabsorption

•

Oral calcium supplementation

•

Vitamin B (pyridoxine) supplementation

•

Binding agents, orthophosphate, magnesium, ferrous sulfate

Low Urinary Volume

Although the efficacy of a high fluid intake has not been proven, most experts recommend an increased fluid intake to

produce a urinary volume from 2-4 liters per day. Most recommend a special effort to hydrate during the evening

hours to produce nocturia. Water hardness does not seem to predispose to stone formation and epidemiologic studies

indicate the incidence of stones is lower in hard water regions than in soft water regions. With regard to other types of

fluids it is best to avoid large amounts of tea, cocoa, cola drinks, and fruit juices, which contain significant amounts of

oxalate in soluble form. Low urinary volume can occur as a solitary finding in a patient secondary to poor dietary

intake or as a consequence to any condition producing chronic fluid loss such as diarrhea.

Treatment of Low Urine Volume:

•

Increase fluid intake to maintain urine output of least 2 liters per day. Patients will need 8-10 glasses of

water per day.

•

Direct patients to take two 8-ounce glasses of water between dinner and bedtime and one at night if they arise

to void.

•

Encourage patients to monitor the amount of urine they produce.

With adequate hydration…..

•

The urine should remain colorless.

•

Urine specific gravity should measure between 1.005 – 1.010.

•

Direct volume measurements should be greater than 2 liters.

Stone Urinalysis Report Sample Page 3

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