Question

A 34-year-old man presented with bilateral recurrent renal stones:
Metabolic causes.

Hint:

Metabolic disturbances like hypercalciuria, hyperoxaluria, and hypocitraturia are key factors in the development of recurrent kidney stones.

Answer 1

Metabolic causes of recurrent bilateral renal stones are often related to disturbances in urine composition, which promote stone formation.
Step 1: Common Metabolic Causes:
1. Hypercalciuria: Excess calcium in the urine can lead to calcium oxalate stone formation. It may be due to dietary factors, hyperparathyroidism, or certain genetic conditions.
2. Hyperoxaluria: Increased excretion of oxalate in the urine, often caused by excessive dietary intake, malabsorption, or certain genetic disorders, can contribute to calcium oxalate stone formation.
3. Hyperuricosuria: High levels of uric acid in the urine can lead to uric acid stones, often associated with conditions like gout or high purine intake.
4. Hypocitraturia: Low levels of citrate in the urine reduce the ability to inhibit stone formation, leading to an increased risk of calcium-based stones.
5. Distal Renal Tubular Acidosis (RT: This condition leads to acidic urine, which promotes the formation of calcium phosphate stones.