Other options for Oxylates and Kidney stones

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  • #325

    One of my patients has elevated oxylates at 445 and the 9 year old girl had a kidney stone 3 months ago. I treated her increased arabinose with diflucan for 10 days and followed it with 2 months of nystatin. After this her oxylates went down a little to 351 but her arabinose is still up at 205. So I’m at a loss of what to do since it appears that the diflucan followed by nystatin had no effect. Of note she has also been on Biocidin for 1 month. What is next?

    Also in regards to the elevated oxylates, how long can it take for them to go down once changes have been made? Can I expect it to take 6+ months to go down? less or more?

    Finally, for helping prevent kidney stones what options do I have. She is currently on an oral calcium citrate-malate suppliment twice a day and magnesium citrate. Does apple cider vinegar, lemon or lyme juice assist with alkalizing urine since they have citric acid in them? Would NaHCO2 one pinch daily be a good add on as well to alkalize the urine?

    Thanks
    Aaron Hartman MD

    #342
    DrWoeller
    Keymaster

      Dr. Hartman,
      I would consider biofilm intervention and keep going with antifungals like Nystatin and Biocidin and recheck arabinose again in 90 days.

      Also, the high oxalates can take awhile to come down, and in some case more than 6 months, particularly if this child has had a documented kidney stone before. Are you doing high dose probiotics too? Are the parents controlling high oxalate foods?

      The use of sodium biocarb could be worthwhile. Here is an interesting abstract from a Journal of Urology 2013 – http://www.ncbi.nlm.nih.gov/pubmed/23602798 on this topic of calcium stone formers. I am assuming this is oxalate and not urate stones since the oxalate was high on the OAT.

      Also, was the glyceric or glycolic high?

      Dr. Woeller

      #343

      Her glyceric and glycolic were both in the normal range.
      I will add on biofilm treatment and sodium bicarb and see what happens in 2-3 months.

      #345
      DrWoeller
      Keymaster

        DR. Hartman,
        Okay. Sounds good.
        Dr. Woeller

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