Outpatient metabolic evaluation of patients with recurrent kidney stones.

We have designed an outpatient, comprehensive metabolic evaluation program for patients with recurrent kidney stone disease. This protocol can be expected to detect and identify specific biochemical abnormalities contributing to kidney stone formation in about 95% of these patients. Individualized therapy can then be started based on the particular metabolic defect discovered in each patient. This diagnostic and treatment program will stop new kidney stone formation in these high-risk patients virtually completely. For each stone-related hospitalization eliminated, the average savings are at least $2,700. The total potential savings in our small community alone are over $460,000! Our metabolic stone evaluation protocol is the only one with which we are familiar that was designed and implemented exclusively at the community hospital level. It is readily adaptable to other medical facilities.