Clinical Workup · uRaology
Kidney Stone Evaluation
Who to evaluate, what to test, and when to go deeper — the HUBRS approach.
Who to Evaluate
Test
1st timers (if interested)
- Interested in understanding their risk
High Risk
High-risk patients
- Family history
(cystine) - Obesity
(↑ recurrence) - Sarcoidosis
(calcium) - Primary hyperparathyroidism
(calcium) - Renal tubular acidosis
(↓ pH) - GI disease
(oxalate) - Gout
(uric acid) - Diabetes
- Urine infection
Other reasons to evaluate
Single kidney
or anatomic abnormality
All children
pediatric stone formers
Recurrence
repeat stone formers
What to Evaluate
Remember: HUBRS
H
History
- Check if patient is high risk
- Medications (if
↑ Ca) - Diet (
↑fluid loss /↑calcium /↑oxalate)
U
Urine
- Routine & culture
- Cysteine
B
Blood
- Renal function tests (RFT) & electrolytes
CO₂- Parathormone (PTH)
- Calcium, uric acid
R
Radiology
- CT scan
- X-ray
S
Stone Analysis
- Composition testing
- Guides prevention
High-Risk Workup
HUBRS + 24-hour urine
24-hour urine sample × 2
One random, one on restricted diet — for comparison
Calcium
Oxalate
Uric acid
pH
Citrate
Na⁺
K⁺
Creatinine
Cystine
Patient education resource by uRaology — Dr. Akshay Rao. For general education — always consult your doctor for personal advice.