The searing pain of a kidney stone – often described as worse than childbirth – affects roughly 1 in 10 people. But for those who experience recurrent stones, life can develop into a relentless cycle of discomfort, emergency room visits, and surgical interventions. Now, researchers at Stanford Medicine are focusing on a new approach: preventing kidney stones before they even form.
While dietary adjustments and existing medications can help some patients manage kidney stones, they don’t always provide a lasting solution. A team led by Dr. Alan Pao, director of the Stanford Medicine Kidney Stone Clinic, is investigating ways to address a key factor in stone formation – low levels of citrate – with a novel drug approach. This research aims to offer hope to individuals who currently have limited options for preventing future episodes.
Kidney stones are typically composed of calcium that combines with other minerals in the urine, creating hard deposits. Citrate acts as a natural deterrent, binding to calcium and keeping it dissolved, allowing it to be safely eliminated from the body. However, up to half of all kidney stone patients have unusually low citrate levels, according to research at Stanford. Existing treatments to increase citrate can unfortunately raise urine pH, potentially leading to the formation of a different type of stone – a particular problem for women who often experience both low citrate and high urine pH.
Dr. Pao’s lab is developing drugs that specifically target and raise citrate levels without the unwanted side effect of increasing urine pH. The team is focusing on a protein called NaDC1 (sodium dicarboxylate cotransporter 1), found in kidney cells, to achieve this targeted increase. “I’m in an environment here at Stanford where I can collaborate with medicinal chemists, cellular physiologists and pharmacologists to come up with new treatments to help these people who don’t have any other options,” Dr. Pao said in a recent interview.
Understanding the Challenges of Kidney Stone Prevention
The current approach to kidney stone prevention often involves general recommendations like increasing fluid intake and making dietary changes. While these measures can be helpful, they aren’t always effective, particularly for individuals with underlying metabolic issues. The Stanford Kidney Stone Clinic emphasizes an evidence-based approach to treatment, collaborating with specialists in nephrology, urology, and endocrinology to provide comprehensive care. Learn more about the clinic’s mission and collaborative partners.
The clinic’s research extends beyond drug development, encompassing efforts to improve diagnosis and tracking of kidney stone disease. Dr. Pao runs a research program investigating how doctors can better diagnose, track and treat kidney stones. As reported recently, this includes exploring new methods for identifying individuals at high risk of developing recurrent stones.
A Collaborative Approach to Research
The Stanford Kidney Stone Clinic isn’t working in isolation. The clinic actively partners with various specialty services to deliver comprehensive medical and surgical care. This collaborative environment fosters innovation and allows for a holistic understanding of kidney stone disease and its related disorders. The clinic’s research programs involve physician-scientists, biostatisticians, and research scientists, creating a robust infrastructure for advancing the field.
Dr. Alan Pao is an associate professor of medicine in the nephrology division at Stanford University School of Medicine. His profile on the Stanford Health Care website details his medical education and board certifications.
The research at Stanford represents a significant step forward in the fight against kidney stones. By focusing on targeted therapies and a deeper understanding of the underlying mechanisms of stone formation, Dr. Pao and his team are working towards a future where recurrent kidney stones are no longer a debilitating reality for millions.
Looking ahead, the success of these new drug therapies will depend on ongoing clinical trials and further research into the complex interplay of factors that contribute to kidney stone development. The Stanford team’s commitment to collaborative research and evidence-based medicine offers a promising path towards more effective prevention strategies.
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Disclaimer: This article is for informational purposes only and should not be considered medical advice. Please consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
