MRCP2-4108

MRCP2-4108

A 36-year-old man has been referred to the renal clinic. He experienced an episode of loin pain and passed a small renal stone two weeks ago. He had a similar episode three years ago but did not seek medical advice. Apart from these episodes, he is healthy.

The results of his investigations are as follows:
– Haemoglobin: 145 g/L (130-180)
– White blood cells: 7.5 ×109/L (4-11)
– Platelets: 210 ×109/L (150-400)
– Serum sodium: 137 mmol/L (137-144)
– Serum potassium: 4.2 mmol/L (3.5-4.9)
– Serum urea: 6.1 mmol/L (2.5-7.5)
– Serum creatinine: 100 µmol/L (60-110)
– Serum corrected calcium: 2.3 mmol/L (2.2-2.6)
– 24-hour urine collection: Volume 1150 ml/24hr – Calcium 18 mmol/24hr (2.5-7.5)

The analysis of the stone showed that it mostly contained calcium. What initial advice would you give to this man?