Staged treatment for substantial bilateral calcium carbonate nephrolithiasis in vegan patient

Calcium carbonate (CaCO3), or calcite, stones average 0.15% of annual nephrolithiasis cases. The authors report a 53 year old female, following a 15 year vegan diet, presenting with left flank pain and later found to have bilateral extensive staghorn renal calculi requiring multiple procedures over the course of months. Calcite stone formation is likely attributed to the patient's vegan diet and vitamin supplements. This stone's formation increases with neutral or alkaline urinary pH in the presence of high levels of magnesium. The authors discuss staged surgical treatment plans and non-surgical management prophylaxis with surgery as another possible route for treatment.