Index

A Autosomal recessive disorder. See Cystine stones; Absorptive hypercalcicuria , 35, 51 ; 2,8-Dihydroxyadenine (DHA) ACA. See Affordable Health Care Act (ACA) stones Acetaminophen , 163, 165 Acetazolamide (Diamox) , 61, 81 Acetohydroxamic acid (AHA) , 38, 126 B Acute injury (AKI) , 154 Bacteriuria , 76 Adenine phosphoribosyl transferase (APRT) , 39 Benign prostatic hypertrophy (BPH) , 59, 71, 76, 94, 99, Adult stone disease , 79 140, 141, 150, 216 Afferent arterioles , 20 Beta agonists , 164–165 Affordable Health Care Act (ACA) Billing and coding process advantages , 236–237 coinsurance , 232 catastrophic coverage plan , 236 copay , 232–233 disadvantages , 237–238 CPT® , 229–230 four metal tiers plans , 236 E & M services , 232 health care law , 235 global period fee , 230 health services , 235 ICD-9 codes , 229 impact of , 235 ICD-10 coding system , 229 AHA. See Acetohydroxamic acid (AHA) modifi er , 230–232 ALARA (“As Low As Reasonably Achievable”) , 81 questionnaires , 233 Allopurinol (Zyloprim) , 52, 58, 64, 124 Bladder , 20 Aloe Vera , 184 exstrophy , 23, 24 Alpha-1 blockers , 76–77 function , 21 Alpha-mercaptopropionylglycine (Alpha-MPG) , 58 overactive , 165, 178 American Society of and the Endourological stones Society , 123 augmentation cystoplasty , 148–149 American Urological Association (AUA) guidelines in children , 80 diet therapies , 219 gender , 71 evaluation , 219 between prostate , 151 follow up , 219–220 symptoms , 27 pharmacologic therapies , 219 treatment , 27, 150 American Urological Association Meeting AUA (2014) , Urat-1, clinical device , 29 123 structure and location , 21–22 Ammonium acid urate calculi , 61, 70 surgical procedure Angiotensin converting enzyme (ACE) , 20 Greenlight™ laser ablation of prostate , 140–141 Antegrade progression , 92 open surgical cystotomy with stone Antibiotics , 38, 62, 120, 211 removal , 141 Anticholinergics , 156, 163–164 transurethral stone removal (cystolitholapaxy) , Anticoagulants , 120 139–140 Anti-epileptic drugs (AEDs) , 64 treatment , 139 Antimicrobial therapy , 38 Blood urea nitrogen (BUN) , 170, 172 Appendicitis , 3, 93, 207 Body mass index (BMI) , 64, 86 Aspirin , 63, 94, 119, 120, 130, 160, 162, 172 BPH. See Benign prostatic hypertrophy (BPH) Asymptomatic stone. See Incidental stones Bucillamine (Rimatil) , 58 Atkins diet , 195, 203–204 Bumetanide , 61

D.A. Schulsinger (ed.), : Say NO to Stones!, 241 DOI 10.1007/978-3-319-12105-5, © Springer International Publishing Switzerland 2015 242 Index

C IV dye (contrast) , 105 Calcium , 35, 184 multiple non-contrast renal protocol , 104 Calcium oxalate (CaOx) stones , 188 non contrast Calcium oxalate dihydrate (COD) advantage and disadvantage , 105 composition and fragility , 46 patient indications , 104–105 fragility of stones , 144 right lower pole renal stone , 148 radiopaque , 46 Congenital anomalies , 81 shape, size and color , 37, 43–44 Cranberry , 184 urinary , 44 Creatinine (Cr) , 172 Calcium oxalate monohydrate (COM) , 36 Crixivan® stones , 40, 62 composition and fragility , 46 Crohn’s disease , 71 radiopaque , 46 Crystallization , 178 shape, size and color , 44 Current Procedural Terminology (CPT® ) , 229–230 Calcium phosphate stones , 37 Cyclooxygenase (COX) , 162 radiopaque , 46 Cystine dimethyl ester (CDME) , 218 shape, size and color , 44, 45 Cystine, Ornithine, Lysine and Arginine (COLA) , 38 Calcium stones. See also Calcium oxalate Cystine stones , 35 dihydrate (COD); Calcium oxalate autosomal recessive inborn error , 38 monohydrate (COM) composition and fragility , 46 associated with obesity , 86 poorly radiopaque , 46 hypercalciuria , 35 prevalence of , 38 metabolic factors , 35 risk factor , 38 oxalate dihydrate , 35, 37 shape, size and color , 45–46 phosphate , 35, 37 treatment , 38–39 surgical therapy , 35 Cystinuria treatment , 36 metabolic and hereditary factors , 53–54 Calcium + Vitamin D3 (OsCal) , 125 stone formation , 58 Cancer , 52 Cystoscope , 157 leukemia , 57 lymphoma , 57 metastatic , 172 D obesity-related conditions , 85 Darifenacin (Enablex) , 164 patient, ureteral stent in , 153 DASH (Dietary Approaches to Stop Hypertension) prostate , 115 diet , 201–202, 209 Captopril , 58, 126 Dehydration , 51, 83, 175–178 Carbonic anhydrase inhibitors , 61 Diabetes , 57 Cardiovascular disease , 71 Diabetic nephropathy , 100 Celebrex (celecoxib) , 58 Diarrhea , 6, 56, 59, 61, 64, 70, 124, 125, 175, 182, 197 Chelating agent , 54, 58 Diet. See also Dietary patterns Chemolysis , 38 kidney stones, infl uence of , 187 Chemotherapeutic agents , 63 Dietary factors Children with stones calcium oxalate stones , 188 composition , 80 condition in digestive tract , 191–192 inherited abnormality , 83 into digestive tract , 190–191 prevention , 82 high urinary calcium excretion , 188–190 risk factors , 80–81 high urinary oxalate excretion , 190 symptomatology , 81 low urinary citrate excretion , 192 treatment , 82 low urinary magnesium excretion , 192–193 types of , 79–80 calcium phosphate stones work-up , 81 high urinary calcium excretion , 195 Chlorthaladone , 124 low urinary citrate excretion , 194 Cholecystitis , 3 case study , 199 Cinnamon , 184 cystine stones , 196 Ciprofl oxacin , 62 diabetes , 196–197 Citric acid (Citrate) , 182–183 macular degeneration , 198 Colchicine , 58 malabsorption , 197 Complete ureteral duplication , 23 nutrition therapy, goals for , 187–188 Computed tompography (CT scan) osteoporosis , 197–198 Index 243

special medical situations , 196 kidney stone , 135 uric acid stones stones , 138–139 high urinary uric acid excretion , 195 urinary stone treatment , 29–30 low (acid) urine pH , 195–196 urine volume ( see Hydration) Dietary patterns F lithogenic diets (see Lithogenic diets) Flank pain/renal colic , 92 with lower risk of stones Flomax® , 130 DASH diet , 201–202 Fluids Mediterranean diet , 202 consumption raw food diets , 203 kidney stone formation, prevention of , 179 vegetarian diet , 203 requirement for , 177–178 Weight Watchers diet , 202–203 timings , 178 Dietary supplements types of cautious about certain , 184 citrus based , 176 citric acid , 182–183 coffee , 177 magnesium , 181–182 food , 176 NSF® International seal, 184 soda , 177 Omega-3 fats , 183 tea , 177 potassium , 182 water , 176 pumpkin seeds , 183 Food and Drug Administration (FDA) , 184 rose hips , 183 Furosemide , 61 safety , 183–184 USP® seal, 184

vitamin B6 (pyridoxine) , 183 G 2,8-Dihydroxyadenine (DHA) stones , 39 Gastric/duodenal ulcer , 3 radiolucent calculi , 46, 143 Gastro-Intestinal Stromal Tumor (GIST) , 5–6 Diuretics , 63 Gender , 73 Dornier Compact Delta II lithotripter , 135 age , 69 Dornier HM1 , 29 anatomical barrier , 71 D-Penicillamine , 125 bladder stones , 71 Drosphila melanogaster , 217 case study , 73 Dual-energy CT (DECT) , 215–216 diseases Dukan diet , 205 cardiovascular disease , 71 Crohn’s disease , 71 eating disorders , 70–71 E laxative abuse , 70 , 145, 146 osteoporosis , 71 Elderly with stones factors diagnosis , 83 post-menopause , 72 management , 83–84 during pregnancy , 72 prevalence , 83 vasectomy , 72 risk factors , 83 hormones , 72 Electrohydraulic lithotripter , 29–30 risk factors , 72 Electrohydrolic force , 77 statistics , 69 Endoscopy equipment, 141–142 stone types , 70 Endourology fellowship , 113, 114 symptoms , 70 Ephedrine , 62–63 Gerota’s Fascia , 20 Epididymitis , 208 Good Manufacturing Practices (GMPs) , 184 , 25 Gout , 57–58 Estrogen , 58, 72 Gross , 94 Ethylene glycol , 217 Guaifenesin stone , 63 Evaluation and management (E & M) services , 232 Extracorporeal shock wave lithotripsy (ESWL) technique, 77 complication , 148 H lower pole stone , 147 Health care plan , 238–239 stone(s) fragment , 82 Hematuria , 173 surgical procedure Heterologous nucleation , 52 244 Index

Horeshoe kidney , 147 Intractable pain , 62, 77, 92, 98, 116, 120, 156 Hounsfi eld units (HU) , 46 Intramural ureter , 92 24 hours urine test Intravenous Urography (IVU) , 106, 107 appropriate time for collecting , 170 determination of urine volume , 179 method , 171 J multiple factors on , 171–172 Jackson Pratt drains , 12 poor man’s , 171 preparation , 170–171 results , 171 K urine container , 170 Ketorolac , 163 “World Series” of urine tests , 170 Kidney Hydration , 129, 179 congenital anomalies fl uids intake (see Fluids) , 22 goals , 178 renal ectopia , 23 management function , 20 fl uid by numbers , 179 retroperitoneum , 20 urine by colors , 178–179 structure and location , 20–21 Hydrochlorothiazide (HCTZ) , 51, 124 Kidney stones. See also Stones Hydromorphone (Dilaudid) , 161–162 in animal models , 216–217 Hydronephrosis , 92, 104, 105, 207 in children , 79–80 Hydroureteronephrosis , 75, 76, 81 management of Hydroxyapatite. See Calcium phosphate stones AUA guidelines for , 219–220 Hyperoxaluria , 35, 52–53, 125 imaging technology , 215–216 Hyperparathyroidism , 58, 172 new medications and probiotics , 217–218 Hypertension , 57, 61, 63, 83, 85, 126, 135, 165, 201, SDM , 216 202, 209 preventing formation of Hyperuricosuria , 35, 36 complimentary medicine (see Dietary metabolic and hereditary factors , 52 supplements) stone formation , 59 nutrition recommendations (see Dietary Hypocitraturia , 35, 51 factors) medical therapy , 124 robotic approaches , 218–219 metabolic and hereditary factors , 52 treatment options , 215 stone formation , 59 Klebsiella , 93 , 23–24 K. pneumonia , 38 Hypoxanthine-guanine phosphoribosyl transferase KUB (Kidneys, and Bladder) (HGPRT) , 80 advantages , 107 disadvantage , 107 plain-fi lm radiography , 106 I radiation dose , 106–107 Ibuprofen , 58, 119, 162, 163, 170, 227 radiopaque stone , 106, 107 Immobilization , 56 steinstrasse , 148 Incidental stones with ultrasound combination , 107 indications to treat , 98 medium sized stones , 98 prevention , 99–100 L small stones , 98 Laxatives , 61 treatment L-cystine dimethylester (L-CDME) , 126 option , 98 Lesch-Nyhan syndrome , 52, 80 planning your procedure from offi ce vs. ER , 99 Leukemia , 57 vs. symptomatic stone , 100 Lithogenic diets work up , 99 Atkins diet , 203–204 Incisional hernia , 11 Dukan diet , 205 Incomplete ureteral duplication , 23 ketogenic diet , 204 Indinavir (Crixivan) , 62 Paleo diet , 205 Indinavir sulfate , 40 South Beach diet , 204 Indispensable water losses , 177 Western diet , 204–205 Indocin (indomethacin) , 58 Zone diet , 204 Indomethacin , 163 Loop diuretics , 61–62, 81 International Classifi cations of Diseases (ICD) , 229 Lymphoma , 57 Index 245

M gender and stone risk factors , 72 Magnesium , 181–182 prevalence of , 85 Magnesium ammonium phosphate stone. See Struvite and stone disease stones body mass index , 86 Magnesium citrate , 53 waist circumference , 86 Magnesium oxide , 53, 125 weight gain , 85–86 Magnesium trisilicate , 61–62 in United States , 85 MAG-3 renal scan Obstructive uropathy , 97 disadvantage , 108 Omega-3 fats , 183 nuclear renogram , 108–109 Open cystolithotomy , 150 Tc-99 m MAG3 , 108 Open-ended catheter , 157 tracers , 108 Opioids , 161 vs. IVP , 108 defi nition , 165 Medical expulsive therapy (MET), 76–77, 98, side effects , 165 107, 130 Oral antibiotic therapy , 53 Medical therapy , 38, 82 Osteoporosis , 71 calcium stone formers Oxalate decarboxylase (Oxazyme) , 218 cystinuria , 125–126 Oxalobacter formigenes , 53, 218 hypercalciuria , 124 Oxybutynin (Ditrpopan, Oxytrol) , 164 hyperoxaluria , 125 Oxycodone (ex. Roxicodone) , 162 hyperuricosuria , 124 hypocitraturia , 124 hypomagnesiuria , 125 P future stones maintenance/management , 210 Paleo diet , 205 non-calcium stone formers Parenchyma , 20 infection stones , 126 Patients Mediterranean diet , 202 asymptomatic stone (see Incidental stones) Medullary sponge kidney (MSK) , 57 ER room #2 (nebulous room) Meperidine (Demerol) , 162 blood test , 4 Metabolic and hereditary factors colonoscopy , 6 cystinuria , 53–54 CT scan in abdomen , 4 hypercalciuria , 51–52 diagnosis and , 4 hyperoxaluria , 52–53 gastrointestinal stromal tumor , 5 hyperuricosuria , 52 hematologist/oncologist investigation , 5–6 hypocitraturia , 52 preparation for surgery , 7–8 hypomagnesiuria , 53 raising appropriate questions , 6, 8 Metabolic therapy , 82 ultrasound evaluation , 4 Microscopic hematuria , 94 future stones maintenance/management Micturition , 20 CM therapy , 210 Mirabegron (Myrbetriq) , 165 diagnosis , 211 Morphine , 161 dietary recommendations , 210 Motrin (ibuprofen) , 58 with dietician , 209 MRI , 103, 107, 145, 238 follow up tests , 210–211 Multiple endocrine neoplasias (MEN) syndrome , 52 follow up with Urologist , 208–209 hydration status , 209–210 medical therapy , 210 N questionnaires , 211 Nephrostomy tube , 157 symptoms awareness , 207–208 Non-steroidal anti-infl ammatory drugs with yourself , 211 (NSAID), 162–163 staghorn calculi, treatment for , 98–99 defi nition , 165 stone procrastinators , 98 side effects , 166 with symptomatic stone (see Symptomatic stone) Pelvic brim , 21 O Percutaneous nephrolithotomy (PCNL) , 29, 77, 82, 103, ObamaCare. See Affordable Health Care Act (ACA) 216 Obesity surgical procedure, kidney stone case study , 86–87 advantages and disadvantages , 132 causes , 85 description , 132–134 description , 85 indication , 132, 133 246 Index

Phenytoin , 81 Serratia , 93 Potassium , 182 Serum calcium test , 172 Potassium citrate (Urocit-K) , 52, 54, 64, 124, 125 Serum chemistry (BUN, Cr) test , 172 Pre-admission testing (PAT) , 130, 131 Serum parathyroid hormone test , 172 Prednisone , 52 Serum uric acid test , 172 Pregnancy and urolithiasis Serum Vitamin D , 173 anatomic factors , 75–76 Shared decision making (SDM) , 216 case study , 78 Shock Wave Lithotripsy (SWL) , 103 follow up , 77 Solifenacin (Vesicare) , 164 incidence , 75 South Beach diet , 204 metabolic factors , 76 Staghorm calculi , 29 symptoms , 76 treatment for , 98–99 treatment of , 76–77 Staphylococcus , 93 work-up , 76 S. aureus , 38 Primary hyperoxaluria , 53, 80, 125, 190 S. epidermidis , 38 Primary hyperparathyroidism. See Resorptive hypercalcicuria Steinstrasse , 148, 155 Probiotics , 183 Steroids , 64 Proteus mirabilis , 38 Stone Cup Strainer , 169 Providencia , 93 Stones. See also specifi c stones Pseudomonas , 38, 93 to access , 145–147 Pumpkin seeds , 183 composition and fragility , 46 Pyelolithotomy , 132 diagnosis Pyelonephritis , 92, 97 radiolucent stones , 143 ureteral stones , 144 etiology , 46 R facts , 32–33 Randall’s plaques , 21, 35, 36 formation Raw food diets , 203 age and gender , 64 R e fl ux , 21 anatomical factors , 59 Renal calyceal diverticula , 147 cancer , 57 Renal colic , 79 climate factors , 55 drug induced , 60–64 diabetes , 57 pain associated with diarrhea , 56 control , 159 dietary factors (see Dietary factors) frequently asked questions , 165–166 ethnicity , 66 location of , 159 family history , 66 medication , 161–165 genetic factors (see Metabolic and hereditary therapy , 159–160 factors) patient interview , 160–161 hormones , 58–59 Renal hypercalcicuria (renal leak) , 35, 51–52 infl ammatory bowel disease , 56 Renal pelvis , 21 lifestyle factors , 56 Renal sinus , 21 medication factors , 60–64 Renal tubular acidosis (RTA) , 52, 58, 124 medullary sponge kidney , 57 Renin , 20 occupational factors , 56 Resorptive hypercalcicuria , 35, 51, 52 sarcoidosis , 56 Retrograde movement , 92 surgical factors (see Surgical procedures) Retrograde (RP) , 108 and urinary pH , 47 Reyataz® (atazanavir) stones , 40 urinary tract infections , 57–58 Rose hips , 183 fragility of , 144–145 Roux-en-Y (RYGB) , 59 and gender , 47 location , 47 lower pole , 147–148 S passage rates , 48 Saponifi cation process , 53 in patient Sarcoidosis , 52, 56 with bladder augmentation cystoplasty , 148–149 Seizure diet (Ketogenic diet) , 204 urinary diversion , 149–150 Seizure disorders personal experiences with , 31–33 acetazolamide , 61 prevalence of , 31 topamax (topiramate) , 40–41 prevention , 129–130 Index 247

Randall’s plaques in papilla , 91 small bowel resection , 60 rule of 50 , 33 on surgery day , 131 size , 47–48 time out , 131 special stone scenarios , 221–227 ureter stones symptoms cystoscopy with ureteral stent antegrade progression , 92 placement, 137–138 dysuria , 92, 95 ESWL , 138–139 fl ank pain/renal colic , 92 open surgery , 136 hydronephrosis , 92 ureteroscopy , 136–137 intramural ureter , 92 Symptomatic stone ipsilateral testicle , 93 composition and location , 97 pain , 92–95 imaging studies , 97 pyelonephritis , 95 medical attention in local hospital , 97 retrograde movement , 92 series of tests , 97 strangury , 95 shapes and size , 97 in UPJ , 91, 92 symptoms , 97 treatment and prevention treatment analysis , 169–170 indications to , 98 24 hours urine test (see 24 hours urine test) options , 98 types of , 35, 36 vs. incidental stones , 100 X-ray characteristics of , 46–47 Systemic lupus erythematosus , 52 Stress , 56 Stricture , 108 Struvite stones , 93 T causes , 37 Tamsulosin dilate , 130 composition and fragility , 46 Testicular torsion , 208 diagnosis , 38 Testosterone , 72 infectious stones , 37–38 Thiazide diuretics , 219 medical management , 37, 38 Thiopronin (Thiola) , 125–126 poorly radiopaque , 46 Tolerance, defi nition , 165 risk factors , 38 Tolterodine (Detrol/Detrol LA) , 164 shape, size and color , 45 Topamax® stones , 40–41 treatment , 37 Topiramate (Topamax) , 64, 81 urinary pH , 47 Tramadol (Ultram) , 162 urinary tract infections , 37–38 Triamterene stone , 63 Sulfadiazine , 62 Trospium (Sanctura/Sanctura XR) , 164 Sulfamethoxazole-trimethoprim (Bactrim) , 62 Tumor lysis syndrome , 194–195 Sulfonamides , 62 Turmeric , 184 Superior mesenteric artery (SMA) , 6 Tylenol , 119, 120 Surgical procedures anesthesia , 131 appropriate questions , 14 U bladder Ultrasonic propulsion , 216 GreenlightT laser ablation of prostate , 140–141 Ultrasound , 4, 29, 46, 77, 135, 144, 216 open surgical cystotomy with stone removal , 141 abdominal , 83 transurethral stone removal (cystolitholapaxy) , kidney and bladder , 81 139–140 KUB with , 107 treatment , 139 renal , 83, 94, 105–106, 211 elective hernia procedure , 12–14 United States gastric bypass procedures , 59–60 bladder stones , 150 ileostomy and colon resection , 60 children with urinary tract stone , 79 kidney stone codes in , 229 ESWL , 135 cystinuria prevalence , 38 open surgery , 132 elderly with stones , 83 PCNL , 132, 133 kidney and ureteral stones , 29 ureteroscopy , 132–135 medullary sponge kidney in , 57 postoperative instruction , 120–121 obesity, prevalence of , 85 preparation , 119–120, 130–131 Urat-1 , 29 site and side verifi cation , 131 Urease inhibition , 38 248 Index

Ureter , 19 Uricosuric agents , 62 function , 21 Urinary calculi , 61 structure and location , 21 Urinary stasis , 57 ureteral duplication , 23 Urinary stones Ureteral jets , 76, 81, 105, 106 history of , 27 Ureteral manipulation , 154 milestones of disease , 27 Ureteral pelvic juncture (UPJ) , 91 symptoms , 27 Ureteral stent treatment advantages crushing stone , 27, 28 infection , 154 cystoscope , 28 injury , 154 electrohydraulic lithotripter , 29 narrowed ureter , 154–155 ESWL , 29–30 obstruction , 154 lithotomous , 27–28 prophylaxis , 155 PCNL , 29 swollen ureter , 154 surgical procedure , 27 alternatives , 156–157 Urat-1 , 29 contact with Urologist , 156 Urinary tract infections (UTI) , 57 disadvantages Urinary tract stones blood , 155 management strategy , 123 calcifi ed stents , 155 medical therapy (see Medical therapy) displaced stents , 155–156 metabolic cause , 123 irritative voiding symptoms , 155 treatment , 123 pain , 155 Urinary tract system stent colic , 156 bladder , 20 insertion of , 156 functions , 19 length , 153 kidneys, two bean-shaped organ , 19 limitations , 156 ureters , 19 materials , 153 urine excretion , 19 removal , 157 Urination , 20 structure , 153, 154 Urine Ureteropelvic junction (UPJ) , 21, 71 dipstick , 173 Ureteropelvic junction obstruction (UPJO) , 145–147 low and high volumes , 81 Ureteroscopy , 129 pH , 81 kidney stone volume (See Hydration) advantages and disadvantages , 135 Urine Analysis, Culture and Sensitivity (UA, C & S) , description , 133–135 173 indications , 133 Urolithiasis ureter stones diagnosis , 103–104 advantages and disadvantages , 137 diagnostic imaging description , 136–137 MRI , 103, 107 indications , 136 ultrasonography , 103 Ureteroscopy (URS) technique , 82, 216 x-rays ( see Computed tompography (CT scan); Ureterovesical junction (UVJ) , 21 Intravenous Urography (IVU); KUB) initial management , 103–104 epispadias , 25 treatment , 103 function , 22 Urologist selection hypospadias , 23–24 different qualities in , 113 structure and location , 22 helpful facts , 114–115 Urethral glands , 22 list of questions , 113, 114 Urethral meatus , 22 second opinion, seeking for , 115–116 Uric acid stones , 35 treatment associated with obesity , 86 electively and emergency room , 116 composition and fragility , 46 option , 116 diabetes , 57 performance place , 116 factors , 36 type of insurance , 114 incidence of , 36 low urine pH , 36 radiolucent , 46 V shape, size and color , 44–45 Vasopressin , 56 treatment , 36 Vegetarian diet , 203 Index 249

Venofer , 13 Western diet , 204–205

Vitamin B6 (Pyridoxine) , 183 Whewellite. See Calcium oxalate monohydrate Vitamin C , 81 Vitamin C (ascorbic acid) , 184 Vitamin D , 76, 81 X Xanthine oxidase , 39 Xanthine stones , 39 W radiolucent , 46 Water , 179 dehydration , 175 intoxication , 175 Z signifi cance of , 175 Zone diet , 204 Weddellite. See Calcium oxalate dihydrate Zonisamide (Zonegran) , 64 Weight Watchers diet , 202–203