Louisville Lectures

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Soundbites from the Quarry- Adventures in Stone Disease by Dr. Lederer

Dr. Eleanor Lederer presents stone disease and how stones may be a presenting feature in many systemic diseases.  She then discusses diseases and how many are accompanied by stones as well as metabolic evaluation leading to therapies that result in limitation or even cessation of nephrolithiasis.

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'adventures in stone disease' Notes

In this lecture, Dr. Lederer gives several cases of systemic diseases presenting with nephrolithiasis. Kidney stones are often seen and referred to Urology without a great deal of additional thought. Dr. Lederer discusses how to use a stone workup to uncover early presentations of significant systemic disease. A deliberate metabolic evaluation for stones can often uncover an underlying and previously undiagnosed disorder.


  • After publishing the recent lecture by Dr. Lederer on clinical decision making, Dr. Lederer walks through her thought process of several cases where she diagnosed an early presentation of a systemic disease via stones and their workup.
  • The mechanisms of formation for several different stones is discussed along with co-morbidities that can cause them.
  • Dr. Lederer does discuss the workup of several types of stones and treatment as she works through her cases.
  • Dr. Lederer makes House, MD look like an amateur.


  • Brief introduction
  • Cases 1-5 (no spoilers!)
    • Presentation, Lab and Workup, and Diagnosis with Pathophysiology Review
  • Conclusion

Further Reading:

Specifically for those wanting a better background on stones, we’ve got two great articles:

  1. From the Canadian Medical Association Journal, a great review of workup of recurrent stones (with cases):


  2. From the Europeans, a recent review of the intersection of medical management and urological management of stone disease (paywall):


Eleanor Lederer, M.D., F.A.S.N., F.A.C.P.

Dr. Eleanor Lederer is Professor of Medicine, Chief of the Nephrology & Hypertension Division and Director of the Neprhology Training Program at the University of Louisville.  Her clinical expertise involves nephrology, transplant, kidney stones, genetic kidney disease and high risk pregnancy.

Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.

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