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Anthony Bray MD
Anthony Bray MD, Physician / Family Practice
Category: Urology
Satisfied Customers: 10341
Experience:  I have 14 years experience in Family Practice which includes the treatment of most co
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I had a complete metobolic panel of blood work done several

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I had a complete metobolic panel of blood work done several months ago and my creatine was slightly elevated but the creatine/bun ratio was normal. My neutrophils absolute were also alittle elevated. My WBC were a little high as well. Everything else was normal range.
Doctor at time said it was fine.
we repeated the bloodwork a month later and all levels were normal .
I recently took a urinalysis and it came back negative for everything. However at the bottom of the report it said Uric Acid Crystals Identified
And mucus 1+
Protein and WBC were normal.
Is this urine result a concern? Does it mean I have kidney issues or perhaps kidneys stones?
As a background I have lost about 25 pounds in the last few months. I have been suffering from severe stress and depression for over a year and am also looking into possibly being hypoglycemic.
I also had a slight incontinence problem for years that has greatly subsided in the past few months, I contributed it to the weight loss.
I took the urine test after being treated with monsels solution a month prior for a cervical polyp removal cauterization and had also used metrogel vaginal gel about a three weeks before the urine test for a vaginal bacterial infection, perhaps these things can reflect crystals in urine , perhaps falsely?
I also have been taking Klonopin for about seven months, could this be causing kidney issues?
What does Uric acid crystals detected mean? Can't it mean other things besides a stone' or perhaps nothing at all?
Can they only mean that I have a stone, that the crystals are shedding from the stone?
I do not want to rush to a urologist, my GYN says to see one, my general practioner says it is not a concern.
I also had crystals detected in 2011.
What do I need to do?
Thank you
Optional Information:
Person's Age: 45


I think that the repeat of your labs a month later and all being normal is most reassuring here...

The uric acid crystals would not necessarily mean that you currently have any kidney stones BUT the presence of crystals would indicate that you may be at an increased risk for developing such in the future. Drink plenty of fluids would be the main precaution to help prevent ANY type of kidney stone!

The elevated creatinine would be reflective of kidney function. It can also be affected by your muscle mass or any muscle breakdown. It sounds reassuring that you had follow up labs that were normal and that your doctor did not express any concern regarding this is also probably a good sign that it was not of a significant degree ....

The elevated white count and neutrophils would be a typical body response to a bacterial infection being present. Here again if this was repeated and normal on follow up and you have no concerning symptoms then this would be signs that you have nothing to worry about at this point!

I hope this helps! Let me know if you have further questions and I will be happy to get back with you!

If my answer has been helpful and to your satisfaction then please remember to leave positive feedback. Thank you and Best Regards,

Anthony Bray MD

Customer: replied 4 years ago.
could the crystals be a results of a bladder or kidney problem caused by the trauma if the polyp removal, metrogel for bacterial infection. possibly an infection now in my bladder or kidneys? And just follow up urine in a month?


No the uric acid crystals WOULD NOT result from any of the things that you mentioned above....

These would result from you having high uric acid in the blood stream which is then filtered into the urine. If the urine is too concentrated with uric acid vs water then crystals form.

That is why drinking plenty of fluids( I recommend 8 to 12 ounces of fluid every 2 hours while awake) is your best protection against these crystals getting worse and having the potential to form kidney stones.

I hope this helps! Let me know if you have further questions!

Best Regards,

Anthony Bray MD

Customer: replied 4 years ago.

So, no need to ruch t a urologist right now, just repeat the urine and drink plenty of fluids, correct?

Hi again!!

Yes there would not seem to be any reason at this point for you to need to consult a urologist... I agree with a follow up urinalysis as a reasonable and prudent step! Yes to the question with regard to push those fluids!! Very good for you in general to stay well hydrated!!

I hope this helps. Let me know if you have further questions!

Best Regards!!

Anthony Bray MD

Customer: replied 4 years ago.

I do already drink alot of fluids , i will drink more.

What else can uric acid crystals in urine mean?

I was told that the crystals shed from the stone? Also told is it because a stone may move around that I sometimes show crystals and sometimes dont.

Hello again!!

It does not have special sinister meaning... there are some foods that you may watch for to help drop your uric acid level (it is weird list >> you may google combination of Gout and Diet for additional info) >>> but less sardines, beer, sweetbreads, Anchovies, liver, spinach (organ meats), spinach, mushrooms, asparagus, cocoa, oatmeal ... (these are foods high in purines)

(I told you it was a weird list right! )

The crystals are not coming off of a kidney stone!! IT does not work that way!! It is the reverse.. crystals may enlarge to form stones but the dissolution of stones would not produce crystals... more like an ice cube melting..

The presence of crystals or high blood level of uric acid in itself does NOT represent a medical problem that requires any treatment!! It is a sign of it being a good idea to do what you can toward prevention of possible gout or uric acid kidney stones however...

I hope this helps!

Let me know if you have further questions!!

Take Care,

Anthony Bray MD

Customer: replied 4 years ago.
thank you . My dad had calcium based (I think) stones in his 40's and 50's , passed stones the size of peas !! on his own! His doctors were stunned at the size. . Couldn't believe he was able to pass them . that is why I probably am overly concerned. He actually went into renal failure and dialysis for the last ten years if his life. Not sure if that is related to stones. I do suffer sometimes from lower left back pain but that pain usually continues down my leg and mid back pain sometimes. It started when I started the klonipin several months ago. Just let me know what the signs are of a stone and I will be on the alert. I was also worried because my incontinence issue has subsided substantially in the past few months, but I have also lost alot if weight, so I attribute it to that.I was also told by another urologist that crystals are Always from a stone so it gets confusing .

Hello again!

I see >> well obviously I strongly disagree that crystals are from stones... as I said crystals may grow to stones. If you had an obstruction of a ureter and uric acid crystals present then this combination would certainly make the detective in us say that this was very good evidence of the stone likely being a uric acid stone....

Typical symptoms of kidney stones would be sharp pain most typically in the flank are( area of side/back just at lower edge of ribcage) That is where your kidneys are located. Kidney stones are notoriously high on the pain scale and usually produce nausea as well. Blood in the urine (this may be microscopic or tea colored urine or blood tinged urine) is another potential sign.

I hope that this information helps. Let me know if you have further questions and I will ill be happy to get back with you!!

Best Regards,

Anthony Bray MD

Customer: replied 4 years ago.
how would I know if I had an obstruction in the urethra?

Hello again,

First a bit of clarification... urethra is the tube from bladder to the outside>> you would not be able to urinate...

The ureters are the tubes from the kidney to the bladder>> usually this would cause pain and nausea.. this location may cause lower abdominal pain however... I have seen a few CHRONIC cases with very few active symptoms >> ongoing nausea sometimes presents... It can cause damage or even failure of one kidney if that occurred... if obstruction was relieved in time then kidney would usually be OK...

I hope this helps to clarify. Let me know if you have further questions!

Best regards,

Anthony Bray MD

Customer: replied 4 years ago.
I did have
Lower stomach pain , kind of by my belly button , for a few weeks, thought is was constipation, took colace . Thatpain has basically subsided.
So, still no real concern at this time?
No CT needed?
Just tell me what to watch for and I will.
Also, wouldn't bloodwork show o problem if something was in the ureter? Like high levels f something? Do I even need another urine test ? Can I just wait and see?

Hello again,

Well I guess that I would tend to favor the cautious side and do a follow up urinalysis. This is a simple and inexpensive test. It could determine if you had blood in the urine as a red flag for example. I do not think that you need a CT or any extensive tests or urology referral at this time if your are not symptomatic in a way that would suggest possible stone...Potential to follow up on presence of uric acid crystals too >> on this issue as I said the mere presence of crystals does NOT indicate the need for any medical intervention (such as drugs to lower the uric acid for example) but is a measure of caution associated with this finding...

No, if one ureter was blocked this would not necessarily be clear on a blood test as one kidney can function sufficiently to handle the body's needs. (Amazing isn't it?)

I hope this has been helpful for you! Let me know if you have further questions!

Best Regards,

Anthony Bray MD

Customer: replied 4 years ago.
There was no blood in the first urine test so I am thinking I should just relax . Just let me know what symptoms I may have if there really was something wrong..would rather not test and worry unneccesarily. Thanks. Won't even worry if crystals show up again in the future as they have already showed up in the past.
And one last question, my incintinence clearing up , could it be a sign of a blocked ureter?

Hello again,

No I think it is good for you to stop over-worrying the matter!!

The improvement of incontinence has never been a BAD thing as far as I know!! No , this would not be any suspicious symptom for you!!

I hope that this helps! Take Care and Best Regards!!

Positive feedback would be very much appreciated if my answers have been helpful and to your satisfaction! Thank you and again Best Regards,

Anthony Bray MD

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Customer: replied 4 years ago.
Wanted to show you what other urologist said about it absolutely being a stone. Also , are you a urologist? You have rated an Answer!From Dr. YTuesday, April 09, 2013 6:45 PM ESTThe crystals can be intermittent appearing in the urine. Any amount of uric acid crystals in the urine should prompt a workup by a urologist as there should not be any uric acid crystals in the urine.My goal is to provide you with excellent service . Please remember to rate my service only after you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!You Rated:Excellent service You repliedTuesday, April 09, 2013 8:09 PM ESThello again, why would crystals come and go from year to year? Whst type of work up would a urologist do with my urine results? Please be specific , would it be a type of bloodwork, different urine tests? thanks You have received an Answer!From Dr. YTuesday, April 09, 2013 8:29 PM ESTIf you have a stone, this can intermittently shed crystals into the urine. This is why you may not see it all the time. The only next test you need is a CT scan to evaluate for the presence of stones.My goal is to provide you with excellent service . Please remember to rate my service only after you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!Rate to FinishYOUR RATING IS REQUIRED to determine your Expert's credit for this answer. Unless you rate "OK service" or higher, your Expert will not receive credit.Bad servicePoor serviceOK serviceGood serviceExcellent serviceSelect the face that best describes your Expert's service and click Submit.Or, Reply to Expert You repliedTuesday, April 09, 2013 9:08 PM ESTIs a stone thel only reason I could have crystals shedding? You have received an Answer!From Dr. YTuesday, April 09, 2013 10:44 PM ESTYes
Hello again!!No I am NOT a urologist. I am in Family Practice and before medical school I worker as a chemist in medicinal chemistry for four years---- may google or Wikipedia "Camptothecin" --- "Irinotecan"---"Topecan"--- Dr. Monroe Wall and Dr. MC Wani were my bosses at the time and are mentioned on some articles. Camptothecin was from a Chinese tree that was found to have some anti- cancer properties and was too toxic to be used. From this compound the two following drugs aboved were made and studied and are now being used as cancer medications. My point is that I KNOW the development of crystals ..... Just like snow flakes crystals form from a concentrated solution.... Snow flakes do NOT fall of of a freaking glacier!!!! Just like this Uric acid crystals could grow large into stones BUT URIC ACID CRYTALS DO NOT BREAK OFF OF A URIC ACUD STONE!!!! A stone may dissolve into solution such as an ice cube into water under the right conditions ( dilute urine and preferably basic ) Now the presence of crystals may very well co-exist with kidney stones... But a stone DOES NOT shed CRYTALS !!! Of this I can assure you!! The best test for evaluating for the presence if stones if present would be a renal CT. This would identify the presence of any stones of significant size . I hope this information helps! Let me know if you have further questions!!Best Regards,Anthony Bray MDPS anything to the contrary to the crystal formation is a misunderstanding of the underlying chemistry and I have worked as a professional chemist prior to training to become a physician....
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