Sept. 13, 2025
Kidney stones represent a common and recurrent urologic condition that affects up to 1 in 10 people. For many patients, the experience of passing stones is acutely painful, frequently disruptive to daily life, and often leads to multiple emergency visits or surgical interventions. In more complex cases, stones can result in infections, obstruction or long-term kidney damage.
At Mayo Clinic in Rochester, Minnesota, the Multidisciplinary Stone Clinic offers a unique, team-based approach to stone disease that consolidates expert care, advanced diagnostics and personalized treatment strategies in a single destination center. The clinic provides referring physicians with a trusted partner in delivering cutting-edge, patient-centered care for kidney stone disease.
Collaborative expertise for comprehensive management
The Multidisciplinary Stone Clinic is built around a team-based model of care that brings together specialists from nephrology, urology, dietetics, clinical genetics and laboratory research. Rather than having patients navigate sequential visits across disciplines, the clinic consolidates care into a collaborative setting. Multiple experts evaluate the patient simultaneously and develop a unified management plan. This not only improves efficiency but also ensures that all relevant aspects of stone disease, from systemic risk factors to anatomical considerations, are thoroughly addressed.
The clinic was co-founded and is co-directed by John C. Lieske, M.D., a nephrologist renowned for his research in stone-forming diseases, and Kevin Koo, M.D., M.P.H., a urologist specializing in minimally invasive surgical treatments. Their joint leadership ensures that every patient benefits from a cohesive and evidence-based care pathway, reducing fragmentation and enhancing outcomes.
"By combining rigorous metabolic evaluation with patient-specific interventions, including timely preemptive surgeries, we can significantly reduce symptomatic kidney stone recurrence rates and improve long-term kidney health," says Dr. Lieske, who also is a professor of medicine at Mayo Clinic College of Medicine and Science. "Our multidisciplinary model enables us to look beyond the stones and identify systemic contributors to disease that may otherwise go unnoticed."
Precision metabolic evaluation and diagnostics
A cornerstone of the clinic's approach is a detailed metabolic workup designed to uncover the root causes of stone formation. Patients undergo 24-hour urine testing, serum metabolic panels and stone composition analysis to identify correctable abnormalities such as hypercalciuria, hypocitraturia, hyperoxaluria or acidic urinary pH.
Advanced imaging techniques, including dual-energy CT scans, provide high-specificity insights into stone composition and burden, guiding both surgical and preventive strategies. In cases where a genetic cause is suspected — such as cystinuria, primary hyperoxaluria, renal tubular acidosis and certain forms of hypercalciuria — targeted genetic testing is available. This comprehensive evaluation enables clinicians to deliver precise, personalized care plans that go beyond symptomatic treatment and focus on long-term prevention.
Minimally invasive surgical options
When surgery is indicated, the Multidisciplinary Stone Clinic offers the full spectrum of state-of-the-art, minimally invasive techniques, including ureteroscopy with laser lithotripsy, percutaneous nephrolithotomy and shock wave lithotripsy. All procedures are performed by fellowship-trained urologists who specialize in the latest endourological technologies. Patients benefit from reduced pain, shorter recovery times and lower complication rates compared with traditional open surgery.
"Our goal is to offer patients minimally invasive solutions that not only remove stones but also address the underlying causes to prevent the burden of future episodes," says Dr. Koo, who also is an associate professor of urology at Mayo Clinic College of Medicine and Science. "Working closely with our nephrology colleagues allows us to deliver surgical care that is precise, safe and highly personalized," he continues.
The multidisciplinary team develops individualized surgical plans for patients with complex or recurrent stones. This ensures that anatomical challenges and metabolic risks are fully accounted for. The integration of surgical and medical management results in more durable stone-free outcomes and enhances patient satisfaction with their comprehensive care.
Access to clinical trials
The Multidisciplinary Stone Clinic is at the forefront of kidney stone research and offers eligible patients access to clinical trials investigating novel therapeutic agents, imaging techniques and prevention strategies. These include inhibitors of oxalate synthesis, microbiome-targeted therapies, and advanced imaging for stone detection and tracking. Participation in clinical trials not only gives patients early access to promising treatments but also supports the advancement of knowledge in this complex field.
Drs. Lieske and Koo also are co-directors of the Mayo Clinic Fostering Research With Additional Resources and Development (FORWARD) urology center, a collaborative kidney stone research center supported by the National Institutes of Health. They are leading active studies on the pathophysiological mechanisms underlying kidney stone formation and the development of predictive models for stone recurrence and mineral composition. They collaborate with a core team of urologists, Aaron M. Potretzke, M.D., and Kevin M. Wymer, M.D., and nephrologists, Andrew D. Rule, M.D., Felix Knauf, M.D., and Neera K. Dahl, M.D., Ph.D., who also have a primary interest in the treatment of stones. The Mayo Clinic model of integrated care ensures seamless integration between all team members when developing and implementing individualized patient care plans.
Next steps for referring physicians
Referring to the Multidisciplinary Stone Clinic offers several advantages for both patients and clinicians. Patients benefit from coordinated, multidisciplinary care that addresses the full scope of their condition in a single visit, minimizing delays and avoiding redundant testing. Referring clinicians gain a trusted referral destination where care is streamlined, comprehensive and informed by the latest research and clinical guidelines.
The clinic's integration of evaluation, surgical intervention and preventive strategies ensures continuity and quality of care. Referrals are appropriate for patients with first-time or recurrent stones, especially those with high stone burden, unusual metabolic profiles or suspicion of genetic predisposition.
For more information
Multidisciplinary Stone Clinic. Mayo Clinic.
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