<s>[INST] I have pedal adema and am a stonemaker. My stones are composed of calcium oxalate . How serious is this? Could I possibly ever need dialysis? This is my worst fear. Ive had open surgery for a staghorn calculus ten years ago, several lithotripsy procedures . I had lithotripsy done one week ago but the treatment was unsuccessful. Currently I have stones on both sides. The pedal edema has been going on for two weeks. What is your opinlon of what to do ? [/INST] Hi, many thanks for the query! As you are recurrent stone former, do - Metabolic workup of 24 hrs urine sample, Sr. PTH, Sr. Calcium, Sr. Uric acid. B/L obstruction to urine outflow due to stones may compromise renal function, do- FT, USG PUB. Dialysis is needed when renal function is severely compromised, in your case, your Sr. creatinine (more than say 7.5 to 8) will decide need for dialysis. You haven't mentioned exact size & site of your stones. Lithotripsy failure is expected as Ca-oxalate stones are very hard to break by ESL, need to be removed by copy/open procedure. Wish you a good health. Take care. Regards. </s>