Two Sisters Consider Mount Sinai’s Dr. Mantu Gupta Their Rock

Nicole Bernardo and her younger sister Renee are in their late twenties, and their bond resembles that of identical twins. Born to parents with a recessive gene for cystinuria, they have suffered from kidney stones since their preteen years. Not the easiest fate for young people but, according to Nicole and Renee, they found a savior in Mantu Gupta, MD, Director of the Kidney Stone Center at Mount Sinai.

For Specialized and Expert Treatment, Sisters Are Referred to the Best

Renee was the first to develop kidney stones back when she was 12 years old. Their mother Susan remembers the day well, as the first call she received on her first-ever cell phone was from the family pediatrician, informing her that Renee had blood in her urine. Nicole quickly followed in her sister’s footsteps a little more than a year later. Their hometown urologist recognized that the girls needed specialized and expert treatment and referred them to Dr. Gupta, endorsing him as “the best.” Fifteen years later, Nicole and Renee could not agree more.

As explained by Dr. Gupta, cystinuria is characterized by the buildup of the amino acid, cystine, a building block of many proteins in the kidneys. As the kidneys filter blood to create urine, cystine is normally absorbed back into the bloodstream. People with cystinuria cannot properly reabsorb cysteine into their bloodstream and therefore, the amino acid accumulates in their urine. As urine becomes more concentrated in the kidneys, the amino acid forms a disulfide bond with itself to form the poorly soluble cystine, which forms crystals within the kidney tubules. Larger crystals become stones that may lodge in the kidneys or in the ureter.

Dr. Gupta has performed numerous surgeries on Nicole and Renee over the years, so they have a lot of stories to tell, most of which are about his “saving the day.” For example, there is the time when both sisters were scheduled for treatment on the same day (a lithotripsy, a minimally invasive surgery very commonly performed for small to moderate-sized kidney stones). It was Nicole’s first such procedure and, in order to make her laugh, Renee (gently and playfully) punched Nicole in the back to show her that the pain would be limited to that area. Renee also insisted Nicole go first in order to decrease the time she might spend worrying.

There is also the time in 2011, when Nicole had a stone so big it resulted in a kidney infection and a fever of 104 degrees. The treatment was split into two parts: first, a stent to alleviate the pain, and then, a ureteroscopy, in which Dr. Gupta lasered the stone into “flecks of dust.” Or the time Renee’s stones were also too large for standard treatment and she needed to have a percutaneous nephrolithotomy, which entailed going under general anesthesia, and having Dr. Gupta create a tract into the kidney through the side to fragment and suction more than 100 stones from her kidney.

Uniquely Flexible Treatment Options

Through it all, these sisters have leaned on each other, their “amazing” family and Dr. Gupta for support and encouragement. Nicole and Renee have Dr. Gupta’s cell number and know they can call him anytime of the day or night. According to the sisters and their mother, Dr. Gupta has demonstrated a quality as important as his fantastic bedside manner and the ability to make them feel safe and hopeful. He has also been uniquely flexible with their treatment decisions.

Both women wanted to decrease (and ideally go off) medications and assess how their lifestyles (mostly around diet) could work in the absence of drugs. Emphatic about Dr. Gupta’s response, Renee says, “Dr. Gupta was perfectly willing and enthusiastic about exploring this avenue. He looks out for the best interest of the patient -- he wants his patients to feel as comfortable as possible.” Nicole adds, “He is an inspiration.”