Kidney Stones

Kidney stones (calculi) typically form when your urine becomes too concentrated. This can cause crystals to separate from the urine and build up inside the kidneys creating stones, which may be as small as a grain of sand or as large as a golf ball. Some stones pass out of the body without the need for surgical intervention, but others can cause severe pain if they become lodged in the ureter (the narrow tube that carries urine from the kidneys to the bladder).

Risk Factors

There may be several reasons for kidney stone to develop including:

  • Dehydration (not drinking enough water)
  • Dietary fators (e.g. excess intake of salt, calcium or oxalates, Vitamin C, etc.)
  • Family history of kidney stones or a previous stone
  • Metabolic diseases (such as hyperparathyroidism or gout)
  • Inactive lifestyle or prolonged bed rest
  • Frequent urinary tract infections or other bladder problems
  • Inflammatory bowel disease (IBD) such as Crohn's disease
  • Certain rare hereditary disorders

Symptoms

The presentation for kidney stones can vary and may include:

  • Sudden, intense pain (e.g. back, side, groin, genitals)
  • Nausea and/or vomiting
  • Blood in your urine
  • Frequent and painful urination
  • Fever (this may be an emergency if a stone is blocking the ureter)
  • Some stones cause no symptoms at all

Diagnosis

In addition to a thorough history and physical, your doctor may order one of the following tests to determine if and where a stone exists:

  • KUB / Plain X-ray of the abdomen
  • CT scan
  • Ultrasound

Treatment

Many kidney stones can be passed on their own with the help of medications but some require surgery. Several procedures exist if your stone needs treatment:

  • Extracorporeal Shock Wave Lithotripsy (ESWL) shock waves pass through the body and break up the kidney stone into smaller, more easily passable fragments.
  • Ureteroscopy with Laser Lithotripsy – a narrow camera is passed through the urethra and into the urinary tract, where the stone can be broken into smaller pieces with a laser and removed.
  • Percutaneous Nephrolithotomy (PCNL) - a camera is placed directly into the kidney from the back to break up and remove large or complicated stones.
  • Nephrolithotomy – major surgery reserved for a small percentage of patients with extremely large stones

Reducing Risk of Stone Recurrence

More than half of those who develop one kidney stone will develop recurrent or additional stones. Your doctor may order special urine and blood tests to help determine how to decrease the risk of recurrence. Based upon these results your doctor may suggest you:

  • Drink more water (between 2 and 3 liters a day)
  • Reduce salt and/or protein intake
  • Avoid foods high in oxalate (e.g. coffee, tea, cola, chocolate, nuts, spinach)
  • Add lemon / lime juice to your water
  • Watch your calcium intake
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