Kidney Stones

It is estimated that one in ten people will have a kidney stone at some point in their lives, and many find themselves in the emergency room when the stones become painful. Since you’re reading this, chances are, you’re part of that group.

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What are Kidney Stones?

Kidney stones are hard deposits made of minerals and salts that form inside your kidneys.

Every kidney stone is different. Some are as small as a grain of sand, others as large as a pearl, and others are even larger than that, up to several inches in size. Some are smooth, while others are jagged. Some stones stay in the kidney, while others travel down the urinary tract, which can be quite painful.

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Signs and Symptoms of Kidney Stones

• Sharp pain in your back or lower abdomen
• Vague discomfort or dull pain, like a stomach ache that doesn’t go away
• Pain or a burning sensation while urinating with an urge to urinate more frequently, or blood in your urine
• For men, pain in your testicles
• Cloudy or foul-smelling urine
• Nausea and occasional vomiting
• Fever and chills

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Kidney Stone Causes:

A kidney stone forms when substances in your urine become highly concentrated – which makes low fluid intake one of the biggest contributing factors. If you do not drink enough water, you may put yourself at a higher risk for developing a stone.

• Exercise (too much or too little)
• Family or personal history of kidney stones
• Food with too much salt or sugar
• Infections
• Medications
• Obesity
• Weight-loss surgery

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Calcium stones

Most kidney stones are made of calcium, stones, usually in the form of calcium oxalate. Oxalate is a substance made daily by your liver or absorbed from your diet. Certain fruits and vegetables, as well as nuts and chocolate, have high oxalate content.

Dietary factors, high doses of vitamin D, intestinal bypass surgery, and several metabolic disorders can increase the concentration of calcium or oxalate in urine.

Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain medications used to treat migraines or seizures.

Struvite stones

Struvite stones form in response to a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

Uric acid stones

Uric acid stones can form in people who lose too much fluid because of chronic diarrhea or malabsorption, those who eat a high-protein diet, and those with diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.

Cystine stones

These stones form in people with a hereditary disorder called cystinuria that causes the kidneys to excrete too much of a specific amino acid.

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Diagnosis

If you are experiencing any of the symptoms and have not yet seen your doctor for a diagnosis, now is the time. At your appointment, your doctor will perform a physical exam and take a medical history, including questions about your family history of kidney stones, your diet and any gastrointestinal problems.

To complete your kidney stone diagnosis, your doctor may also perform:

• A blood test to reveal any biochemical problems that can lead to kidney stones
• An imaging test such as an X-ray, ultrasound or CT scan to find your stone’s location and show any conditions that may have caused it to form
• A urinalysis to determine whether you have an infection or if your urine contains substances that may form stones

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Prevention

Drinking plenty of fluids is the best way to keep a kidney stone from forming. Your doctor may recommend you drink two to three liters of water (or other pH-neutral drinks) every day. Try to drink evenly throughout the day, monitor how much you urinate, and make sure your urine is light in color. If the weather is hot, or you exercise a lot, drink more to help balance fluid loss.

Other steps your doctor may suggest to prevent another kidney stone:

• Adapt your diet to include more vegetables, fibers, and fruits while limiting animal proteins and reducing your sodium intake
• Maintain a healthy weight
• Adopt a healthier lifestyle by exercising two or three times per week and avoiding stress
• Take medicine to reduce your risk, if your doctor advises it

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Treatments

Treatment depends on the type of stone, how bad the stone is, and the length of time you have had symptoms. There are different treatments to choose from. It is important to talk to your urologist about what treatment is best for you.

Wait for the stone to pass

Often you can simply wait for the stone to pass. Smaller stones are more likely than larger stones to pass on their own. This can take time and is safe as long as the pain is bearable, there are no signs of infection, and the kidney is not completely blocked. If the stone is small enough, it is likely to pass. You should drink normal amounts of water.

Medication

Certain medications have been shown to improve the chance that a stone will pass. Common medicines relax the ureter, making it easier for the stone to pass through. 

Extracoporeal Shockwave Lithotripsy (ESWL)

ESWL utilizes an X-ray machine to locate the stone(s) within the body, and shock waves are used to break up the stone(s) into very small particles that can be passed through the urine. This procedure is the least invasive option – there are no incisions and no scopes placed into the patient’s body. ESWL, however, may not be appropriate for all patients as the shock waves may not adequately break up stones in certain cases.

Percutaneous Nephrostolithotomy (PCNL)

This is an innovative surgical treatment for patients who have large, complex kidney stones that cannot be treated successfully using other treatments. Typically, PCNL and tubeless PCNL are used to remove kidney stones that are larger than 2cm in diameter and cannot be passed through the urinary tract.

Contact Florida Urology Center at 386-673-5100 to learn more or schedule a consultation.

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