A TEAM APPROACH TO CARE
Kidney stones form from tiny crystals in the urine. When the urine is concentrated, these crystals coalesce to form hard deposits. These stones are most commonly made of calcium, but can also be composed of other minerals made in the body.
There are many underlying causes of kidney stones. The most common cause is dehydration or inadequate fluid intake. Certain metabolic disorders and diseases (such as hyperparathyroidism) can be associated with kidney stones. Another common cause is a family history of kidney stones.
Chronic urinary infection and urinary obstruction can also lead to stone formation. Certain mineral levels in the urine, when too high or too low can either inhibit or promote stone formation. These levels are often affected by foods and beverages found in the common diet.
4 Types of Kidney Stones
- Calcium Stones: The majority of kidney stones are calcium stones that consist of calcium oxalate. Calcium stones may also occur in the form of calcium phosphate.
- Struvite Stones: Most people suffer struvite stones following a urinary tract infection (UTI) or other types of infection. Struvite stones often grow quickly and occur within any warning signs.
- Uric Acid Stones: Uric acid stones have been shown to develop in individuals who lack sufficient fluids or have a very acidic urine pH. Additionally, uric acid stones may occur due in part to a high-protein diet, gout, or certain genetic factors.
- Cystine Stones: Cystine stones form due to cystinuria, a hereditary disorder that causes the kidneys to excrete an excess amount of certain amino acids.
Determining the type of kidney stone that an individual is dealing with is paramount for proper treatment. Therefore, a urologist performs a comprehensive patient assessment to find out what type of kidney stone a patient experiences. A urologist then crafts a personalized treatment plan to help a patient address his or her kidney stone symptoms.
Symptoms of Kidney Stones
Kidney stones most commonly do not cause any symptoms when lying in the kidney. In fact, many people who have kidney stones do not even know that they have them. However, these small deposits can begin causing symptoms when moving around in the kidney, or when passing into the ureter (the tube draining from the kidney into the bladder) as they pass into the bladder.
These symptoms can include
- back pain under the ribcage
- blood in the urine
- lower abdominal or groin pain
- nausea or vomiting
- urinary urgency or frequency
- burning with urination or intermittent stream
Kidney Stone Diagnosis
Our physicians at Comprehensive Urology begin with a thorough history and subsequent physical examination. A combination of examinations may be performed to help diagnose a kidney stone. These may include urinalysis as well as radiographic examinations (i.e. ultrasound, plain x-ray, intravenous pyelogram, and computerized tomography (CT) scan). These tests may help delineate the location and size of the stone, as well as reveal if there is any evidence of urinary obstruction.
Many kidney stone treatment options are available. Each treatment is designed to help a patient alleviate kidney stone symptoms both now and in the future.
Dietary Modification: Once a kidney stone has been diagnosed, your doctor may recommend certain dietary modifications to help decrease the rate of stone formation. This would be tailored to each specific patient’s clinical situation. Dietary modifications may include increasing fluid intake, increased intake of citrate containing foods (lemons, oranges), limiting salt intake, and limiting red meats.
Medical Treatments –Your physician may also recommend medical therapy to help manage the kidney stone. Certain medications (such as alpha blockers often used for BPH) may help facilitate passage of a kidney stone that is lodged in the ureter. Other medications are used often to help dissolve kidney stones or to help future stone formation.
Surgical Treatment – Surgical treatment may also be offered or recommended depending on each patient’s specific scenario. Reasons to potentially treat a stone include:
- the stone is in the kidney, medical treatment and dietary changes have been made, and the stone is either increasing in size or causing irritative symptoms
- a trial of stone passage has been attempted but it has still not passed and is causing pain
- the stone is causing obstruction of urinary tract and potential damage to the kidney
- the stone is resulting in urinary tract infection
- the stone is deemed too large to pass on its own
ARE KIDNEY STONES PREVENTABLE
Approximately 10% of all people will experience kidney stones at some point in their lifetime. Fortunately, there are many quick, easy ways to reduce the risk of kidney stones, such as:
- Stay Hydrated: Drinking sufficient amounts of water enables a person to dilute substances in the urine that otherwise may cause kidney stones.
- Consume Calcium: The combination of oxalate-rich foods (like grains, legumes, and certain fruits and vegetables) with calcium has been shown to lower a person’s risk of kidney stones.
- Avoid excessive use of Vitamin C Supplements: Vitamin C supplements have been shown to cause kidney stones. However, research indicates vitamin C from food does not carry the same risk. As such, people should strive to get vitamin C from foods rather than supplements.
- Consume Less Animal Protein: Beef, fish, poultry, and pork are primary sources of animal protein that may increase urine acid. Therefore, avoiding significant amounts of foods high in animal protein may help an individual lower his or her risk of kidney stones.
- Consume Less Sodium: A high-sodium diet raises an individual’s risk of calcium kidney stones. But an individual who reduces his or her salt intake can lower his or her urine calcium levels, thereby limiting the possibility of kidney stones.