Why Kidney Stones Can Be A Problem
Stones dont always stay in the kidney. Sometimes they pass from the kidney into the ureters. Ureters are small and delicate, and the stones may be too large to pass smoothly down the ureter to the bladder.
Passage of stones down the ureter can cause spasms and irritation of the ureters. This causes blood to appear in the urine.
Diagnosis of kidney stones requires a complete health history assessment and a physical exam. Other tests include:
- blood tests for calcium, phosphorus, uric acid, and electrolytes
- blood urea nitrogen and creatinine to assess kidney functioning
- urinalysis to check for crystals, bacteria, blood, and white cells
- examination of passed stones to determine their type
The following tests can rule out obstruction:
The contrast dye used in the CT scan and the IVP can affect kidney function. However, in people with normal kidney function, this isnt a concern.
There are some medications that can increase the potential for kidney damage in conjunction with the dye. Make sure your radiologist knows about any medications youre taking.
Risk Factors For Kidney Stones
The greatest risk factor for kidney stones is making less than 1 liter of urine per day. This is why kidney stones are common in premature infants who have kidney problems. However, kidney stones are most likely to occur in people between the ages of 20 and 50.
Different factors can increase your risk of developing a stone. In the United States, white people are more likely to have kidney stones than black people.
Sex also plays a role. More men than women develop kidney stones, according to the National Institute of Diabetes and Digestive and Kidney Diseases .
A history of kidney stones can increase your risk. So does a family history of kidney stones.
Other risk factors include:
- frequent need to urinate
- urinating small amounts of urine
In the case of a small kidney stone, you may not have any pain or symptoms as the stone passes through your urinary tract.
The Evaluation For Kidney Stones
If your , imaging is often the first step in an evaluation. For many years the standard of care was a type of abdominal x-ray called an intravenous pyelogram . In most medical centers, this has been replaced by a type of computed tomography called unenhanced helical CT scanning. In some cases, such as when a person has impaired renal function or a contrast dye allergy, renal ultrasound may be used as an alternative.
You will also have blood tests, including tests for renal function . Your doctor may suggest other blood tests as well. A urinalysis will be obtained and if infection is suspected, a urine culture will be sent.
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Why Do Doctors Examine The Contents Of The Stone
There are four types of stones. Studying the stone can help understand why you have it and how to reduce the risk of further stones. The most common type of stone contains calcium. Calcium is a normal part of a healthy diet. The kidney usually removes extra calcium that the body doesn’t need. Often people with stones keep too much calcium. This calcium combines with waste products like oxalate to form a stone. The most common combination is called calcium oxalate.
Less common types of stones are: Infection-related stones, containing magnesium and ammonia called struvite stones and stones formed from monosodium urate crystals, called uric acid stones, which might be related to obesity and dietary factors. The rarest type of stone is a cvstine stone that tends to run in families.
Take Steps To Bypass Kidney Stones
Even though kidney stones can be common and recur once youve had them, there are simple ways to help prevent them. Here are some strategies that can help:
1. Drink enough water. A 2015 meta-analysis from the National Kidney Foundation found that people who produced 2 to 2.5 liters of urine daily were 50% less likely to develop kidney stones than those who produced less. It takes about 8 to 10 8-ounce glasses of water daily to produce that amount.
2. Skip high-oxalate foods. Such foods, which include spinach, beets, and almonds, obviously raise oxalate levels in the body. However, moderate amounts of low-oxalate foods, such as chocolate and berries, are okay.
3. Enjoy some lemons. Citrate, a salt in citric acid, binds to calcium and helps block stone formation. “Studies have shown that drinking ½ cup of lemon juice concentrate diluted in water each day, or the juice of two lemons, can increase urine citrate and likely reduce kidney stone risk,” says Dr. Eisner.
4. Watch the sodium. A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine. Federal guidelines suggest limiting total daily sodium intake to 2,300 milligrams . If sodium has contributed to kidney stones in the past, try to reduce your daily sodium to 1,500 mg.
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How Common Are Kidney Stones
Each year, more than half a million people go to emergency rooms for kidney stone problems. It is estimated that one in ten people will have a kidney stone at some time in their lives.
The prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. The prevalence of kidney stones was 10% during 20132014. The risk of kidney stones is about 11% in men and 9% in women. Other diseases such as high blood pressure, diabetes, and obesity may increase the risk for kidney stones.
Herbal Formulas Designed By Book Experts With No Clinical Experience
Many herbal urinary tract formulas are designed by so-called experts who have never seen a patient. They are called in by herbal manufacturers to do a job. These “experts” do not have direct experience using these herbs. They simply have esoteric book knowledge. Book knowledge and direct experience are vastly different. A clinician is able to adjust formulas based on the results that occur from taking herbs. For example:
- There are herbs that dissolve kidney stones, but some can be harsh on the urinary tract.
- Other herbs are not organic, and they contain pesticide residues that can irritate the bladder lining.
- Dissolving urinary tract stones can leave sharp edges that can injure the delicate lining of the urinary tract.
This is why it’s sometimes not a good idea to take a single herb at a time. Herbs work together, synergistically – some increase the healing effects of a main herb while others can offset undesirable effects. A good formula has much more beneficial effects than taking just a single herb.
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- fever and chills
- urine that smells bad or looks cloudy
The kidney stone starts to hurt when it causes irritation or blockage. This builds rapidly to extreme pain. In most cases, kidney stones pass without causing damage-but usually not without causing a lot of pain. Pain relievers may be the only treatment needed for small stones. Other treatment may be needed, especially for those stones that cause lasting symptoms or other complications. In severe cases, however, surgery may be required.
Kidney Stone Causes Symptoms Treatments & Prevention
Your kidneys remove waste and fluid from your blood to make urine. Sometimes, when you have too much of certain wastes and not enough fluid in your blood, these wastes can build up and stick together in your kidneys. These clumps of waste are called kidney stones.
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How Kidney Stones Are Treated
Treatment is tailored according to the type of stone. Urine can be strained and stones collected for evaluation.
Drinking six to eight glasses of water a day increases urine flow. People who are dehydrated or have severe nausea and vomiting may need intravenous fluids.
Other treatment options include:
Should I Cut Calcium Out Of My Diet If I Develop Calcium Oxalate Kidney Stones
If you develop kidney stones composed of calcium, you may be tempted to stop eating foods that include calcium. However, this is the opposite of what you should do. If you have calcium oxalate stones, the most common type, its recommended that you have a diet higher in calcium and lower in oxalate.
Foods that are high in calcium include:
- Cows milk.
Its also important to drink plenty of fluids to dilute the substances in your urine.
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What Are Kidney Stones
Kidney stones are solid crystals formed from the salts in urine. They are sometimes called renal calculi. Kidney stones can block the flow of urine and cause infection, kidney damage or even kidney failure. They can vary in size and location.
The risk of kidney stones is about one in 10 for men and one in 35 for women. Between four and eight per cent of the Australian population suffer from kidney stones at any time.
After having one kidney stone, the chance of getting a second stone is between five and 10 per cent each year. Thirty to fifty per cent of people with a first kidney stone will get a second stone within five years. After five years, the risk declines. However, some people keep getting stones their whole lives.
Medication For Kidney Stones
For most people with recurrent calcium stones, a combination of drinking enough fluids, avoiding urinary infections, and specific treatment with medications will significantly reduce or stop new stone formation.
Certain medications such as thiazide diuretics or indapamide reduce calcium excretion and decrease the chance of another calcium stone. Potassium citrate or citric juices are used to supplement thiazide treatment and are used by themselves for some conditions where the urine is too acidic.
For people who have a high level of uric acid in their urine, or who make uric acid stones, the medication allopurinol will usually stop the formation of new stones.
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The Huge Study Reveals An Important Link But No Conclusive Evidence
While this study offers an important insight into the possible link between antibiotics and kidney stones, its not yet direct proof that antibiotics cause kidney stones.
Its an association study, notes Pascale Hammond Lane, MD, a pediatric nephrologist and section chief at the University of Oklahoma Health Sciences Center and the chair of the Media and Communications Committee for the American Society of Nephrology. You cant say theres cause and effect.
But the study is a noteworthy one with many strengths, including numbers, Dr. Lane says. It involves a huge data set.
The findings definitely warrant further investigation, Lane adds.
Tasian and his colleagues are hoping to expand this research into broader, population-based studies to better understand the mechanism of how changes in microbiome composition may influence the development of kidney stones or what microbes can be replaced to minimize risk of kidney stones.
How Are Kidney Stones Diagnosed
Your healthcare provider will discuss your medical history and possibly order some tests. These tests include:
- Imaging tests: An X-ray, CT scan and ultrasound will help your healthcare provider see the size, shape, location and number of your kidney stones. These tests help your provider decide what treatment you need.
- Blood test: A blood test will reveal how well your kidneys are functioning, check for infection and look for biochemical problems that may lead to kidney stones.
- Urine test: This test also looks for signs of infection and examines the levels of the substances that form kidney stones.
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Treating Renal Colic And Pain Management
See your doctor if you have symptoms of renal colic or urinary stones. Your doctor can do tests to look for increased levels of substances that form stones in your blood or urine. A CT scan can look for stones in your kidneys and other urinary organs.
If you have a large stone, your doctor can do one of these procedures to remove it and relieve renal colic:
- Extracorporeal shock wave lithotripsy : This procedure uses shock waves aimed at your kidneys to break up the stones into very small pieces. You then pass the stone fragments in your urine.
- Ureteroscopy: Your doctor inserts a thin, lighted scope up through your urethra and bladder to remove the stone.
- Percutaneous nephrolithotomy: This procedure uses tiny instruments inserted through a small cut in your back to remove a stone. You will be asleep during this procedure.
In the short term, your doctor will give you medicines to relieve the pain of renal colic. Options include:
- nonsteroidal anti-inflammatory drugs such as ibuprofen
- drugs to prevent muscle spasms
- opioid medicines
What Does The Treatment Involve
You will be positioned on an operating table. A soft, water-filled cushion may be placed on your abdomen or behind your kidney. The body is positioned so that the stone can be targeted precisely with the shock wave. In an older method, the patient is placed in a tub of lukewarm water. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes.
Sometimes, doctors insert a tube via the bladder and thread it up to the kidney just prior to SWL. These tubes are used when the ureter is blocked, when there is a risk of infection and in patients with intolerable pain or reduced kidney function.
After the procedure, you will usually stay for about an hour then be allowed to return home if all goes well. You will be asked to drink plenty of liquid, strain your urine through a filter to capture the stone pieces for testing, and you may need to take antibiotics and painkillers. Some studies have reported stones may come out better if certain drugs are used after SWL.
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Treating And Preventing Kidney Stones
Most kidney stones are small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication.
Larger stones may need to be broken up using ultrasound or laser energy. Occasionally, keyhole surgery may be needed to remove very large kidney stones directly.
Read more about treating kidney stones.
It’s estimated that up to half of all people who have had kidney stones will experience them again within the following five years.
To avoid getting kidney stones, make sure you drink plenty of water every day so you don’t become dehydrated. It’s very important to keep your urine diluted to prevent waste products forming into kidney stones.
Read more about preventing kidney stones.
What Can The Patient Expect After Treatment
The recovery time is usually fairly brief. After treatment, the patient can get up to walk almost at once, Many people can fully resume daily activities within one to two days. Special diets are not required, but drinking plenty of water helps the stone fragments pass. For several weeks, you may pass stone fragments.
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What Are The Causes And Risk Factors Of Kidney Stones
Anyone can get a kidney stone, but some people are more likely than others to have them. Men get kidney stones more often than women do. Kidney stones are also more common in non-Hispanic white people than in people of other ethnicities. You may also be more likely to have kidney stones if:
- You have had kidney stones before.
- Someone in your family has had kidney stones.
- You dont drink enough water.
- You follow a diet high in protein, sodium and/or sugar.
- You have had gastric bypass surgery or another intestinal surgery.
- You have polycystic kidney disease or another cystic kidney disease.
- You have a certain condition that causes your urine to contain high levels of cystine, oxalate, uric acid or calcium.
- You have a condition that causes swelling or irritation in your bowel or your joints.
- You take certain medicines, such as diuretics or calcium-based antacids.
Types Of Kidney Stones
There are four major types of kidney stones, including:
- stones formed from calcium not used by the bones and muscles, combined with oxalate or phosphate these are the most common kidney stones
- stones containing magnesium and the waste product ammonia these are called struvite stones and form after urine infections
- uric acid stones these are often caused by eating very large amounts of protein foods
- cystine stones these are rare and hereditary.
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What Treatments Are Available
Because of the pain caused by kidney stones, many people find that they need pain relief. Many describe it as the worst pain theyve ever felt.
If you have a kidney stone, you will be encouraged to drink a lot of water if you dont have a medical condition that limits the amount you may have. The extra fluid is to help wash the stone through your urinary system.
If the stone doesnt pass within a reasonable amount of time, your doctor may recommend extracorporeal shock wave lithotripsy . Shock waves are sent through to the stone to break them down into smaller pieces that can be passed. Sometimes, surgery may be needed.
The stone should be removed because of the high risk of infection, which could in turn lead to sepsis.