Water Can Stave Off Stones
Salt may lead to stones, but good old H2O can help prevent them.
Water intake is the single most important dietary risk factor for kidney stone formation, Nabhani says. Not drinking enough water is estimated to play a role in 50% of kidney stones. We recommend patients drink enough water to make 2.5 liters of urine per day, or try to keep their urine clear to very pale yellow.
Why You Get Stones
Part of preventing stones is finding out why you get them. Your health care provider will perform tests to find out what is causing this. After finding out why you get stones, your health care provider will give you tips to help stop them from coming back.
Some of the tests he or she may do are listed below.
Medical and Dietary History
Your health care provider will ask questions about your personal and family medical history. He or she may ask if:
- Have you had more than one stone before?
- Has anyone in your family had stones?
- Do you have a medical condition that may increase your chance of having stones, like frequent diarrhea, gout or diabetes?
Knowing your eating habits is also helpful. You may be eating foods that are known to raise the risk of stones. You may also be eating too few foods that protect against stones or not drinking enough fluids.
Understanding your medical, family and dietary history helps your health care provider find out how likely you are to form more stones.
Blood and Urine Tests
Imaging Tests
When a health care provider sees you for the first time and you have had stones before, he or she may want to see recent X-rays or order a new X-ray. They will do this to see if there are any stones in your urinary tract. Imaging tests may be repeated over time to check for stone growth. You may also need this test if you are having pain, hematuria or recurrent infections.
Stone Analysis
What Is A Kidney Stone
A kidney stone is a hard object that is made from chemicals in the urine. There are four types of kidney stones: calcium oxalate, uric acid, struvite, and cystine. A kidney stone may be treated with shockwave lithotripsy, uteroscopy, percutaneous nephrolithomy or nephrolithotripsy. Common symptoms include severe pain in lower back, blood in your urine, nausea, vomiting, fever and chills, or urine that smells bad or looks cloudy.
Urine has various wastes dissolved in it. When there is too much waste in too little liquid, crystals begin to form. The crystals attract other elements and join together to form a solid that will get larger unless it is passed out of the body with the urine. Usually, these chemicals are eliminated in the urine by the body’s master chemist: the kidney. In most people, having enough liquid washes them out or other chemicals in urine stop a stone from forming. The stone-forming chemicals are calcium, oxalate, urate, cystine, xanthine, and phosphate.
After it is formed, the stone may stay in the kidney or travel down the urinary tract into the ureter. Sometimes, tiny stones move out of the body in the urine without causing too much pain. But stones that don’t move may cause a back-up of urine in the kidney, ureter, the bladder, or the urethra. This is what causes the pain.
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How Can I Prevent Kidney Stones
There are several ways to decrease your risk of kidney stones, including:
- Drink water. Drink at least six to eight 8-ounce glasses every day . Staying hydrated helps you urinate more often, which helps flush away the buildup of the substances that cause kidney stones. If you sweat a lot, be sure to drink even more.
- Limit salt. Eat less sodium. You may want to connect with a dietician for help with planning what foods you eat.
- Lose weight. If youre overweight, try to lose some pounds. Talk to your healthcare provider about an ideal weight.
- Take prescriptions. Your healthcare provider may prescribe some medications that help prevent kidney stones. The type of medication may depend on the type of stones you get.
What Are The Costs Of Medicines To Lower Your Chance Of Getting Another Calcium Stone
Thiazide diuretics, citrates, and allopurinol are all available in generic form and are usually not very expensive. The costs to you for these medicines depend on:
- Your health insurance
- Review Medicines for Early Stage Chronic Kidney Disease: A Review of the Research for Adults With Kidney Disease and Diabetes or High Blood PressureJohn M. Eisenberg Center for Clinical Decisions and Communications Science. Comparative Effectiveness Review Summary Guides for Consumers. 2005
- Review Medicines for Rheumatoid Arthritis: A Review of the Research for AdultsJohn M. Eisenberg Center for Clinical Decisions and Communications Science. Comparative Effectiveness Review Summary Guides for Consumers. 2005
- Review Antipsychotic Medicines for Treating Schizophrenia and Bipolar Disorder: A Review of the Research for Adults and CaregiversJohn M. Eisenberg Center for Clinical Decisions and Communications Science. Comparative Effectiveness Review Summary Guides for Consumers. 2005
- Review Medicines for Psoriatic Arthritis: A Review of the Research for AdultsJohn M. Eisenberg Center for Clinical Decisions and Communications Science. Comparative Effectiveness Review Summary Guides for Consumers. 2005
- Review Medicines To Treat Alcohol Use Disorder: A Review of the Research for AdultsJohn M. Eisenberg Center for Clinical Decisions and Communications Science. Comparative Effectiveness Review Summary Guides for Consumers. 2005
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Certain Foods Can Cause Stones But Not Calcium
Ironically, although kidney stones are often made up of calcium, they are not caused by calcium intake itself. Calcium does not usually affect stone formation, unless you are eating much, much more than the recommended daily amount, Nabhani explains. We recommend most patients with kidney stones eat the daily recommended amount of calcium.
So what foods do lead to kidney stones?
High salt and nondairy animal protein all types of meat, beef, chicken, fish and pork are associated with increased stone formation, Nabhani says.
Salt keeps calcium from being absorbed by the body.
In addition, foods rich in oxalate, such as nuts, chocolate, spinach and tea, may cause increased stone formation, he adds.
Kidney Stones Can Be Many Different Sizes
You may have heard that passing a kidney stone is just as painful as childbirth and while that may be true in some instances, the pain level depends on the shape and size of the stone.
Kidney stones can be the size of a pea or although rare can grow to the size of a golf ball. The largest kidney stone ever recorded, according to Guinness World Records, was just over 5 inches at its widest point. Although very small stones can pass without you even noticing, the larger they are, the more they usually hurt.
Its estimated that 12% of Americans will develop a kidney stone in their lifetime and the incidence is rising.
Jamal Nabhani, MD
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Who Is At Risk For Getting Calcium Stones
Several factors can increase your chance of getting calcium stones, including:
- Not drinking enough water
- Not getting enough calcium in your diet
- Eating or drinking calcium-rich foods does not increase your chance of getting calcium stones. In fact, a diet too low in calcium can actually increase the risk of getting calcium stones.
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More Than One Type Of Stone Exists
There are four major types of kidney stones: calcium, struvite, uric acid and cystine. At around 80% of stones, the calcium type is the most common.
Struvite stones sometimes occur after repeated urinary tract infections. Uric acid stones form when urine is too acidic. Cystine stones, which are the rarest, form due to a genetic disorder.
Calcium and cystine stones are hard, says Jamal Nabhani, MD, a urologist at Keck Medicine of USC and assistant professor of clinical urology at the Keck School of Medicine of USC. Struvite stones tend to be softer and larger, sometimes taking up the entire area where urine collects in the kidney. Theyre called staghorn stones, because they can look like bull horns.
Uric acid stones, in particular, can be tricky to diagnose without the right tools. Although uric acid and calcium stones are often similar in appearance, you cant see uric acid stones on an X-ray, Nabhani says. A CT scan is often used for diagnosis.
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B Searching For The Evidence: Literature Search Strategies For Identification Of Relevant Studies To Answer The Key Questions
We will identify evidence for this review by searching relevant bibliographic databases, as well as several sources commonly used to identify grey literature. Bibliographic database searching will utilize MEDLINE and the Cochrane Central Register of Controlled Trials to identify RCTs published in 1948 to the present . Initially, the search strategy will identify studies indexed with the MeSH term urolithiasis and related keywords. Results from this initial search will be limited to relevant publication types or keywords to identify controlled trials, RCTs, systematic reviews, and meta-analyses. Bibliographic database searches will be supplemented with hand searching of the reference lists of included studies, previous systematic reviews, and relevant clinical guidelines. Additional search strategies may include forward citation searching of included RCTs and systematic reviews by using the Web of Science and Google Scholar. The literature search will be updated while the draft report is under public and peer review.
The search strategies we will use are outlined below:
- Ovid MEDLINE Search Strategy
- 1 urolith*.mp. or exp Urolithiasis/
- 2 .mp.
- 3 renal colic.mp. or exp Renal Colic/
- 4 hypercalciuria.mp. or exp Hypercalciuria/
- 5 exp Hyperoxaluria, Primary/ or exp Hyperoxaluria/ or hyperoxaluria.mp.
- 6 hyperuricemia.mp. or exp Hyperuricemia/
- 7 cystinuria.mp. or exp Cystinuria/
- 8 .mp.
- 9 .mp.
- 10 or/1-9
- 20 limit 19 to English language
How Can I Tell If I Have A Kidney Stone
Routine screening for kidney stones common but not recommended for all people.
Kidney stones can be detected using imaging such as X-rays, ultrasound, CT scan, or MRI. The best imaging currently available for kidney stone detection is a CT scan.
If you have crystals in your urine, that does not mean that you have a kidney stone. Crystals in the urine are common. If you have crystals in your urine along with other symptoms of kidney stones, you should see a doctor for an exam and imaging.
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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.
What Does It Feel Like To Have A Kidney Stone
Everyone experiences kidney stones differently. Typically, kidney stones within the kidney do not cause pain.
If a stone falls onto the opening where the kidney meets the ureter or passes into the ureter, this can prevent urine from draining out of the kidney. This backing up of urine can lead to back pain just below your ribs. Sometimes the pain can be severe enough to cause nausea and vomiting.
As a stone moves, the blockage of urine may be relieved and symptoms may improve or go away. The pain may return if the stone begins to cause blockage of urine again. This changing of symptoms is called renal colic.
Blood in the urine may be a sign of kidney stones. Sometimes the blood isnt visible to the naked eye and must be detected by a urine test.
If a stone is able to pass down the ureter and close to the bladder, the pain may move to the front of the abdomen, near the pelvis.
Stones very close to the bladder can cause pain that is felt in the genitals. A stone that reaches the bladder can cause burning with urination or changes in how often or how urgently you need to urinate.
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As Always Consult Your Physician
If you feel you may be suffering from kidney stone symptoms, your first course of action should always be to consult your physician. Dr. Cornell is a well-respected, board certified urologist serving the greater Houston area. Contact our office today to get a referral if you are suffering from urinary or kidney pain.
Kidney Stones Feel Like A Stomachache
MYTH BUSTED: Kidney stones are more along the lines of a contraction, and some people it is more severe than labor, so go ask your mom if labor is just like a stomachache and send us her reaction. Trust us, the pain can range from a stabbing sensation to pain along the lines of menstrual cramps. Its definitely not a tummy ache.
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Factors That Increase Your Risk Of Kidney Stones
Kidney stones often have no single cause, and several factors may increase your risk for getting them. Some of these factors are listed below. They include:
Lack of water
You need to make enough pee to dilute the things that can turn into stones. If you donât drink enough or sweat too much, your pee may look dark. It should be pale yellow or clear.
If youâve had a stone before, you should make about 8 cups of urine a day. So aim to down about 10 cups of water daily, since you lose some fluids through sweat and breathing. Swap a glass of water for a citrus drink. The citrate in lemonade or orange juice can block stones from forming.
Where Does The Information Come From
Researchers funded by the Agency for Healthcare Research and Quality , a Federal Government research agency, reviewed 28 studies on dietary changes and medicines to lower the chance of having recurrent kidney stones published between January 1948 and November 2011. Nearly all the adults in the research studies for this summary were young to middle-aged men with calcium stones. The report was reviewed by clinicians, researchers, experts, and the public. You can read the report at www.effectivehealthcare.ahrq.gov/kidney-stones.cfm.
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Calcium Oxalate And Calcium Phosphate Stones
Calcium stones are the most common type of kidney stones, and can be either calcium oxalate or calcium phosphate. As mentioned, good hydration is important to prevent calcium stones. It may be surprising, but results of a randomized clinical trial show that people with calcium kidney stones should not cut back on dietary calcium. In fact, they should consume the recommended daily allowance of calcium . Why? Calcium binds to oxalate in the intestine and prevents its absorption through the gut, so there is less in the urine to form stones. Ideally, calcium should come from food. Talk with your doctor before taking calcium supplements, and increasing fluid intake might be beneficial depending on how much calcium you take.
Foods high in oxalates can increase the amount of oxalate in the urine. Consume these in moderation.
Calcium phosphate stones are less common than calcium oxalate stones. Causes include hyperparathyroidism , renal tubular acidosis , and urinary tract infections. It is important to understand if one of these conditions is behind the formation of calcium phosphate stones.
Good hydration can help prevent recurrence of calcium stones. In addition, thiazide diuretics such as hydrochlorothiazide can help the kidney absorb more calcium, leaving less of it in the urine where it can form stones. Potassium citrate is another medication that can bind to calcium and help keep calcium oxalate and calcium phosphate in the urine from forming into stones.
How Do Kidney Stones Form
Most stones form just under the inner surface of the kidney. Small crystals in your urine fuse together, similar to the way salt crystals form from evaporating saltwater.
More crystals can bind over time until a stone is formed. The stone can then continue to grow bigger and ultimately become so heavy that it breaks off within the kidney. Once free to move around, it can either stay in the kidney or try to pass down the ureter.
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If You Meet All Of The Following This Information Is For You
- You have had a kidney stone in the past.
- Your doctor told you that your kidney stone was a calcium stone . The research for this summary was only on people with calcium stones. If you do not know what type of stone you had, the information in this summary may still be useful to you.
- You want to know about options to lower your chance of getting another calcium stone.
- And you are age 18 or older. The information in this summary is from research on adults.
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When Can Swl Be Used
SWL works better with some stones than others. Very large stones cannot be treated this way. The size and shape of stone, where it is lodged in your urinary tract, your health, and your kidneys’ health will be part of the decision to use it. Stones that are smaller than 2 cm in diameter are the best size for SWL. The treatment might not be effective in very large ones.
SWL is more appropriate for some people than others. Because x-rays and shock waves are needed in SWL, pregnant women with stones are not treated this way. People with bleeding disorders, infections, severe skeletal abnormalities, or who are morbidly obese also not usually good candidates for SWL. lf your kidneys have other abnormalities, your doctor may decide you should have a different treatment. lf you have a cardiac pacemaker, a cardiologist will decide if you can have SWL.
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