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.
New Kidney Stone Treatment Would Nudge Rather Than Blast
ByRachael Rettner20 October 2009
Passing kidney stones is often described as the worst pain people have ever experienced. Even worse, about half of kidney stone sufferers will get another stone within the following five years. Worse still, it’s often the initial treatment that leads to the subsequent stones.
But scientists are working on a new technique that could help prevent reoccurring kidney stones and maybe even get rid of smaller fragments before they become large and painful.
The technique involves using ultrasound waves to gently nudge stones toward the kidney exit. Testing in live pigs, whose kidneys are similar to ours, has shown success.
“It just takes a flick, just a fraction of a second, we see the stone just jump in the kidney several centimeters, and sometimes it even bounces right out the door of the kidney,” Michael R. Bailey from the University of Washington in Seattle. “We have always been able to move the stones in each animal.”
What they are
Kidney stones are crystallized mineral deposits that form inside the kidneys. They form when the basic elements that make up urine are out of balance. This can happen when there is not enough liquid to dissolve the minerals and salts, or if there is an abundance of these crystal-forming materials.
People who are dehydrated or who have certain metabolic conditions are prone to kidney stones.
Blasting vs. nudging
A Closer Look At This Common Condition
Former presidential candidate turned New York City mayoral candidate Andrew Yang, 46, was hospitalized briefly last week with a kidney stone. The tech entrepreneur’s campaign released a statement saying: “After experiencing abdominal pain this morning, Andrew Yang visited an emergency room where he was diagnosed with what appears to be a kidney stone.”
Later that day, Yang tweeted: “Thank you to the team at Mt Sinai West for the excellent care! And thanks Evelyn for keeping me company as I experienced my first kidney stone. Have been discharged and will now proceed to drink lots of water for the rest of the day.”
While at the hospital, Evelyn Yang tweeted: “In the hospital with Andrew where we had our babies. Andrew is doing well on meds, with the best care team ever. We are joking about how this kidney stone is our third baby. Apparently, it’s the closest men can get to labor.”
Kidney stones are hard, pebble-like pieces of material that form in the kidneys when high levels of certain minerals collect in the urine. These crystal concretions are usually formed within the kidneys. The scientific names for kidney stones include renal calculus, nephrolith, or urolith. Approximately 12% of the world’s population is affected by kidney stone disease.
There are four main types of kidney stone:
The pain may last for a short or long time or may come and go in waves.
Other symptoms include:
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Treatment For Kidney Stones
The size of your kidney stone and its location help determine the treatment. You may be asked to drink plenty of fluids to help push the stone through your urinary tract. If a kidney stone is too large, or if it’s blocking the flow of urine additional treatments may include:
- Shock wave lithotripsy – high-energy sound waves blast the stone into smaller fragments that pass easier through your urine
- Ureteroscopy – an endoscope is inserted through the ureter to retrieve or obliterate the stone
- Percutaneous nephrolithotomy – a tube is surgically inserted into your kidney to remove the stone
What Is Kidney Stone Surgery
Kidney stone surgery involves a surgeon either physically removing a kidney stone whole or in pieces, or essentially blasting it apart so that it can be passed by the body.
This surgery may be scheduled or performed urgently by a urologista doctor who deals with diseases of the urinary tract.
There are different types of kidney stone surgeries. Depending on the one performed, you may go home the same day or stay in the hospital for one or more nights.
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Blasting Of Kidney Stones Has Risks Study Reports
WASHINGTON, April 9 – The use of shock waves to pulverize kidney stones into sand-like material significantly increases the risk for diabetes and high blood pressure later in life, according to the longest follow-up study of the popular therapy.
In the study, which is to be published on Monday from the Mayo Clinic, patients who underwent the pulverizing procedure, known as lithotripsy, developed diabetes at almost four times the rate of those whose kidney stones were treated by other methods. The lithotripsy group also developed high blood pressure about 50 percent more often than a group treated by other methods, the study in The Journal of Urology found.
The diabetes risk was related in part to the number of shocks given, said the Mayo Clinic researchers in Rochester, Minn. The risk for high blood pressure, also known as hypertension, was related to treatment of stones in both kidneys but not to the total number of shocks, which can number in the hundreds or thousands.
The Mayo Clinic issued a news release saying that its researchers are “sounding an alert about the side effects of shock wave lithotripsy” and that the findings are “completely new.”
The findings also were surprising because earlier studies had not identified diabetes as a complication of the procedure, said Dr. Amy Krambeck, a co-author of the study. There have been conflicting findings about hypertension as a complication.
Blast Away Kidney Stones With Moses
TAMPA, Fla. About one in ten people in the U.S. will develop kidney stones at some point in their life and the summer months are when they are more likely to occur because of dehydration. Some people compare the pain to childbirth or being stabbed. ;New technology is bringing fast relief to these patients.
Sixty-six-year-old Jack Osmanski is enjoying the retirement life.
I hunt and fish with my son. Ive been reading a lot more,; Osmanski, told Ivanhoe.
Until one night he woke up with a sudden and sharp pain.
Osmanski shared, Ive been through a few car crashes. I fell through the ceiling seven years ago and I never had a thing that was quite as painful as that in my life.
Jack had developed a five-millimeter kidney stone, the size of a pencil top eraser.
It felt like someone was actually stabbing me in the back, Osmanski exclaimed.
He was given pain meds at the hospital and took a let it pass on its own approach. But the stone was not moving.
If they dont pass on their own, you cant leave a kidney stone blocking the kidney for longer than four to six weeks without having long-term kidney damage, noted Ross Simon, MD, MS, a urologist at Tampa General Hospital noted.
So, Dr. Simon suggested a new laser technology called MOSES. With its ability to fire two pulses of a laser, it can treat bigger kidney stones more efficiently.
Within two to three days, I started to feel a lot better, he remarked.
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Is It Urgent That The Patient Be Treated With A Procedure Like This
lf the stone does not pass on its own, it will require treatment. lf you have an infection, severe pain, or if your kidney function is threatened, your doctors will act quickly. lf you only have one kidney or have had a kidney transplant, your stone will be treated more quickly. lf you have large stones or stones in both kidneys, your doctors will not wait to treat you.
How Do They Blast Kidney Stones
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Reducing Kidney Stone Risk
Drinking enough fluid will help keep your urine less concentrated with waste products. Darker urine is more concentrated, so your urine should appear very light yellow to clear if you are well hydrated. Most of the fluid you drink should be water. Most people should drink more than 12 glasses of water a day. Speak with a healthcare professional about the right amount of water that’s best for you. Water is better than soda, sports drinks or coffee/tea. lf you exercise or if it is hot outside, you should drink more. Sugar and high-fructose corn syrup should be limited to small quantities.
Eat more fruits and vegetables, which make the urine less acid. When the urine is less acid, then stones may be less able to form. Animal protein produces urine that has more acid, which can then increase your risk for kidney stones.
You can reduce excess salt in your diet. What foods are high in salt? Everyone thinks of salty potato chips and French fries. Those should be rarely eaten. There are other products that are salty: sandwich meats, canned soups, packaged meals, and even sports drinks.
Some herbal substances are promoted as helping prevent stones. You should know that there is insufficient published medical evidence to support the use of any herb or supplement in preventing stones.
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What To Expect During Lithotripsy
Lithotripsy is usually done on an outpatient basis. This means that youll go to the hospital or clinic on the day of the procedure and leave the same day.
Before the procedure, you change into a hospital gown and lie on an exam table on top of a soft, water-filled cushion. This is where you remain while the procedure is performed. Youre then given medicine to sedate you and antibiotics to fight infection.
During lithotripsy, high-energy shock waves will pass through your body until they reach the kidney stones. The waves will break the stones into very small pieces that can easily be passed through your urinary system.
After the procedure, youll spend about two hours in recovery before being sent home. In some cases, you may be hospitalized overnight. Plan to spend one to two days resting at home after the procedure. Its also a good idea to drink plenty of water for several weeks after lithotripsy. This will help your kidneys flush out any remaining stone fragments.
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Different Treatments For Kidney Stones
As we age, the body starts slowing down and mystery ailments start to pop up. After a lifetime of abusing our bodies, the bill comes due. Even for seemingly healthy people, illness and conditions occur that we have no control over. Kidney stones are one such ailment were all susceptible to. They develop in the kidneys because of excessive minerals in the body, and many of us wont know its happening until they are ready to come out, which is an ordeal thats best avoided. Passing kidney stones is an excruciating process that no one wants to endure. Fortunately, medical science is evolving and coming up with newer and better treatments for kidney stones.
Prevention FirstAs the saying goes, An ounce of prevention is worth a pound of cure. That is especially true for kidney stones. If you can prevent them from forming, youll be better off in the long run. You can do this by drinking lots of water daily. Drinking lots of water keeps the body hydrated and the urine diluted. The diluted urine is important for removing the excess minerals that cause the stones. Six to eight ounces of water a day is enough to help prevent kidney stones. Maintaining a healthy and balanced diet is important as well. Too many fatty foods and not enough fiber will lead to stones.
How Does Laser Stone Surgery Work
The surgery is minimally invasive and requires no incisions on your body. Once you are asleep, a small lighted instrument is placed into your urethra and bladder to access your ureter and kidney.
Once the stone is seen, a laser fiber is used to transmit Holmium energy to break up your kidney stones. The surgeon removes some pieces through the urethra with a small basket, and smaller pieces can be passed later with urination. The surgeon may also use a high-powered holmium laser with high-frequency emissions that “dust” the stones into a fine powder. You can then pass the fine particles in your urine after surgery. An even more efficient way of transmitting the holmium laser is by modulating the pulse using the Moses effect, which may result in more efficient stone dusting or fragmentation.
The surgeon will likely insert a tube called a stent between the kidney and urethra. This promotes healing and lets small stone fragments pass more easily. Most importantly, this stent allows your kidney to drain during the healing process. The stent is removed about 1 week after surgery. The length of surgery is generally under 1 hour, depending on the size and number of your kidney stones. Use of the dusting technique combined with the Moses effect may decrease the need to remove stones with a basket, thereby minimizing the need to use a stent.
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What Are The Risks Of Ureteroscopic Lithotripsy
All surgical procedures have risks, but complications are rare for this procedure. The most common side effects are:
- Pain when the stone particles pass. Dr. B-T will give you pain medication to go home with.
- Blood in your urine.
- Urinary blockage if particles get stuck in the ureter.
- Incomplete breakage and passage of stone fragments.
Morbidity And Mortality Rates
Colicky renal pain is very common when gravel is being passed. Other problems may include perirenal hematomas in 66% of the cases; nerve palsies; pancreatitis ; and obstruction by stone fragments. Death is extremely rare and usually due to an undiagnosed associated or underlying condition that is aggravated by the lithotripsy procedure.
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What About Stones In The Ureter
Most small ureteral stones will pass on their own. lf they don’t pass, then another intervention is usually done. Ureteral stones that occur near the kidney are usually treated by SWL with or without moving the stone to a better spot. Ureteral stones that occur lower may also be treated with SWL, but they usually require ureteroscopy especially if they are large .
How Successful Is Shock Wave Lithotripsy
ln those patients who are thought to be good candidates for this treatment, some 50-75% are found to be free of stones within three months of SWL treatment. The highest success rates seem to be in those patients with smaller stones .
After treatment, some patients may still have stone fragments that are too large to be passed. These can be treated again if necessary with shock waves or with another treatment.
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What Will Happen After I Leave The Hospital
After treatment, you will have blood in your urine and possibly abdominal pain or aching for several days. Other people experience a severe cramping pain as shattered stone fragments make their way out of the body. Oral pain medication and drinking lots of water will help relieve symptoms.
Sometimes, the stone is not completely broken up, or big pieces remain and additional treatments may be needed.
Rarely, more serious problems occur, such as bleeding near the kidney that might require a blood transfusion, damage to the area around the stone, or pieces of the stone blocking the flow of urine.
Large Kidney Stones Require More Extensive Treatment
Large kidney stones are stones that measure approximately 5 mm or larger. Based on their size, they may have trouble moving through the urinary tract out of the body. In fact, they are prone to become lodged causing severe pain and other symptoms.
Large kidney stones require intervention for removal, typically, a surgical procedure.; Reasons that initiate surgical treatment include:
- A stone that becomes lodged and wont pass on its own.
- Severe pain that makes it difficult to wait for the stone to pass on its own.
- Having an infection.
- Having a stone that is blocking the flow of urine from the kidney.
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Kidney Stone Causes And Risk Factors
Both men and women can get kidney stones, but menâs chances of getting them are about double that of womenâs.
Itâs often hard to figure out what caused a kidney stone. But they happen when your urine has high levels of certain minerals. These include:
- Uric acid
If you donât have enough urine in your body to water down the high concentration of minerals, stones can form. Think about stirring up your favorite drink from a powder mix. If you donât add enough liquid — say, water or juice — the powder will clump up and turn into hard, dry chunks.
Things that can raise your risk for kidney stones include:
- What you eat
- Some medications like triamterene , a diuretic that treats high blood pressure; antiseizure drugs; ; corticosteroids; and protease inhibitors like indinavir sulfate for HIV.