Extracorporeal Shock Wave Lithotripsy
All shock wave lithotripsy machines deliver shock waves through the skin to the stone in the kidney. Most but not all of the energy from the shock wave is delivered to the stone.
Stone size is the greatest predictor of ESWL success. Generally:
- stones less than 10 mm in size can be successfully treated
- for stones 10 to 20 mm in size, additional factors such as stone composition and stone location should be considered
- stones larger than 20 mm are usually not successfully treated with ESWL.
Stones in the lower third of the kidney can also be problematic because, after fragmentation, the stone fragments may not be cleared from the kidney. Due to gravity, these fragments dont pass out of the kidney as easily as fragments from the middle and upper thirds of the kidney.
Obesity also influences whether ESWL treatment will be successful. The urologist will calculate the skin-to-stone distance to help determine whether this treatment is likely to be effective.
The possible complications of ESWL include:
When To See A Doctor
Even though it is incredibly painful to pass a kidney stone, most of the time medical intervention isn’t necessary. If the pain is too much, you can ask your doctor for pain medication. Your doctor may also prescribe medication like tamsulosin or nifedipine to relax the ureter so you can more easily pass the stone.
If you aren’t able to pass urine, there is blood in your urine, or you have nausea, vomiting, fever, or chills, you should contact your doctor. In these cases, your doctor may use one of these methods to break up and remove the stone:
Todays Stone Age: How To Eat To Prevent Kidney Stones
by Daniel Marchalik, MD, UrologyJuly 5, 2017
Kidney stones are very common: Men have a nearly one in five chance of developing kidney stones over their lifetime, and women have a nearly one in 10 chance. And as part of what is known as the Kidney Stone Belt, D.C.-area residents are at even higher risk of developing kidney stones.
This is a major problem, and its one thats only gotten worse with time. The overall risk for kidney stones in the late 1970s was calculated at 3.8 percent. In the late 2000s, that number had jumped to 8.8 percent. Thats more than a 231 percent increase in the overall risk of kidney stones in just 30 years.
If you have one kidney stone, the chances of developing a second one or more over your lifetime are more than 50 percent. And having kidney stones also can put you at greater risk for long-lasting problems such as kidney failure, recurrent infections, and multiple other conditions.
Fortunately, making smart dietary choices can prevent kidney stones from developing in the first place. And if you develop a kidney stone, we can determine whats causing it and lower your risk for developing another one.
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Diet And Calcium Stones
Follow these guidelines if you have calcium kidney stones:
- Drink plenty of fluids, particularly water.
- Eat less salt. Chinese and Mexican food, tomato juice, regular canned foods, and processed foods are often high in salt. Look for low-salt or unsalted products.
- Have only 2 or 3 servings a day of foods with a lot of calcium, such as milk, cheese, yogurt, oysters, and tofu.
- Eat lemons or oranges, or drink fresh lemonade. Citrate in these foods prevents stones from forming.
- Limit how much protein you eat. Choose lean meats.
- Eat a low-fat diet.
Do not take extra calcium or vitamin D, unless the provider who is treating your kidney stones recommends it.
- Watch out for antacids that contain extra calcium. Ask your provider which antacids are safe for you to take.
- Your body still needs the normal amount of calcium you get from your daily diet. Limiting calcium may actually increase the chance that stones will form.
Ask your provider before taking vitamin C or fish oil. They may be harmful to you.
If your provider says you have calcium oxalate stones, you may also need to limit foods that are high in oxalate. These foods include:
- Fruits: rhubarb, currants, canned fruit salad, strawberries, and Concord grapes
- Vegetables: beets, leeks, summer squash, sweet potatoes, spinach, and tomato soup
- Drinks: tea and instant coffee
- Other foods: grits, tofu, nuts, and chocolate
Kidney Stone Diet Plan And Prevention
If you have kidney stones, you may need to follow a special diet plan. First, your healthcare professional will run blood and urine tests to find out what kind of risk factors you may have. Then your healthcare professional will tell you the diet changes and medical treatment you need to prevent having kidney stones come back.
A registered kidney dietitian can help you make the necessary changes in your diet plan and lifestyle.
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S For Preventing Kidney Stones
If youve ever had a kidney stone, you surely remember it. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body. For many, kidney stones arent a one-time thing: in about half of people who have had one, another appears within seven years without preventive measures.
Preventing kidney stones isnt complicated, but it does take some determination.
Kidney stones form when certain chemicals become concentrated enough in the urine to form crystals. The crystals grow into larger masses , which can make their way through the urinary tract. If the stone gets stuck somewhere and blocks the flow of urine, it causes pain.
Most stones occur when calcium combines with oxalate. Stones can also form from uric acid, which is a byproduct of protein metabolism.
Risk Factors You Cannot Control
Things you can’t control include:
- Age and gender.
- Men between the ages of 30 and 50 are most likely to get kidney stones.
- Postmenopausal women with low estrogen levels have an increased risk for kidney stones. Women who have had their ovaries removed are also at increased risk.
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How Common Are Kidney Stones
Researchers have concluded that about one in ten people will get a kidney stone during their lifetime. Kidney stones in children are far less common than in adults but they occur for the same reasons. Theyre four times more likely to occur in children with asthma than in children who dont have asthma.
How Can I Prevent Kidney Stones
The best way to prevent most kidney stones is to drink enough fluids every day. Most people should drink eight to 12 cups of fluid per day. If you have kidney disease and need to limit fluids, ask your doctor how much fluid you should have each day. Limiting sodium and animal protein in your diet may also help to prevent kidney stones. If your doctor can find out what your kidney stone is made of, he or she may be able to give you specific diet recommendations to help prevent future kidney stones.
If you have a health condition that makes you more likely to have kidney stones, your doctor might tell you to take medicine to treat this condition.
Never start or stop any treatment or diet without talking to your doctor first!
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A Formula For Kidney Stone Protection: Drink Enough Water
Dehydration is the biggest risk factor for kidney stones that most people face. Our kidneys filter blood to remove waste products. These waste products enter our bloodstream from what we eat and drink. When urine is more concentrated, its more likely that the waste products filtered out by the kidneys will form a stone. The darker yellow urine is, the more concentrated it is. Urine should be light yellow or clear if youre getting enough to drink.
#Dehydration is the biggest risk factor for #kidneystones that most people face. goo.gl/4rKg5v via @MedStarWHC
Sadly, most of us dont get enough to drink. Kidney stones tend to be more common in areas of the world with warmer temperatures, where the heat makes it easier to get dehydrated. We call this the Kidney Stone Belt, and it includes Maryland, Virginia and Washington, D.C., among other places.
The simple answer for dehydration is to drink more. Water is best, of course. Citrus fruits like lemon can lower the risk for kidney stones because they contain a compound called citrate. Therefore, adding lemon to water or drinking lemonade also can help.
Of course, drinking more water is easier for some people than others. Ive seen patients who come in with kidney stones, and they tell me, I have no idea what my risk factor is. Then I find out they dont drink water all day because they cant go to the bathroom during the workday.
Limiting Foods With Calcium Oxalate
Kidney stones can consist of many different compounds, including uric acid, struvite, and cysteine. The most common type of kidney stone involves calcium oxalate.
One 2014 study examined nearly 44,000 kidney stones and found that 67% were composed predominately of calcium oxalate.
Doctors usually only recommend restricting oxalate intake to those at a high risk of kidney stones or those with high oxalate levels.
Consuming calcium alongside oxalate-rich foods may reduce the risk of kidney stones by binding the chemicals together before they reach the kidneys.
Foods that contain high levels of oxalate include:
- grapefruit and cranberry juice
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Not All Stones Are Created Equal
In addition to calcium oxalate stones, another common type of kidney stones is uric acid stones. Red meat, organ meats, and shellfish have high concentrations of a natural chemical compound known as purines. “High purine intake leads to a higher production of uric acid and produces a larger acid load for the kidneys to excrete,” said Dr. Jhagroo. Higher uric acid excretion leads to lower overall urine pH, which means the urine is more acidic. The high acid concentration of the urine makes it easier for uric acid stones to form.
To prevent uric acid stones, cut down on high-purine foods such as red meat, organ meats, and shellfish, and follow a healthy diet that contains mostly vegetables and fruits, whole grains, and low fat dairy products. Limit sugar-sweetened foods and drinks, especially those that contain high fructose corn syrup. Limit alcohol because it can increase uric acid levels in the blood and avoid crash diets for the same reason. Eating less animal-based protein and eating more fruits and vegetables will help decrease urine acidity and this will help reduce the chance for stone formation.
Monitoring The Intake Of High Acid Foods
Highly acidic urine can increase the risk of uric acid kidney stones and make passing them more painful.
High amounts of acid in the urine also encourage the kidneys to reabsorb citrate rather than excrete it. Citrate is a compound that can help flush out calcium-based stones, as well as impair their growth.
Highly acidic foods include:
According to the National Kidney Foundation, almost 1 in 10 people in the United States develop a kidney stone during their lifetime. The risk is around 19% for men and 9% for women.
Most men experience their first kidney stone after the age of 30 years.
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Facts About Kidney Stones
For Urinary Tract Infections
Since three of the most common causes of kidney discomfort occur in the urinary tract, here are some remedies to relieve pain in the kidneys related to the urinary tract:
1. Stay Hydrated
Hydration is key to relieving pain in the kidneys since water will help flush bacteria out of the body. Plus, staying hydrated will help clear out the urinary tract as a whole and work to eliminate any possible infections.
Many specialists recommend the 8×8 rule, meaning you should drink eight 8 oz. glasses of water a day. However, water intake is highly dependant on you and your health, so take this article into consideration when determining your daily amount of water intake.
2. Drink Cranberry Juice
While not scientifically proven, cranberry juice is known to be a remedy for urinary tract infections. If you choose to alternate between cranberry juice and water, be sure to choose a cranberry juice that isnt packed full of additional sweeteners. A cranberry supplement or pure cranberry juice is always the best way to go!
3. Take Probiotics
Its no secret that probiotics are beneficial for you, especially when it comes to fighting bacteria and kidney pain. Studies show that probiotics can improve kidney function and assist in processing waste too.
4. Drink Parsley Juice
You can also mix parsley into a smoothie to make drinking it more bearable. Check out these recipes for inspiration!
5. Take a Warm Epsom Salt Bath
6. Apply Heat
7. Use Non-Aspirin Pain Killers
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Six Steps To Control Oxalate For Kidney Stones
The following six steps can be taken to reduce the risk of forming calcium oxalate stones:
1. Eat fewer high-oxalate foods.
The first suggestion is the most obvious. The more oxalate that is absorbed from your digestive tract, the more oxalate in your urine. High-oxalate foods to limit, if you eat them, are:
- French fries
- Nuts and nut butters
You do not need to cut out other healthy foods that provide some oxalate. In fact, oxalate is practically unavoidable, because most plant foods have some. Often a combination of calcium from foods or beverages with meals and fewer high-oxalate foods is required.
2. Increase the amount of calcium in your diet.
Low amounts of calcium in your diet will increase your chances of forming calcium oxalate kidney stones. Many people are afraid to eat calcium because of the name “calcium oxalate stones.” However, calcium binds oxalate in the intestines. A diet rich in calcium helps reduce the amount of oxalate being absorbed by your body, so stones are less likely to form. Eat calcium rich foods and beverages every day from dairy foods or other calcium-rich foods.
Also, eating high calcium foods at the same time as high oxalate food is helpful for example have low fat cheese with a spinach salad or yogurt with berries. If you take a calcium supplement, calcium citrate is the preferred form.
3. Limit the vitamin C content of your diet.
4. Drink the right amount of fluids every day.
5. Eat the right amount of protein daily.
Easy Ways To Prevent Kidney Stones
Did you know that one in ten people will have a kidney stone over the course of a lifetime? Recent studies have shown that kidney stone rates are on the rise across the country. Those in the know believe that some major misconceptions may be the culprit.
The National Kidney Foundation has teamed up with Dr. Allan Jhagroo, a kidney stone specialist at the University of Wisconsin School of Medicine and Public Health, to help you stay stone-free by debunking some of the major kidney stone myths and misconceptions.
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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.
How To Avoid Kidney Stones
Here are the five ways to help prevent kidney stones:
Drink plenty of water: Drinking extra water dilutes the substances in urine that lead to stones. Strive to drink enough fluids to pass 2 liters of urine a day, which is roughly eight standard 8-ounce cups. It may help to include some citrus beverages, like lemonade and orange juice. The citrate in these beverages helps block stone formation.
Eat calcium rich foods: Dietary calcium binds to oxalate in your intestines and thereby decreases the amount of oxalate that gets absorbed into the bloodstream and then excreted by the kidney. This lowers the concentration of oxalate in the urine, so there is less chance it can bind to urinary calcium. That leads to decreased risk of kidney stones.
Reduce sodium: A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine. So, a low-sodium diet is recommended for the stone prone. Current guidelines suggest limiting total daily sodium intake to 2,300 mg. If sodium has contributed to kidney stones in the past, try to reduce your daily intake to 1,500 mg. This will also be good for your blood pressure and heart.
Avoid stone-forming foods: Beets, chocolate, spinach, rhubarb, tea, and most nuts are rich in oxalate, which can contribute to kidney stones. If you suffer from stones, your doctor may advise you to avoid these foods or to consume them in smaller amounts.
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