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 In most medical centers, this has been replaced by a type of computed tomography called unenhanced helical CT scanning.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.
Risk Factors You Can’t Control
White men have a greater risk for kidney stones than other groups, starting in the 40s. Women see their risk rise in the 50s. And your odds also go up if you have a family history of kidney stones. Certain medical conditions can boost the risk — high blood pressure, gout, urinary tract infections, certain kidney conditions such as polycystic kidney disease — but treating or controlling these conditions generally helps prevent stone formation.
What Are The Types Of Kidney Stones
The four types of kidney stones are:
Calcium oxalate stones are the most common type of kidney stone. They represent almost 70-80% of all stones. They are caused by a build-up of calcium and oxalate or phosphate. While there are many reasons for why calcium stones form, calcium intake, too little fluid intake, or even too much Vitamin C consumption are some of the more well recognized causes.
This type of kidney stone can be caused by urine that is too acidic or in individuals with gout. It results from the buildup of uric acid.
Struvite kidney stones are uncommon . They are typically caused by certain bacteria that may infect the kidney. Stones are comprised of magnesium, phosphate and ammonium.
Cystine stones are quite rare and usually only found in people with genetic condition called cystinuria. This condition makes them unable to reabsorb a normal body chemical, called cystine. As a result, they excrete an abnormal amount of cystine which can crystallize, forming stones.
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What Is A Kidney Stone
A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi.
The condition of having kidney stones is termed nephrolithiasis. Having stones at any location in the urinary tract is referred to as urolithiasis, and the term ureterolithiasis is used to refer to stones located in the ureters.
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.
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Are There Any Foods Or Drinks That Help Treat Kidney Stones Are There Any Home Remedies
There are three liquids rumored to help with kidney stones:
- Cranberry juice. Although cranberry juice can help prevent urinary tract infections , it doesnt help with kidney stones.
- Apple cider vinegar. Vinegar is acidic and it can sometimes create changes to your urine, which helps with kidney stones. But, this doesnt always help. Talk to your healthcare provider about the use of vinegar.
- Lemon juice. Lemon juice is rich in citrate, which can help prevent kidney stones from forming. Citrates are found in several citrus fruits including lemons, limes, oranges and melons.
- Coffee. Studies show that coffee may decrease your risk of developing kidney stones.
Avoid soda and other drinks with added sugar or fructose corn syrup. They increase your risk.
Kidney Stone With Pain
The sharp cramping pain on either side of your lower back and nausea or vomiting that you have are because of a small stone that has formed in the kidney. It’s now passing down a narrow tube on its way to your bladder. Once the stone reaches your bladder, the pain will often stop. But it may come back as the stone continues to pass out of the bladder and through the urethra. The stone may pass in your urine stream in one piece. The size may be 1/16 inch to 1/4 inch . Or, the stone may break up into sandy fragments that you may not even notice.
Once you have had a kidney stone, you are at risk of getting another one in the future. There are 4 types of kidney stones. Eighty percent are calcium stonesmostly calcium oxalate but also some with calcium phosphate. The other 3 types include uric acid stones, struvite stones , and rarely, cystine stones.
Most stones will pass on their own, but may take from a few hours to a few days. Sometimes the stone is too large to pass by itself. In that case, the healthcare provider will need to use other ways to remove the stone. These techniques include:
Lithotripsy. This uses ultrasound waves to break up the stone.
Ureteroscopy. This pushes a basket-like instrument through the urethra and bladder and into the ureter to pull out the stone.
Surgery. You may need surgery to remove the stone.
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Getting A Kidney Stone To Pass
After identifying the size and location of your kidney stone, follow the recommended treatment by your doctor. The vast majority of small kidney stones are able to be passed without medical intervention and can be helped with these steps:
Drinking water: By consuming as much as 3 liters of water a day, this will help flush out your renal system.
Take pain medication: Kidney stones can be extremely painful, therefore, taking pain medication like ibuprofen can help make the passing less agonizing.
Get an alpha-blocker from your doctor: An alpha-blocker can help relax your ureter and progress the kidney stone through your system.
Cut out the right foods: Removing high-oxalate foods like spinach, beets, potatoes, and nuts, as well as animal protein can help limit kidney stone minerals from forming.
Drink juice: Consuming juices from lemons, basil, and dandelion roots can provide compounds that regulate uric acid levels and help breakdown calcium deposits.
For larger stones , medical treatment is often required to enable kidney stones to be passed through the body. Common methods of care include soundwave therapy, surgery, and using a ureteroscope.
Shock Wave Therapy: A process called extracorporeal shock wave lithotripsy creates vibrations targeted at kidney stones to break the larger minerals into smaller pieces that can be passed by the body.
Time Needed For Passing Kidney Stones
The size of kidney stones determine the time needed for their removal from the kidneys. Smaller the size of a stone, the faster it can pass through the urinary tract. For example, a 2mm stones may pass through the kidneys in about 12 days but stones of size 4mm can take about 30 days to pass out.
|Rare genetic disorder: increased cystine in urine|
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How Can Kidney Stones Be Prevented
The best way to avoid kidney stones is to prevent the most common cause â dehydration. You are adequately hydrated when your urine is light yellow. Most people require between 8 to 10 glasses of water per day. Scientists are studying grapefruit juice and other drinks high in citric acid, which may help prevent the most common type of kidney stone.
What Are Risk Factors You Can Control
Diet is a factor in some cases of kidney stones. A dietician can recommend foods to reduce the risk of kidney stones. Higher than recommended amounts of vitamin D, vitamin C, salt, protein, and foods containing high oxalates may increase the risk of stone formation. Eating a low-protein, low-sodium diet with adequate calcium decreases the chance of developing stones. A balanced vegetarian diet that includes dairy might offer your body the best protection against kidney stones.
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What You Need To Know About Kidney Stones
Aug 07, 2019Cedars-Sinai Staff
Passing a kidney stone is said to be some of the most severe physical pain a person can experience.
You may picture someone passing a kidney stone in excruciating pain while a small rock moves through their bladder, but according to Dr. Brian Benway, director of the Comprehensive Kidney Stone Program, pain peaks much earlier in the stone’s journey.
Nothing subtle about a kidney stone
“Contrary to popular belief, passing a kidney stone once it reaches the bladder isn’t the painful part,” says Dr. Benway.
The pain usually starts once the stone has migrated from the kidney into the ureter, the tube that carries urine from the kidney to the bladder.
“Basically, for the first-timer with a kidney stone, the symptoms are not subtle.”
“The pain is usually sudden and quite severe on one side of your back and it can cause immediate nausea and vomiting,” says Dr. Benway
“Basically, for the first-timer with a kidney stone, the symptoms are not subtle.”
This sudden pain will begin to ebb and flow after the first few hours, gradually getting better after a few days. Dr. Benway says you shouldn’t wait for the pain to easeseek evaluation right away.
“Along with pain, kidney stones can sometimes be associated with infection, which will present itself as a fever,” he says.
“Go to the ER right away if you have strong pain with nausea or fever.”
Treating the stone
Capturing the stone
Ureteroscopic Lithotripsy For Large Kidney Stones
Percutaneous nephrolithotomy is currently the first-line recommended treatment for large kidney stones 20 mm. PNL yields an excellent stone-free rate for large kidney stones. However, its invasiveness is not negligible due to its considerable major complication rates. The puncture and dilation of a nephrostomy tract, although it is an essential process in PNL, may induce renal parenchymal damage, blood loss, or visceral injury. A recent global study of PNL reported the major complication rates, which included significant bleeding in 7.8%, renal pelvis perforation in 3.4%, and hydrothorax in 1.8%. Blood transfusions were necessary in 5.7% of the patients. Postoperative high-grade fever occurred in 10.5%. The conventional prone position during the surgery may induce the respiratory problems.
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Foul Smelling Or Cloudy Urine
The presence of stones in your kidneys makes your urine more concentrated. The kidney stones are caused due to crystallization of concentrated minerals and make the urine cloudier, stinky, and darker. The strong or foul smell is often compared with ammonia, but it may be due to a urinary infection rather than just a kidney stone.
What Is Considered A Large Kidney Stone
They considered any kidney stone over 2.5cm to be large, and the average size of the large stones in their study was 3cm . Kidney stones dont need to pass out of the body as long as they remain in the kidney and cause no problems due to size or amount. But they cause severe pain if they move into the urinary tract.
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How Long Does It Take A Kidney Stone To Form
You can have kidney stones for years without knowing theyre there. As long as these stones stay in place within your kidney, you wont feel anything. Pain from a kidney stone typically starts when it moves out of your kidney. Sometimes, a stone can form more quickly within a few months.
Talk with your healthcare provider about your risk factors. They might do a 24-hour urine test to check how quickly you develop stones.
Treating Small Kidney Stones
Small kidney stones may cause pain until you pass them, which usually takes 1 or 2 days.
A GP may recommend a non-steroidal anti-inflammatory drug to help with pain.
To ease your symptoms, a GP might also recommend:
- drinking plenty of fluids throughout the day
- anti-sickness medicine
You might be advised to drink up to 3 litres of fluid throughout the day, every day, until the stones have cleared.
To help your stones pass:
- drink water, but drinks like tea and coffee also count
- add fresh lemon juice to your water
- avoid fizzy drinks
- do not eat too much salt
Make sure you’re drinking enough fluid. If your pee is dark, it means you’re not drinking enough. Your pee should be pale in colour.
You may be advised to continue drinking this much fluid to prevent new stones forming.
If your kidney stones are causing severe pain, your GP may send you to hospital for tests and treatment.
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How To Treat The Kidney Stones Of Size 8mm
For larger stones, like 8mm diameter, that cannot be passed naturally through the urine, surgery is required. If the word surgery has scared you, breathe a sigh of relief. With modern procedures like laparoscopic surgery and shock wave lithotripsy have come into existence. You dont need to go through conventional invasive surgery and get any major cuts or incisions on your body.
The procedure of Shockwave lithotripsy
Modern procedures for kidney stone treatment are minimally invasive and highly effective. The best treatment for stones of 8mm size is Shock Wave Lithotripsy. Shock wave lithotripsy involves the use of thousands of shockwaves in order to break the large stone into smaller stone pieces.
Once this is achieved, you are allowed to go home and the doctor asks you to drink plenty of fluids. The small stone pieces are then flushed out through the urine and you need to collect them in a medical strainer so that they can be sent for further tests.
Other benefits of shockwave lithotripsy
Shock Wave Lithotripsy is an absolutely painless and safe procedure and helps you say goodbye to these pesky stones within no time. It is a convenient procedure too. Aftershock wave lithotripsy, the recovery is quite fast and you can go back to your routine life in 2-3 days.
Thus, if you have a stone that is too large to be removed naturally, undergoing shock wave lithotripsy in time is the wisest choice you can make.
Can Small Kidney Stones Pass Naturally
Kidney stones of less than 5mm are considered to be small. Small kidney stones can easily pass through the urinary tract without any medical assistance. 4mm size stones have 80% chances to pass through the kidneys in about a month, but 5mm size stones have 60% chances of passage in about 45 days.
To pass small-sized kidney stones naturally in urine, certain home remedies can be helpful such as increased fluid intake, increased water, lemon and citrus juice consumption and low salt, calcium and protein diet. High water concentration does not allow growth of kidney stones and they can slowly pass along with the urine. Read about passing of kidney stones with urine.
If you experience any pain in the lower abdomen during passing of the kidney stones, you can take an analgesic such as ibuprofen or any other painkiller as suggested by the doctor. Painkillers help in relieving pain and also speed up the process of passing the stone. Read about relieving kidney pain.
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What Are The Characteristics When The Kidneys Begin To Have Problems
Tired, and hard to concentrate
When kidney function is impaired, toxins and impurities can accumulate in the blood. The condition makes people feel tired, weak, and difficult to concentrate. When a persons kidneys are troubled, he or she generally also has anemia. It makes people often tired and lethargic.
How Are Kidney Stones Treated
Once diagnosed, your healthcare provider will first determine if you even need treatment. Some smaller kidney stones may leave your system when you urinate. This can be very painful. If your provider decides that you do need treatment, your options include medications and surgery.
Medications. Medications may be prescribed to:
- Your healthcare provider may recommend that you take an over-the-counter medication like ibuprofen or, if youre in the emergency room, an IV narcotic.
- Manage nausea/vomiting.
- Relax your ureter so that the stones pass. Commonly prescribed medicines include tamsulosin and nifedipine .
You should ask your healthcare provider before you take ibuprofen. This drug can increase the risk of kidney failure if taken while youre having an acute attack of kidney stones especially in those who have a history of kidney disease and associated illnesses such as diabetes, hypertension and obesity.
Surgery. There are four types of surgeries used to treat kidney stones. The first three are minimally invasive, meaning that the surgeon enters your body through a natural opening , or makes a small incision.
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Prevention Of Kidney Stones
Knowing what kind of kidney stone you are more prone to may help in the prevention. In general the number 1 way to avoid kidney stones is to stay hydrated. So drink plenty of water throughout the day .
Calcium Kidney Stone
- Calcium-based foods do not cause kidney stones, but calcium supplements can. Make sure you check with your doctor to see if you should stop taking a calcium supplement or continue .
- In calcium stones, the oxalate that combines with the calcium to form the stone can be acquired through diet and these foods should be avoided: spinach, swiss chard, okra, bran flakes, rhubarb, soy products, french fries, potato chips, sweet potatoes, chocolate, tea, black pepper and nuts.
Uric Acid Kidney Stone
- Avoid acidic juices and foods that may cause your urine to be more acidic. Also avoid foods that contain high amounts of uric acid such as: alcohol, organ meats , spinach, sardines and some other fish and seafood, bacon, turkey, veal and venison.