When Should A Kidney Stone Be Treated
When a kidney stone causes pain to the extent that the pain cannot be controlled with oral pain medication, the stone should be treated. Similarly, stones that are associated with severe nausea or vomiting should be treated. Some stones are associated with infection or fever such situations can be life threatening and demand prompt attention. Stones that are associated with a solitary kidney, poor overall kidney function or complete blockage of urine flow should also all be treated.
Sometimes, when a stone is associated with bothersome symptoms, it may be appropriate to wait and see if the stone will pass on its own. If the stone is small, this is a very reasonable course of action. However, stones larger in size than 5 mm are unlikely to pass on their own and should be considered for treatment.
Kidney Stones Without Symptoms
As we mentioned earlier, not all stones have symptoms. You might not even realize you have a stone until you have an imaging test for another health issue. In these circumstances, stones might not need treatment. However, we might recommend having asymptomatic stones removed if we think they will grow and cause discomfort later. Youll need to think about how quickly you could get treatment if the stone started giving you trouble.
How Are Kidney Stones Classified
Kidney stones vary in size, shape, and color. They are also made from different substances, depending on the type of stone. Knowing of the type of kidney stone you have helps us treat it most effectively.
Calcium stones. Most kidney stones are made from either calcium oxalate or calcium phosphate. These can form if theres too much calcium in your urine.
Uric acid stones. Uric acid is produced when your body breaks down compounds called purines, which are found in foods like anchovies, dried beans, and peas. When uric acid crystals accumulate, they can form a uric acid stone.
Struvite stones. Struvite stones are more common in people who get frequent urinary tract infections . Bacteria that cause UTIs disrupt the chemical balance in the urine. Struvite stones are sometimes called staghorns because they have a jagged appearance.
Cystine stones. This type of stone, made from an amino acid called cystine, is caused by a rare inherited condition called cystinuria. People with cystinuria have too much cystine in their urine.
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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.
Its 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 dont become dehydrated. Its very important to keep your urine diluted to prevent waste products forming into kidney stones.
Read more about preventing kidney stones.
Tests To Diagnose Kidney Stones
Your doctor may do one or more of the following tests to help diagnose kidney stones, see where they are located, and find out if they are causing or may cause damage to the urinary tract.
- A non-contrast spiral computed tomography scan is a special type of CT scan that moves in a circle.
- An ultrasound examination uses reflected sound waves to produce a picture of your urinary tract.
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What Other Treatment Choices For Kidney Stones Are Available
Drug treatment is being studied with such drugs as such as calcium channel blockers , steroids and alpha-adrenergic blockers. The idea is that the stone might be dissolved with medication. Other drugs such as K-citrate, thiazides or allopurinol are prescribed to prevent new stones from developing. Most doctors agree that more medical trials are needed.
When SWL is not appropriate or doesn’t work, some people will need ureteroscopy, a technique that goes through the bladder to reach the stone or percutaneous nephrolithotomy, a technique that goes through a small incision created in your back. Some people, in extremely rare cases, even need open surgery, a technique that involves a larger incision in your abdomen. The medical terms for kidney stone surgery are ureterolithotomy or nephrolithotomy.
Which Procedure Is Best
As mentioned above, the answer depends on your situation. For example, shock wave lithotripsy has low complication rates, but ureteroscopy could address all the stones with one procedure.
Patients who dont have success with the approaches mentioned above may need to have laparoscopic, open, or robot assisted surgery to remove the stone.
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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.
Can A Large Kidney Stone Cause An Injury
Your risk of injury from a kidney stone can go up based on the size and location of the stone. A larger stone could get stuck in a ureter, causing pressure to build up. This can lead to renal failure and, in the worst-case scenario, you could lose your kidney. The chance of passing a 1 cm stone is less than 10%, and stones larger than 1 cm typically dont pass.
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What Are Kidney And Bladder Stones
Kidney or bladder stones are solid build-ups of crystals made from minerals and proteins found in urine. Bladder diverticulum, enlarged prostate, neurogenic bladder and urinary tract infection can cause an individual to have a greater chance of developing bladder stones.
If a kidney stone becomes lodged in the ureter or urethra, it can cause constant severe pain in the back or side, vomiting, hematuria , fever, or chills.
If bladder stones are small enough, they can pass on their own with no noticeable symptoms. However, once they become larger, bladder stones can cause frequent urges to urinate, painful or difficult urination and hematuria.
Getting The Stone Out
In most cases, treatment means letting the stone pass naturally. Your healthcare provider may give you medicine for pain relief. Then he or she will add fluids until the ureter builds up enough pressure to push the stone out. You will usually be asked to catch the stone in a strainer so it can be looked at in the lab. If the stone hasn’t passed in 8 to 12 hours, you may need to see a urologist to push the stone back to the kidney so it can be broken up.
For stones that don’t pass on their own, other treatments are used:
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What Are The Most Common Types Of Kidney Stones
The most common type of kidney stone is a calcium oxalate stone. This type happens when calcium and oxalate combine in your urine. It can happen when you have high quantities of oxalate, low amounts of calcium and arent drinking enough fluids.
Stones caused by uric acid are also fairly common. These come from a natural substance called purine, which is a byproduct of animal proteins .
What Are The Symptoms Of Cystinuria
Cystinuria only causes symptoms if you have a stone. Kidney stones can be as small as a grain of sand. Others can become as large as a pebble or even a golf ball. Symptoms may include:
- Pain while urinating
- Sharp pain in the side or the back
- Pain near the groin, pelvis, or abdomen
- Nausea and vomiting
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There Are A Number Of Reasons To Treat A Kidney Stone Even If It Is Not Causing Any Painful Symptoms
Recurring urinary tract infections
Some kidney stones may be infected, and in many cases, despite proper antibiotic treatment, the infection cannot be cleared from the stone. In such cases, the only way to remove the infection completely is to remove the stone.
Staghorn stones
These are extremely large stones that grow to fill the inside of the kidney. There are serious health risks associated with these stones, and left untreated they are associated with an increased risk of kidney failure.
Occupational requirements
For example, the Federal Aviation Administration will not allow a pilot to fly until all stones have been cleared from his or her kidney. Other occupations also do not allow for the unplanned passage of a kidney stone.
Extensive travel
The patient who, whether for business or otherwise, travels to locales where medical care is not reliable may wish to consider preventive treatment.
Patient preference
After thorough consideration of all options available to them, many patients elect to remove their stones at a time when it is convenient for them.
What Are The Treatments For Kidney Stones
The treatment for a kidney stone depends on the size of the stone, what it is made of, whether it is causing pain and whether it is blocking your urinary tract. To answer these questions and to figure out the right treatment for you, your doctor might ask you to have a urine test, blood test, x-ray and/or CT scan. A CT scan sometimes uses contrast dye. If you have ever had a problem with contrast dye, be sure to tell your doctor about it before you have your CT scan.
If your test results show that your kidney stone is small, your doctor may tell you to take pain medicine and drink plenty of fluids to help push the stone through your urinary tract. If your kidney stone is large, or if it is blocking your urinary tract, additional treatment may be necessary.
One treatment option is shock wave lithotripsy. This treatment uses shock waves to break up the kidney stones into small pieces. After the treatment, the small pieces of the kidney stone will pass through your urinary tract and out of your body with your urine. This treatment usually takes 45 minutes to one hour and may be done under general anesthesia, which means you will be asleep and unable to feel pain.
In rare cases, a surgery called percutaneous nephrolithotomy is needed to remove a kidney stone. During the surgery, a tube will be inserted directly into your kidney to remove the stone. You will need to be in the hospital for two to three days to have and recover from this treatment.
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Whos Most Likely To Get Kidney Stones What Are The Risk Factors
White men in their 30s and 40s are most likely to get kidney stones. However, anyone can develop kidney stones.
There are several risk factors for developing kidney stones. These include:
- Not drinking enough liquids.
- Having a diet that includes the substances that form the stones .
- Having a family history of kidney stones.
- Having a blockage in your urinary tract.
Certain medical conditions can also increase your risk of developing stones. This is because they may increase or decrease levels of the substances that make up a kidney stone. These conditions can include:
- Hypercalciuria .
Certain foods can also place you at risk of a kidney stone. These foods include:
- Meats and poultry .
- Sodium .
- Sugars .
All About Kidney Stones
A kidney stone is a solid piece of material that forms in the kidney. It is made from substances that normally dissolve in the urine. Each year, about 1 million people in the U.S. get kidney stones.
Kidney stones are more common in whites than in African Americans. They typically strike between age 20 and 50 and are more common in men than women. If you get one stone, you are more likely to get more. Repeated stone attacks can affect your kidneys.
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Who Is More Likely To Develop Kidney Stones
Men are more likely to develop kidney stones than women. If you have a family history of kidney stones, you are more likely to develop them. You are also more likely to develop kidney stones again if youve had them once.
You may also be more likely to develop a kidney stone if you dont drink enough liquids.
Kidney Stone Causes Symptoms Treatments & Prevention
Your kidneys remove waste and fluid from your blood to make urine . Sometimes, when you have too much waste 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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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.
Will I Be Hospitalized For This Procedure
Yes. This requires general anesthesia. You will need a short hospitalization. You may be off work for a week or so. Depending on the position of the stone, the procedure is completed in 20 to 45 minutes. The goal is to take out all of the stones so that none are left to pass through the urinary tract.
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Staying Hydrated Is Key
Drinking plenty of fluids is a vital part of passing kidney stones and preventing new stones from forming. Not only does the liquid flush out toxins, but it also helps move stones and grit through your urinary tract.
Although water alone may be enough to do the trick, adding certain ingredients can be beneficial. Be sure to drink one 8-ounce glass of water immediately after drinking any flavored remedy. This can help move the ingredients through your system.
Talk to your doctor before getting started with any of the home remedies listed below. They can assess whether home treatment is right for you or if it could lead to additional complications.
If youre pregnant or breastfeeding, avoid using any remedies. Your doctor can determine whether a juice may cause side effects for you or your baby.
What Is Shock Wave Lithotripsy
Shock Wave Lithotripsy is the most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. The stones are broken into tiny pieces. lt is sometimes called ESWL: Extracorporeal Shock Wave Lithotripsy®.
These are what the words mean:
- extracorporeal: from outside the body
- shock waves: pressure waves
- lithotripsy
So, SWL describes a nonsurgical technique for treating stones in the kidney or ureter using high-energy shock waves. Stones are broken into “stone dust” or fragments that are small enough to pass in urine. lf large pieces remain, another treatment can be performed
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Increase Your Intake Of Stone Inhibitors
Several substances found in the urine have been clearly shown to reduce the formation of calcium based kidney stones. Two of the most important are citrate and magnesium.
Lemon juice has been found to increase the level of citrate in the urine. Real lemonade is an excellent way to increase both your citrate and fluid intake.
Nutritional supplements containing magnesium, potassium and citrate may also help to increase the concentration of stone inhibitors in the urine. Ask your urologist before starting any regimen of nutritional supplementation.
Does The Patient Need Anesthesia
Yes, even though there is no incision, there will be pain. You and your doctor will discuss whether light sedation and local or general anesthetics will be used. The choice depends on the technique, the type of stone and the patient. SWL can be delivered with just mild sedation, but in general, some type of anesthesia–either local, regional or general–is used to help the patient remain still, reduce any discomfort, and this improves the breaking of the stone.
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Who Gets Kidney Stones
The National Kidney Foundation estimates that one in ten people will get a kidney stone at some point in their lifetime and that each year, about half a million people go to the emergency room because of kidney stones.
Men tend to get kidney stones more often than women do. Stones are most common in people over age 30.