How Does The Urinary System Work
The body takes nutrients from food and converts them to energy. After the body has taken the food that it needs, waste products are left behind in the bowel and in the blood.
The urinary system keeps chemicals, such as potassium and sodium, and water in balance, and removes a type of waste, called urea, from the blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys.
Severe Kidney Stones Treatment
They are associated with a greater risk of developing chronic kidney disease and end stage kidney disease . There are limited effective treatment options for recurrent kidney stone.
Some kidney stones pass without symptoms, others cause severe pain, but kidney stones usually do not cause lasting damage. Kidney stones may be made of.
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.
If you have kidney or ureteral stones, your treatment will depend on how large the stones are, how severe your symptoms are, the type of stones and the.
When the acute event is resolved, we offer effective medical evaluation to help patients define the causes of their stone formation to help prevent stone.
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This new article looks at the importance of tailoring treatment for elderly chronic kidney disease.
prostate or kidney stone, could cause.
What Else Should I Ask My Healthcare Provider
If you have a uric acid stone, ask your provider:
- What treatment will work best?
- Will I need surgery?
- How can I prevent a stone from forming again?
- What diet is right for me?
- Should I avoid any foods or beverages?
- Do I need to take any supplements?
A note from Cleveland Clinic
Uric acid stones are a type of kidney stone. When you have a high level of uric acid in your blood and urine, small stones can form. These stones can block the passage of urine out of your body, causing pain and other symptoms. Many uric acid stones pass on their own. Your provider may prescribe medication to help the stone pass. For larger stones, your provider may recommend noninvasive or minimally invasive procedures. These treatments include shockwave lithotripsy, ureteroscopy and PCNL. Treatments are successful, but uric acid stones may come back. Avoid or limit foods high in purines to reduce your risk. If you have pain in your side, burning when you pee or see blood in your urine, talk to your healthcare provider. The right diagnosis and treatment can help you feel your best.
Last reviewed by a Cleveland Clinic medical professional on 08/19/2021.
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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.
Complications Of Kidney Stones
Kidney stones can range in size from a grain of sand to that of a pearl or even larger. They can be smooth or jagged, and are usually yellow or brown. A large stone may get stuck in the urinary system. This can block the flow of urine and may cause strong pain.
Kidney stones can cause permanent kidney damage. Stones also increase the risk of urinary and kidney infection, which can result in germs spreading into the bloodstream.
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Treatment And Prevention Of Kidney Stones: An Update
LYNDA FRASSETTO, MD, University of California School of Medicine, San Francisco, California
INGRID KOHLSTADT, MD, MPH, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Am Fam Physician. 2011 Dec 1 84:1234-1242.
Patient information: See related handout on preventing kidney stones, written by the authors of this article.
The prevalence of nephrolithiasis is increasing in women and with increasing age. The risk of developing kidney stones is 10 to 15 percent in the United States, although this number is trending higher.13 Table 1 includes rates of different types of kidney stones in children and adults.48 Contributing risk factors for kidney stones are obesity, insulin resistance, gastrointestinal pathology, living in warmer climates, and certain dietary patterns and medications.2,9
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 .
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Where Do Kidney Stones Come From
Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The crystals grow larger into “stones.” About 80% to 85% of kidney stones are made of calcium. The rest are uric acid stones, which form in people with low urine pH levels.
After stones form in the kidneys, they can dislodge and pass down the ureter, blocking the flow of urine. The result is periods of severe pain, including flank pain , sometimes with blood in the urine, nausea, and vomiting. As the stones pass down the ureter toward the bladder, they may cause frequent urination, bladder pressure, or pain in the groin.
“If you experience any of these symptoms, see your primary care physician,” says Dr. Eisner. “He or she will likely perform a urinalysis and a renal ultrasound, abdominal x-ray, or CT scan to confirm kidney stones are the source of your pain and determine their size and number.”
Kidney Stone Treatment Options
We work with patients in every stage of their condition, creating a personalized plan whether surgery is needed or not. We also try to identify factors that may be causing the stones, so we can keep current stones from getting larger and reduce the risk of developing future stones.
When suspected of having a kidney stone, we take a history, perform a physical, exam, and obtain radiological imaging. Studies may include a plain x-ray of the abdomen, a renal ultrasound, or a CT scan. They help us determine the location of the stone, its size, the degree to which the stone may be causing an obstruction to urine flow, and what types of therapy would be appropriate for management.
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Medical Therapy For Kidney Stones
Most evidence suggests that stones less than 10 mm in diameter have a reasonable chance of passing through the urinary tract spontaneously. You may be offered medical expulsive therapy using an alpha blocker medication, such as tamsulosin. Its important to understand that this is an off-label use of the drug. Rarely, tamsulosin causes a condition called intraoperative floppy iris syndrome that can complicate cataract surgery.
Not all experts feel MET is worthwhile, and its use remains controversial. Discuss your options with your doctor or a urologist.
What Are The Best Kidney Stone Medicines
Kidney stones are masses that resemble pebbles and can cause tremendous pain in the lower back and abdominal regions of the body. There are several types of kidney stone medicines available, including over-the-counter and prescription medications. Some medications are designed to lessen the pain caused by the stones, while others are aimed at helping to break up the stones. Depending on the type of stone, medications can sometimes be given to try to prevent stones in patients who are known to develop frequent kidney stones.
Over-the-counter pain relievers are often used as kidney stone medicines. Ibuprofen and aspirin are popular choices, although these non-prescription medications do not often provide significant pain reduction for kidney stone sufferers. Many times, prescription pain relievers are better choices as kidney stone medicines. Hydrocodone is the most widely prescribed pain medication for this type of pain.
Kidney stone medicines such as alpha-blockers are sometimes prescribed to help the stones pass more quickly. These medications work by relaxing surrounding muscles and opening blood vessels. Alpha-blockers are traditionally used to treat prostate problems and high blood pressure, but doctors have found that they may also help in the passing of kidney stones.
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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.
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:
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Diagnosis: Low Urine Ph
Citrate supplements, such as potassium citrate, will raise the pH of your urine, making stones, such as those composed of uric acid, less likely to form. If your blood potassium level is high, your doctor may prescribe sodium bicarbonate or Bicitra.
Lower protein intake
A diet high in protein will reduce urinary pH. As a general recommendation, limit your daily protein intake to 12 ounces per day of beef, poultry, fish and pork. Twelve ounces is equivalent in size to about three decks of cards. This will be plenty of protein to meet your bodys needs.
Increase fluid intake
No matter what your diagnosis, you should drink enough water to produce at least 2 liters of urine per day.
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.
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Symptoms Of Kidney Stone
Kidney stones may lie silently in the kidney without any symptom. Severe pain with other associated symptoms appear when the stone tries to enter the ureter from the kidney or from the ureter into the urinary bladder or when it tries to pass down from the urinary bladder to the urethra. Pain caused by kidney stones is felt in the flanks , lower back and often extends to the groin area or genitals. The urine may contain blood or pus. Painful urination or urgency to urinate may also be present. Nausea and vomiting is yet another symptom associated with kidney pain.
Keeping Kidney Stone Pain Under Control
If you are experiencing the intense discomfort of kidney stones , pain control is a top priority. A 2018 analysis of multiple randomized trials looked at different pain relief medicines given to people treated in the emergency department for acute renal colic. It compared nonsteroidal anti-inflammatory drugs with paracetamol or opioids. The study found NSAIDs offered effective pain relief with fewer side effects than paracetamol or opioids. NSAIDs directly inhibit the synthesis of prostaglandins, which decreases activation of pain receptors and reduces renal blood flow and ureteral contractions.
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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 .
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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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.
- What food may cause a kidney stone?
- Should l take vitamin and mineral supplements?
- What beverages are good choices for me?
Risks Of The Procedure
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.
Complications of lithotripsy may include, but are not limited to, the following:
- Bleeding around the kidney
- Obstruction of the urinary tract by stone fragments
- Stone fragments left that may require more lithotripsies
Contraindications for lithotripsy include, but are not limited to, the following:
- Pregnant patients
- Patients on “blood thinners” or patients with bleeding disorders. Aspirin or other blood thinners must be discontinued for at least 1 week prior to lithotripsy.
- Patients with chronic kidney infection, as some fragments may not pass, so the bacteria will not be completely eliminated from the kidney.
- Patients with obstruction or scar tissue in the ureter, which may prevent stone fragments from passing.
- Patients who require immediate and/or complete clearance of stone material.
- Patients with stones composed of cystine and certain types of calcium, as these stones do not fragment well with lithotripsy
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