Rapid Access Kidney Stone Clinic
The Rapid Access Kidney Stone Clinic at the Livonia Center for Specialty Care offers kidney stone patients access to x-rays, CT scans and the option for same-day diagnosis and treatment, all under one roof. All of this is complemented by the improved access to doctors and convenient parking available at the Livonia Center for Specialty Care.
Duration Of Kidney Stones
A kidney stone often goes unnoticed until it starts to pass into your ureters. Once this happens, symptoms typically appear without warning. Youll likely feel sharp, stabbing pain at the bottom of your ribcage, though the pain can shift into the genital area as well.
The pain from kidney stones often comes in waves, and you may feel better for a few hours before the pain comes back.
Depending on the size of the stone, it can take up to six weeks to pass . Small stones may take only a few days to a week to pass. Your doctor will likely prescribe medications to help you manage the pain during this time.
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.
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How Are Kidney Stones Diagnosed
Usually, it is the sharp and severe pain of a stone moving through the ureter that motivates a patient to see a healthcare professional. The healthcare provider, however, is interested in more than just getting the stone out. Kidney stones are typically a symptom, not a disease, so the healthcare provider will want to know what caused it.
A healthcare professional will ask about medical history and perform a physical examination. Imaging the stone is required for diagnosis, as it determines both the location and size of the stone. Imaging is usually done with an ultrasound or a CT scan . X-rays are seldom used for kidney stone diagnosis these days.
In addition, the provider will usually perform blood tests and urine tests to determine what mineral or substance is causing the stone and possibly determine an underlying cause.
Finally, when the stone passes or is removed, the physician or healthcare provider may want to have it tested to determine the cause of stone formation. Recurrent stone formation is a hazardous condition, so preventing the formation of future stones is an essential part of kidney stone treatment.
There are four types of kidney stones, each with different causes and risk factors:
What Can I Do To Keep My Kidneys Healthy
Kidney disease caused by analgesics is often preventable Here are some things you can do to help keep your kidneys healthy.
- Do not use over-the-counter pain relievers more than 10 days for pain or more than three days for fever. If you have pain or fever for a longer time, you should see your doctor
- Avoid prolonged use of analgesics that contain a mixture of painkilling ingredients, like aspirin, acetaminophen and caffeine mixtures in one pill
- If you are taking analgesics, increase the amount of fluid you drink to six to eight glasses a day
- If you are taking analgesics, avoid drinking alcohol
- If you have kidney disease, consult your doctor before taking an analgesic, particularly NSAIDs and higher dose aspirin.
- Use NSAIDs under your doctor’s supervision if you have heart disease, high blood pressure, kidney disease or liver disease or if you take diuretic medications or are over 65 years of age
- Make sure your doctor knows about all medicines you are taking, even over-the-counter medicines
- Make sure you read the warning label before using any over-the-counter analgesics.
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Can Analgesics Hurt Kidneys
Check with your doctor to be sure you can use these medicines safely, particularly if you have kidney disease. Heavy or long-term use of some of these medicines, such as ibuprofen, naproxen, and higher dose aspirin, can cause chronic kidney disease known as chronic interstitial nephritis. The warning labels on over-the-counter analgesics tell you not to use these medicines for more than l0 days for pain and more than three days for fever. If you have pain and/or fever for a longer time, you should see your doctor. The doctor can check for possible medical problems and advise you about what medications you should take.
If you have decreased kidney function, painkillers called NSAIDs and higher dose aspirin are not recommended. Even with normal kidney function, you should use analgesics:
- Exactly as prescribed or as on the label
- At the lowest dose possible
- For the shortest period of time
Things That Can Help You Take A Pass On Kidney Stones
- By Matthew Solan, Executive Editor, Harvard Men’s Health Watch
If youve ever passed a kidney stone, you probably would not wish it on your worst enemy, and youll do anything to avoid it again. “Kidney stones are more common in men than in women, and in about half of people who have had one, kidney stones strike again within 10 to 15 years without preventive measures,” says Dr. Brian Eisner, co-director of the Kidney Stone Program at Harvard-affiliated Massachusetts General Hospital.
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What Are Kidney Stones
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. Between four and eight per cent of the Australian population suffer from kidney stones at any time.;
After having one kidney stone, the chance of getting a second stone is between five and 10 per cent each year. Thirty to fifty per cent of people with a first kidney stone will get a second stone within five years. After five years, the risk declines. However, some people keep getting stones their whole lives.
How Are Children Treated For Kidney Stones
Most childrens kidney stones can be treated with the shock wave lithotripsy , a completely non-invasive procedure. Your child is placed under anesthesia and sound waves of specific frequencies are focused on the stones to shatter them into fragments small enough to be easily passed during urination.
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Symptoms Of Kidney Stones
Many people with kidney stones have no symptoms. However, some people do get symptoms, which may include:
- a gripping pain in the back usually just below the ribs on one side, radiating around to the front and sometimes towards the groin. The pain may be severe enough to cause nausea and vomiting
- blood in the urine
- cloudy or bad smelling urine
- shivers, sweating and fever if the urine becomes infected
- small stones, like gravel, passing out in the urine, often caused by uric acid stones
- an urgent feeling of needing to urinate, due to a stone at the bladder outlet.
Laser And Shockwave Lithotripsy
Laser lithotripsy and Shock Wave lithotripsy are the most technologically advanced kidney stone treatments available currently. Both these treatment procedures are quite similar. The main aim in both these surgeries is to crush the stone into smaller pieces, so that they can be easily move out from the body along with the urine.
In laser lithotripsy, this is achieved using a lighted ureteroscope inserted through the urethra. Laser energy is used to break the stone. Some of the stone pieces are removed using a surgical basket, whereas the rest are flushed out while urinating.
Shock wave lithotripsy, on the other hand, makes use of shock wave pulses to crush the stone. Once this is done, the doctor asks you to drink plenty of fluids so that the stones can be passed easily.
Both laser lithotripsy and shock wave lithotripsy are very effective and absolutely painless. These are outpatient procedures, which means you can go home on the same day. There is no risk of postoperative complications, and the recovery is very fast and smooth.
This is all about the kidney stone laser treatment. There is one more surgical option that is gaining preference these days. It is the laparoscopic surgery of the kidney stones.
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Drugs For Kidney Stones
Drugs for kidney stones are used to treat the acute symptoms like pain caused by the stone and also to prevent new stones from forming. Kidney and other urinary tract stones are a common problem that can affect individuals of all age groups. Urinary tract stones cause pain. Their passage through the ureters causes severe spasmodic pain, which is an attempt by the urinary tract to expel the stone.
Kidney stones also cause symptoms of nausea, vomiting and blood in the urine. They may obstruct the flow of urine through the urinary tract resulting in swelling of the kidney , kidney infection and chronic kidney disease. Early treatment is necessary to relieve symptoms and prevent long-term damage.
Kidney stones vary according to their chemical composition. Calcium oxalate stones are the most common type, followed by calcium phosphate, uric acid, struvite / triple phosphate stones and cystine stones. Some stones can be mixed.
Smaller stones may be expelled spontaneously by the urinary tract and medical treatment helps to relieve symptoms, dissolve the stone and assist in its expulsion. Larger stones require surgical treatment. The introduction of minimally invasive surgeries has almost eliminated the need for open surgeries.
Drugs used to treat kidney stones can be classified based on the role they play in the treatment of kidney stones:
Drugs that relieve the symptoms such as Pain and Vomiting or Nausea Caused by Kidney Stones:
Types Of Kidney Stones
- Calcium stones are the most common type of kidney stones. They are usually made of calcium and oxalate , but are sometimes made of calcium and phosphate.
- Uric acid stones form when your urine is often too acidic. Uric acid can form stones by itself or with calcium.
- Struvite stones can happen when you have certain types of urinary tract infections in which bacteria make ammonia that builds up in your urine. Struvite stones are made of magnesium, ammonium and phosphate.
- Cystine stones are made of a chemical that your body makes naturally, called cystine. Cystine stones are very rare, and happen in people who have a genetic disorder that causes cystine to leak from the kidneys into the urine.
Kidney stones can be as small as a grain of sand or as largesometimes larger thana pearl. They can stay in your kidneys or travel through your ureters , and out of your body with your urine. When a kidney stone moves through your ureters and out your urethra with your urine, it is called passing a kidney stone. A kidney stone can also get stuck in your urinary tract and block urine from getting through. When you pass a kidney stone or a large kidney stone blocks the flow of your urine, it can be very painful.
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Which Is The Best Medicine For Kidney Stones
There is no best medicine for kidney stones. Small kidney stones will pass out of the body without medical intervention. Medicines can help relieve the pain or speed up the process of passing kidney stones. Some stones will be treated with drugs specific to that type of kidney stone. Large stones, however, will need to be broken up into small pieces through shock waves or laser lithotripsy or be surgically removed.
How Do Health Care Professionals Treat Kidney Stones
Health care professionals usually treat kidney stones based on their size, location, and what type they are.
Small kidney stones may pass through your urinary tract without treatment. If youre able to pass a kidney stone, a health care professional may ask you to catch the kidney stone in a special container. A health care professional will send the kidney stone to a lab to find out what type it is. A health care professional may advise you to drink plenty of liquids if you are able to help move a kidney stone along. The health care professional also may prescribe pain medicine.
Larger kidney stones or kidney stones that block your urinary tract or cause great pain may need urgent treatment. If you are vomiting and dehydrated, you may need to go to the hospital and get fluids through an IV.
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Kidney Stone Inhibitors And Promoters
Inhibitors are substances which decrease the initiation of supersaturation, nucleation, crystal growth, rate of aggregation, or any other processes required to stone formation . Normally, urine contains chemicals that prevent crystal formation. Inhibitors in urine includes small organic anions such as citrate, small inorganic anions such as pyrophosphates, multivalent metallic cations such as magnesium, or macromolecules such as osteopontin, glycosaminoglycans, glycoproteins, urinary prothrombin fragment-1, and TammHorsfall proteins . These inhibitors do not seem to work equally for everyone; therefore, some people form stones. But, if crystals formed remain tiny, usually it travels through the urinary tract and passes out from the body with urine splash without being noticed. Inhibitors may act either directly by interacting with crystal or indirectly by influencing the urinary environment . When inhibitory compounds adsorb onto the surface of the crystal, it inhibits nucleation, crystal growth, aggregation, or crystal-cell adherence.
Diagnosis Of Kidney Stones
Many kidney stones are discovered by chance during examinations for other conditions. Urine and blood tests can help with finding out the cause of the stone. Further tests may include:;
- CT scans
- x-rays, including an intravenous pyelogram , where dye is injected into the bloodstream before the x-rays are taken.
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What Is The Best Treatment For Kidney Stones
Treatment for kidney stones varies, depending on the type of stone and the cause.
Small stones with minimal symptoms
Most kidney stones wont require invasive treatment. You may be able to pass a small stone by:
Drinking water. Drinking as much as 2 to 3 quarts a day may help flush out your urinary system. Unless your doctor tells you otherwise, drink enough fluid mostly water to produce clear or nearly clear urine.
Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen , acetaminophen or naproxen sodium .
Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain.
Large stones and those that cause symptoms
Kidney stones that cant be treated with conservative measures either because theyre too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections may require more extensive treatment. Procedures may include:
Using sound waves to break up stones. For certain kidney stones depending on size and location your doctor may recommend a procedure called extracorporeal shock wave lithotripsy .
Drugs Used To Prevent Kidney Stone Formation
Once a stone has formed the chances of a second stone forming in the kidney is almost 50%. Underlying conditions that can promote stone formation include primary hyperparathyroidism and distal tubular acidosis and these should be treated with appropriate medications to prevent kidney stone formation. Drugs used to prevent specific types of kidney stones include the following:
For Calcium Stones:
When Should You Take Potassium Citrate, Magnesium and Vitamin B6 Tablets or solution?
It is best to consume potassium citrate, vitamin B6 and magnesium at the time when oxalate-containing food is present in the digestive tract. Hence, it is advised that these should be consumed at the time of having meals to give the best long term outcomes of preventing stones.
Drugs like orthophosphate and sodium cellulose phosphate have been used to prevent calcium stones. However, thiazides are preferred because they are effective and have a better safety profile.
For Uric Acid Stones:
For Cystine Stones:
For Struvite Stones:
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Calcium Channel Blockers Alpha Blockers For Kidney Stone Treatment
Other types of medications are sometimes used to speed the passage of kidney stones. Calcium channel blockers and alpha blockers are two classes of drugsthat have been shown to speed the passage of kidney stones by relaxing the spasming ureter. Medications that have been successfully used to treat kidney stones include the calcium channel blockernifedipine and an alpha blocker such as tamsulosin .
With particularly large kidney stones that are not able to pass on their own, shock waves can be used to break the stone into smaller fragments. This procedure is termed lithotripsy. Surgical treatments are also available for stones that do not respond to other treatment methods.
The most common surgical procedure is a ureteroscopy with laser lithotripsy. This procedure involves using a small scope to reach the stone, a laser to fragment the stone, and a small basket to remove the pieces.
Your doctor can recommend the best course of treatment if you suffer from kidney stones.
What Are The Advantages And Disadvantages Of This Treatment
The main advantage of this treatment is that it treats kidney stones without an incision. As a result, hospital stays and recovery time are reduced.
But, while SWL can work, it doesn’t always work. After SWL, about 5O% of people will be stone free within a month. In others, stone fragments of various sizes remain. Sometimes a repeat procedure is needed.
SWL has the potential to cause kidney injury. Whether or not SWL causes or leads to the development of high blood pressure and diabetes remains controversial. These possibilities are still being studied. You should ask your doctor about risks and benefits of SWL in your situation.
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