What Increases Your Risk
Several things can affect your risk for getting kidney stones. These include:
- How much fluid you drink. The most common cause of kidney stones is not drinking enough water.
- Your diet. Diets high in protein and sodium increase your risk for kidney stones. So do oxalate-rich foods, such as dark green vegetables. If you think that your diet may be a problem, a dietitian can help.
- Being overweight. This can cause both insulin resistance and increased calcium in the urine, which can increase your risk for kidney stones.
- Medicine. Some medicines can cause kidney stones to form.
Your age, gender, and whether you have a family history of kidney stones can also affect your risk. But these things are out of your control.
D Assessment Of Methodological Quality Of Individual Studies
The primary and secondary abstractors/evaluators will independently review each study included in the review. Study quality for the individual RCTs included in the systematic review will be evaluated by using criteria based on the domains recommended by the Cochrane Collaboration. These criteria include an assessment of the risk of bias within each study by specifically evaluating: 1) adequacy of allocation concealment, based on the approach developed by Schulz and Grimes 30 2) blinding methods 3) data completeness and 4) whether reasons for dropouts/attrition were reported .31 Studies will be assigned individual ratings of good, fair, or poor. A rating of good generally indicates that the trial reported adequate allocation concealment, blinding, analysis by intention-to-treat, and that reasons for dropouts/attrition were reported. Studies will be rated as poor if the method of allocation concealment was inadequate or not defined, blinding was not defined, analysis by intention-to-treat was not utilized, and reasons for dropouts/attrition were not reported and/or there was a high rate of attrition. The quality of RCTs and observational cohort studies reporting adverse events will be evaluated by using a subset of questions from the McHarm Scale.32
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 .
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British Columbia Specific Information
If you have had kidney stones before, you are at a higher risk of getting them again. Eating certain foods may help lower your risk of having kidney stones again. To learn about what foods you should choose to help lower your risk of having kidney stones, see our Healthy Eating Guidelines for Prevention of Recurrent Kidney Stones web page.
You may also call 8-1-1 to speak to a registered dietitian, Monday to Friday 9:00 a.m. to 5:00 p.m., or you can Email a HealthLinkBC Dietitian.
Causes Of Kidney Stones
Kidney stones happen when your pee has a high concentration of minerals and other substances — like calcium, oxalate, and uric acid — that come together to make crystals. Crystals stick together to make one or more stones. Stones happen when your urine doesnât have enough fluid and other substances to keep them from happening.
A kidney stone can be as tiny as a grain of sand, and you can pass it without ever knowing. But a bigger one can block your urine flow and hurt a lot. Some people say the pain can be worse than childbirth.
Different things can bring on kidney stones, including what you eat and certain medications. If you or someone in your family has had a kidney stone, youâre more likely to have them.
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Why Do People In Southern States Get More Kidney Stones
Doctors and researchers have discovered that people who live in the Kidney Stone Belt have a much higher chance of developing kidney stones, even as much as 50 percent higher! One South Carolina study found that South Carolina teens showed a 26 percent increase in kidney stones from 1997 to 2012. Why such a difference between Northerners and Southerners?
- The Hot, Humid Climate: The climate in the South is hot and humid for most months of the year. Southerners are more likely to become dehydrated due to the heat and chronic dehydration is the number one risk factor for kidney stones. Excessive sweating also means your body has less fluid to excrete in your urine, so your kidneys arent being flushed.
- Obesity: The southeastern states also have some of the highest obesity rates in the nation.
The Southern Diet: Southerners tend to drink more iced tea and eat foods high in oxalates such as okra and grits and oxalates are a known kidney stone cause. And Southern diets include a lot of high-calorie and fried foods, which contribute to obesity.
You might be wondering why rates in the American Southwest, which sees higher temperatures than the Southeast, arent equally as high. Researchers believe that our bodys thermoregulation system doesnt function as well in humid climates. Our bodies sweat when were overheated to try to cool our temperature but sweat doesnt evaporate well in humidity, so our bodies struggle to stay cool.
F Grading The Evidence For Each Key Question
The overall strength of evidence for the RCTs will be evaluated by using methods developed by the AHRQs Evidence-based Practice Center Program as outlined in the Methods Guide for Effectiveness and Comparative Effectiveness Reviews.35 For each of several important clinical outcomes within each comparison evaluated, the strength of the evidence will be evaluated based on four required domains: 1) risk of bias 2) consistency 3) directness and 4) precision . The risk of biasbased on study design and conductwill be rated low, medium, or high. Consistency will be rated as consistent, inconsistent, or unknown/not applicable . Directness will be rated as either direct or indirect, and precision will be rated as either precise or imprecise. A precise estimate is one that would yield a clinically meaningful conclusion. Other factors that may be considered in assessing strength of evidence include the dose-response relationship, the presence of confounders, the strength of association, and publication bias.
Based on these factors, the overall evidence will be rated as:
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The 4 Stages Of Passing A Kidney Stone
Your kidneys work hard to remove fluid and waste from the body. During this process, kidney stones can sometimes form. Kidney stones are hardened mineral deposits that can form in the urinary tract. They often pass unnoticed or can be extremely painful and require treatment.
This article provides a look at the four main stages of passing a kidney stone.
supersizer / Getty Images
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
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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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.
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.
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It Is Not The Getting Fatter
We get fatter with age. Everyone knows that. Not everyone does it, but on average we all do. I suppose it is less exercise and too much food, but we are not studying this matter here, now.
Below, you can see body mass index rising with age in this very large set of data patient lab
studies. It goes up in men and women, and it goes up very rapidly between 33 or younger and 50.
But, if you adjust for the BMI, the urine pH fall is not affected.
The urine pH falls about the same in both sexes. Compare the graph just to your left with the one just above.
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:
- x-rays, including an intravenous pyelogram , where dye is injected into the bloodstream before the x-rays are taken.
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Why Does The Ph Fall
We asked ourselves that very question and tried to find out.
Lots of things happen as we get older. We get fat. Our kidneys gradually lose their youthful glow. Both of these can lower the urine pH. We get diabetic, and that surely lowers urine pH. Do any of these account for what this figure shows us?
Types Of Kidney Stones
The different types of stones are made of different types of substances. It’s important to know the type of stone you have, so you can know what may have caused it and how to prevent it.
If you pass a kidney stone, you should take it to your doctor so they can send it to the lab and find out what kind it is:
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Calcium stones. Most kidney stones are made from calcium, in the form of calcium oxalate. There are two kinds of calcium stones:
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Calcium oxalate. Oxalate is a substance made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, are high in it. Your body absorbs the substance when you eat these foods. Other things that can make the concentration of calcium or oxalate in your urine to rise are taking high doses of vitamin D, intestinal bypass surgery and certain metabolic disorders.
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Calcium phosphate. This type of stone happens more often in people with metabolic conditions, like renal tubular acidosis or with people who take medications to treat migraines or seizures.
Struvite stones. These can form from a urinary tract infection . The bacteria that cause the infection make ammonia build up in your urine. This leads to formation of the stones. The stones can get large very quickly.
Uric acid stones. These form in people who lose too much fluid because of chronic diarrhea or malabsorption eating a high-purine diet or having diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.
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Opinions Of Urologists In General
Though the physiologic basis of pain in the setting of obstruction is clear, it does not provide an explanation for one of the most commonly encountered conundrums in stone disease the symptomatic non-obstructing stone. These can be actual free stones that have not passed, stones attached to plaque, or actual plugs in the kidney tubules that are massed together enough to show up on a CT scan as stones though actually tissue calcifications.
There is perhaps as much variation in clinical opinion in such instances as any other clinical scenario in the field.
If one were to ask a group of urologists whether they believed that small nonobstructing stones could cause renal colic, opinions would range from absolute certainty to complete dismissal of the concept altogether.
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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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.
How Kidney Stones Are Diagnosed
There are several tools doctors can use to diagnose kidney stones, according to the NIDDK. After talking to you about your symptoms and doing a physical exam, your doctor may order these tests as well:
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Urinalysis: This is a test of your pee that can show whether your urine contains high levels of minerals that form kidney stones. A urinalysis can also tell whether your pee has blood, bacteria, or white blood cells in it .
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Blood tests: Your doctor may want to take a sample of your blood to test for high levels of certain minerals that can lead to kidney stones.
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Abdominal X-Ray: This is a picture of your abdominal area that can potentially show the location of kidney stones in your urinary tract. One major caveat, though: Not all kidney stones can be seen on X-ray.
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Computed Tomography Scan: CT scans use a combination of X-rays and computer technology to create images of your urinary tract. In some cases you might be given an injection of contrast medium, a dye or other substance that makes certain things inside your body easier to see during imaging tests.
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Treatment Of Kidney Stones
Treatment is not usually necessary for small kidney stones most pass on their own after drinking plenty of water. Pain medication may be prescribed to relieve symptoms. A larger stone that cannot pass on its own, or that blocks the urinary tract, may require more aggressive treatment, which is designed to locate the stone, and break it up into tiny pieces so it can pass through the urine. This may be performed through a procedure known as a shock wave lithotripsy , or a ureteroscopy. More-invasive surgery may be necessary to remove a very large stone.
Clinical Presentation Of Nephrolithiasis
Nephrolithiasis often is incidentally identified in asymptomatic patients who undergo plain radiographs or computed tomographic imaging for another indication.15 Small stones generally pass through the urinary tract without symptoms. While larger stones may cause symptoms, more than 90 percent of stones 5 mm in diameter still pass through the urinary tract without intervention, as compared to spontaneous passage of approximately 50 percent of stones 5 to 10 mm in diameter.16 Potential symptoms of nephrolithiasis include: urinary symptoms such as dysuria, hematuria, and urgency renal colic with severe abdominal and flank pain nausea and vomiting urinary tract obstruction infection and acute, though generally transient, impairment in renal function. Large struvite stones remain in the renal pelvis and may not cause pain. Some studies have suggested that nephrolithiasis also may increase the risk of chronic kidney disease.17,18 Nephrolithiasis also may lead to hospitalizations and procedure-related morbidity. Direct medical expenditures for nephrolithiasis in the United States have been estimated at $2.1 billion annually.1
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