Dr. Victor Emanuel MD

Dr. Victor Emanuel MD

WHAT ARE KIDNEY STONES?

As the kidneys filter waste from the blood, they create urine. Sometimes, salts and other minerals in urine stick together to form small kidney stones. These range from the size of a sugar crystal to a table tennis ball, but they are seldom noticed unless they cause a blockage. They may cause intense pain if they break loose and push into the ureters, the narrow ducts leading to the bladder.

KIDNEY STONE SYMPTOMS

When kidney stones move through the urinary tract, they may cause:
•    Severe pain in the back, abdomen or groin
•    Frequent or painful urination
•    Blood in the urine
•    Nausea and vomiting

Small stones may pass without causing symptoms.

KIDNEY STONES OR SOMETHING ELSE?

If you have sudden, severe pain in the back or abdomen, it’s best to seek medical care right away. Abdominal pain is associated with many other conditions, including emergencies like appendicitis and ectopic pregnancy. Painful urination is a common symptom of a urinary tract infection or an STI.

DIAGNOSING KIDNEY STONES

Kidney stones are seldom diagnosed before they begin causing pain. The pain is often severe enough to send patients to the Emergency Room, where a variety of tests can uncover the stones. These may include a CT Scan, X-Rays, ultra sound and urinalysis. Blood tests can help look for high levels of minerals involved in forming kidney stones. You know, many men never appreciate the labor pains of women in childbirth until they’ve had a kidney stone.

HOME CARE FOR KIDNEY STONES

If your kidney stone seems small enough , your doc may recommend you take pain medicine and wait for the stone to pass out of your body on its own. During this time, doc may recommend that you drink enough water and fluids to keep your urine clear – about 8 to 10 glasses a day.

HOW SMALL IS SMALL ENOUGH

The smaller the kidney stone, the more likely it will pass on its own. If it is smaller than 5mm (1/5 inch), there is a 90% chance it will pass without further intervention. If the stone is between 5 and 10 mm, the odds are 50%. If a stone is too large to pass on its own, several treatment options are available.

TREATMENT: MEDICATION

There are prescription medications that can help your body pass a kidney stone. Drugs known as alpha blockers relax the walls of the ureter. This widens the passages so a stone can fit through more easily. Side effects are generally mild and may include headache or dizziness. Other types of medications can help prevent new stones from forming.

TREATMENT: SHOCK WAVE THERAPY

The most common medical procedure for treating kidney stones is known as extracorporeal shock wave lithotripsy (ESWL). This therapy uses high energy shock waves to break a kidney stone into little pieces. The small pieces can then move through the urinary tract more easily. Side effects can include bleeding, bruising, or pain after the procedure.

TREATMENT: URETEROSCOPY

When a stone has made its way out of the kidney and is close to the bladder, the most common procedure is ureteroscopy. A thin tube is passed through the urinary tract to the stone’s location. A surgeon breaks up the stones and removes the fragments through the tube. No incisions are made in the body. For very large stones, surgical procedures may be needed.

KIDNEY STONE ANALYSIS

Once a kidney stone has passed or been removed, doc may want to know what it’s made of. Nearly 80% of kidney stones are calcium-based. The remainder are made primarily of uric acid, struvite, or cystine. A chemical analysis can determine which type of stone you have. Once you know, you can take steps to prevent new ones from forming in the future.

WHAT CAUSES KIDNEY STONES?

Stones may form when there’s a change in the normal balance of the water, salts, and minerals found in urine. Different kinds of changes result in different types of kidney stones. There are many factors that can trigger changes in the urine, ranging from chronic medical conditions to what you eat and drink.

RISK FACTORS YOU CAN CONTROL

Drinking too little water is the commonest cause of kidney stones. Diet also plays an important role. Eating a lot of protein, sodium and high-oxalate foods, such as chocolate or dark green vegetables, can boost the risk for kidney stones in some people. Other risk factors include putting on weight and taking certain medications.

RISKS 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 raise the risk – high blood pressure, gout, urinary tract infections – but treating or controlling these conditions generally helps prevent the formation of stones.

PREVENTING FUTURE KIDNEY STONES

If you had a calcium stone, your doc may suggest cutting back on salt and sodium, which causes the body to dispense more calcium into the urine. You may also be advised to avoid high – oxalate foods, including chocolate, instant coffee, tea, beans, berries, dark leafy greens, oranges, toffee, and sweet potatoes. The best way to ward off new kidney stones is to drink enough water to keep your urine clear.

THE CALCIUM DEBATE

While most kidney stones contain calcium, you may not need to avoid calcium-rich foods. In fact, eating moderate amounts of dairy products and other calcium-rich foods may lower you risk of forming new stones. This does not apply to calcium supplements, which have been linked to kidney stones in some people. Ask you doc or dietitian what role calcium should play in your diet.

See you next week.