Kidney Stones

Kidney Stones - a hard mass developed from crystals that separate from the urine. Typically these crystals (kidney stones) are small enough to pass along with the urine unnoticed. Sometimes they are too big to get through the urinary tract and cause dangerous blockages of the urinary tract.

Types of Kidney Stones

• Regular Kidney stones - contain calcium in combination with either oxalate or phosphate. These are part of a normal diet and make up important parts of the body, such as bones and muscles
• Struvite or Infection stone - caused by Urinary Tract Infections
• Uric acid stones - less common
• Cystine stones - very rare type of kidney stone

Kidney Stones Risk Factors

• Kidney Stones occur more frequently in men
• Caucasians are more prone to develop kidney stones than African Americans
• Men ages 40 to 70
• People who have had stones before are at an increased risk

Kidney Stones Causes

Causes are not always identified, but generally the following reasons are considered:

• Pain or burning sensation when urinating (dysuria)
• Difficulty urinating
• Weak stream or dribbling
• Frequent urination, particularly at night (nocturia)
• Urgent need to urinate
• Pain in the abdomen
• Pain in groin or lower back
• Pain in the area between the penis and rectum (perineum)
• Pain of the penis or testicles
• Painful ejaculations

Doctors do not always know what causes a kidney stone to form.

• People with a family history of kidney stones are more likely to develop it themselves
• People with urinary tract infections are at in increased risk
• Cystic kidney diseases patients are at risk
• Hyperparathyroidism is also linked to stone formation
• People with a rare hereditary diseases called Renal Tubular Acidosis, Cystinuria and Hyperoxaluria are at risk for developing kidney stones
• Hyperuricosuria - a disorder of uric acid metabolism
• Gout
• Excess intake of vitamin D
• Blockage of the urinary tract
• Drugs called diuretics (water pills) and calcium-based antacids may increase the risk of forming kidney stones
• Patients with chronic inflammation of the bowel

Kidney Stone Symptoms

While kidney stones may not have any symptoms, the first symptom of a kidney stone is extreme, sharp and sudden pain in the back and side in the area of the kidney or in the lower abdomen, from a stone in the urinary tract blocking the flow of urine, possible causing Oliguria.

• Nausea and vomiting can occur
• Pain may spread to the groin
• Red and bloody urine (Hematuria)
• Pink or Orange Urine
• Cloudy Urine
• Burning or painful urination
• Fever and chills (implicative of additional infections)

Testing and Diagnosing Kidney Stones

• X-rays
• Ultrasound - in case of red and bloody urine or sudden pain
• Urine test
• CT scan
• Intravenous pyelogram (IVP)

Kidney Stones Treatment

Surgery is not usually necessary. Most kidney stones can pass through the urinary system after drinking plenty of water. Important lifestyle change to prevent stones

• Drink plenty of water to avoid further stone buildup
• Avoid foods with added vitamin D
• Eat less meat, fish, and poultry to decrease acid in urine
• Medications to help prevent calcium and uric acid stones
• Medicines which help reduce the amount of cystine in the urine

If diet and drug treatments do not help and the pain persists without passing of the stone, surgery may be an option. Kidney stone recovery periods do not tend to be too long.

• Extracorporeal Shock Wave Lithotripsy(ESWL) - the most frequently used procedure for the treatment of kidney stones in which shock waves travel through the skin and body tissues until they hit the denser stones to break the stones apart into small particles which easily pass through the urinary tract in the urine. Recovery time is relatively short, and most people can resume normal activities in a few days
• Percutaneous Nephrolithotomy - used when the stone is quite large or in a location that does not allow effective use of ESWL
The surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney to remove the stones. Recovery time is a little longer then ESWL
• Ureteroscopic Stone Removal - may be needed for mid and lower-ureter stones. No incision is made and instead, the surgeon passes a small fiberoptic instrument called a ureteroscope through the urethra and bladder into the ureter to locate the stone and removes or shatter it