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Kidney Stones: Identification and Treatment

Those who have had kidney stones won’t forget it. Each year, more than half a million people go to the ER suffering from the severe pain of them. The National Kidney Foundation estimates that one in 10 people will have a kidney stone at some time in their lives.

For most of us, our kidneys are able to effectively flush out chemicals, such as calcium and oxalate, from our bodies. But if those chemicals build up in our kidneys, they can bind together and form kidney stones.

Some stones are so small they pass out of our body without notice. Others may be as large as a golf ball. If these larger stones have trouble leaving your body, they can block urine, causing sharp pain in your lower back, side, or stomach.

Fortunately, UPMC’s urological team in Central Pa. offers a number of treatment options to remove the stones and the pain. Like most conditions, the sooner you have them treated the better. Here are some things you should know about kidney stones.

Risk Factors of Kidney Stones

Some people are more at risk to get kidney stones:

  • Caucasians are more likely to get kidney stones than African Americans.
  • Although stones happen more often in men, the number of women who get kidney stones has been increasing.
  • Kidney stones strike mostly people between age 20 and 40.
  • Once a person develops a kidney stone, he or she is more likely to get another.
  • You’re more likely to get kidney stones if:
    • You don’t drink enough fluids (especially water) and tend to be dehydrated.
    • You drink high amounts of tea and dark sodas, such as Coca-Cola and Pepsi.
    • You eat foods high in protein, sodium, and dark green vegetables (oxalate-rich types of foods).
    • You are overweight. This increases your body’s insulin resistance, which increases the amount of calcium in your urine. In turn, this increases your kidney stone risk.
    • You take medicines such as diuretics and anti-viral medicines. Some medicines increase your risk of getting kidney stones.

Preventing Kidney Stones: Drink Water

The best way to treat kidney stones and their pain is to prevent them. If you’ve never had kidney stones, you can reduce your risk by drinking eight 12-ounce glasses of water daily. Ginger ale, lemon-lime sodas, and fruit juices are also okay. Limit caffeinated drinks such as coffee, tea, and cola to one or two cups a day.

If you’ve already had kidney stones, drinking water is also important. Here are some additional prevention tips to be aware of:

  • Take your medications – Your doctor may prescribe medications, including vitamins and minerals, for certain types of stones. Some medications decrease stone-forming chemicals in your blood. Others help prevent those chemicals from crystallizing in urine. Still others help keep a normal acid balance in your urine. Take your medicine as prescribed, even if you feel fine. Once you start feeling symptoms, it may be too late to take your medication.
  • Watch your diet – Some foods you eat may lead to the development of kidney stones. Your doctor may suggest talking to a dietitian. He or she can help you plan meals. You may be told to limit certain foods, depending on which type of stones you’ve had.
  • For calcium oxalate stones: Limit animal protein, such as meat, eggs, and fish. Limit grapefruit juice and alcohol. Limit high-oxalate foods (such as cola, tea, chocolate, spinach, rhubarb, wheat bran, and peanuts).
  • For uric acid stones: Limit high-purine foods, such as mushrooms, peas, beans, anchovies, meat, poultry, shellfish, and organ meats. These foods increase uric acid production.
  • For cystine stones: Limit high-methionine foods (fish is the most common, but eggs and meats, also). These foods increase production of cystine.

You should also limit the amount of salt you consume to about 2 grams a day. Also, make sure you get an adequate amount of calcium in your diet.

Symptoms and Diagnosis of Kidney Stones

If preventive steps don’t help, it’s important to identify and treat kidney stones as soon as possible. Here are the most common symptoms of kidney stones:

  • Extreme, sharp pain in the back or side that will not go away, or may come and go.
  • Blood in the urine
  • Nausea and vomiting
  • Cloudy or odorous urine
  • Frequent urination
  • A burning feeling when you urinate
  • Fever and chills

If you have any of these symptoms, see a doctor right away. The earlier stones are diagnosed and treated the fewer problems and the less pain you’ll experience.

Your UPMC Pinnacle provider will look at your history and complete a physical exam. We may do some tests, including:

  • Intravenous pyelogram (IVP). This is a series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein. It helps find tumors, abnormalities, kidney stones, or any obstructions, and to check blood flow to the kidney.
  • Computerized tomography (CT or CT scan). This is an imaging test that uses x-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.
  • Urinalysis. This is a lab exam of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
  • Blood tests. This is a lab exam of the blood to detect substances that might promote stone formation.
  • Renal ultrasound. This is a noninvasive test in which a transducer is passed over the kidney producing sound waves that bounce off the kidney. It sends a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction in the kidney.

The symptoms of kidney stones may look like other conditions or medical problems. Always talk with your doctor about your symptoms.

Treatment Options for Kidney Stones

Some kidney stones pass out of the body on their own without treatment. In cases that cause lasting symptoms or other complications, kidney stones may need to be treated by a doctor.

UPMC Pinnacle offers a full range of urological procedures for kidney stones.

  • We often treat kidney stones using lithotripsy. This is a noninvasive procedure that uses high-energy sound waves to blast the stones into fragments that are then more easily passed out in the urine.
  • In other cases, it is best that we use an advanced laser procedure which involves feeding a thin laser through the ureter to break up the stone.
  • Using a ureteroscope, a long wire with a camera attached to it, we can enter the bladder through the urethra to the ureter where the stone is located and remove it.
  • Particularly large or hard to reach kidney stones may require tunnel surgery (also called percutaneous nephrolithotomy). In this procedure, a small cut is made in your back and the stone is removed via a narrow tunnel from inside the kidney.

If you require surgery, you can trust the urological team at UPMC in Central Pa. to provide the most innovative, high-quality kidney stone treatment.

Kidney stones are a common problem. If you have any symptoms of kidney stones, contact UPMC Central Pa. Urology for advanced, compassionate care.