Kidney Stones


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Kidney Stones

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When salt and other minerals stick together in urine, kidney stones are the result.

Kidney stones can vary in size. Some are like fine grains of sand, while others are about the size of golf balls. Kidney stones can remain within the kidneys, or they may travel through the urinary tract.

  • It’s often when the stones travel through the urinary tract that painful symptoms are experienced.
  • The resulting discomfort may be felt in the back or side, or in the pelvis as the stones travel into the bladder.

Why Do People Get Kidney Stones?

More common in men and people who are overweight, kidney stones are sometimes the result of an inherited disease. They can also be genetic and run in families. Kidney stones form when there’s a significant change in the natural balance of minerals, water, and other substances normally found in urine. Lack of sufficient hydration is the most common cause of kidney stones as not drinking enough water results in a low urine flow, which creates a perfect environment for stones to form. Diabetes, gout, and other medical conditions may also contribute to the development of kidney stones.

Common Symptoms

Kidney stones that remain within the kidneys may produce little or no discomfort. Sudden and severe pain may be experienced if the stones move through the urinary tract. Pain sometimes becomes worse if the stone becomes lodged in the ureters, which are the tubes that connect the kidneys to the bladder. Symptoms related to kidney stones may include:

• Severe stomach, side, or lower back pain
• Painful urination that may include burning sensations
• Frequent urination or an urgent need to go
• Blood in the urine
• Cloudy or odorous urine
• Nausea and vomiting
• Fever and chills

How Are Kidney Stones Diagnosed and Treated?

In order to diagnose kidney stones, imaging studies such as a kidney ultrasound, CT scan or plain radiograph is usually performed. CT scans have the highest sensitivity and specificity in diagnosing kidney stones. Once a kidney stone is diagnosed, several treatment options exist, including a trial of passage or surgical intervention. During a trial of passage, a person attempts to pass the stone spontaneously, sometimes with the aid of pharmacological therapy (e.g Flomax). If the stone does not pass, then surgical intervention is often indicated.

For small stones, options include shock wave lithotripsy (SWL), which involves the use of shock waves to break down stones, or ureteroscopy. During ureteroscopy, a flexible tube with a light and camera is inserted into the urethra and bladder. Once the stone is identified, a laser may be used to break the stone into smaller pieces where a tiny wire basket may used to retrieve the stone’s fragments. If the particles are the size of dust, then they are allowed to pass spontaneously.

With larger stones, a percutaneous approach through the back is indicated. Percutaneous nephrolithotomy (PCNL) has now become the gold standard to treat larger stones, as open surgery is more of a relic of the past.

In some situations, a stent may be used to temporarily relieve a kidney that is obstructed or to keep the ureter open after surgery. A stent is never left permanently and must be removed or exchanged after initial placement.

Affecting just over 10 percent of the population, kidney stones aren’t always preventable. Even so, adjustments to diet and exercise habits may minimize the risk of developing stones. Staying hydrated can help by maintaining a steady flow of urine. Processed and salty foods should be avoided if you have a history of kidney stones.

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