Kidney Stones

Kidney stones, sometimes called ureteral stones, affect one in 10 people at some point in their lives, according to the National Kidney Foundation. They are created when minerals and salts in urine – including calcium, oxalate, phosphate, and sometimes uric acid – crystallize and bind together.

Sometimes a patient won’t know a kidney stone exists until it passes into the ureter, blocking passage and causing urine to back up into the kidney. This can be acutely painful.

Most patients with kidney stones carry excess minerals and salts in their urine, making them susceptible. Stones tend to be more common in young and middle-aged adults than in the elderly, and more prevalent in men than women. Research suggests that not drinking enough fluids can exacerbate the chemical oversaturation in urine, contributing to stones.

Symptoms of kidney stones include:

• Waves of sharp pain that radiate from the back and side to the groin or testicles (in men)
• Pain on the side, between the ribs and hip
• Nausea and vomiting, often the result of pain
• Blood in the urine
• A frequent urge to urinate

Sometimes the stones may cause an infection, triggering these symptoms:

• Fever and chills
• Painful urination
• Cloudy or foul-smelling urine

Because the symptoms of kidney stones duplicate those of other urinary problems, the physician will perform an evaluation that may include urine tests, blood tests, and imaging tests. Imaging tests may include:

• Standard x-ray.
• CT scan: An imaging test that screens for and determines the extent of the disease.
• An intravenous pyelogram (IVP): A series of x-rays using a contrast dye to highlight abnormalities(this test is less commonly used).

If the kidney stone is small, it may pass on its own within days or weeks. In this case, a physician may prescribe drinking plenty of water – at least three quarts a day – and a pain medication. Alpha-blockers, which relax muscles, and medications that open the ureter also may be prescribed.

If complications develop, such as an infection or total blockage of the ureter, the stone must be removed. Depending on its size, type, and location, the stone can be removed by one of several means:

• Ureteroscopy: A thin telescopic instrument is inserted into the urinary tract and extracts the stone or breaks it down using a laser or other device.
• Lithotripsy: High-energy shock waves break the stones into tiny pieces, allowing them to pass through the urine. The Urology Group’s lithotripsy equipment includes ultrasound technology to more accurately and quickly pinpoint the type and location of kidney stones.
• Percutaneous nephrolithotomy: The surgical removal of the kidney stones through an incision in the back using a telescopic instrument that reaches the stones through a narrow tube.

Many times, stone treatments involve the temporary placement of a small tube called a “stent” in the ureter. The stent allows urine to bypass possible blockage from the stone or a swollen ureter. It is usually removed after a week, and in the interim can cause frequent urination, blood in the urine, and sometimes abdominal discomfort.

This video from our Cincinnati office provides an overview of lithotripsy:

While some people are more susceptible to kidney stones than others, there are several actions you can take to decrease your chances of developing kidney stones.

• Stay hydrated: Drink plenty of water (not colas or alcoholic beverages), especially when engaging in exercise or activities that cause a lot of sweating.
• Reduce sodium: A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine.
• Get the calcium you need: Getting too little calcium in your diet can cause oxalate levels to rise and cause kidney stones. To prevent this, make sure to take in an amount of calcium appropriate to your age.
• Avoid eating too many stone-forming foods: Chocolate, beets, spinach, rhubarb, tea, and many nuts are rich in oxalate, and soda is rich in phosphate, both of which can contribute to kidney stones. Don’t avoid those healthy foods like spinach and beets, but just balance your diet with other foods and drink plenty of water.
• Limit animal protein: Eating too much red meat, poultry, eggs, and seafood can boost the level of uric acid and could lead to kidney stones.