Kidney Stone disease is a disorder involving hardened accumulations of mineral crystals that are deposited in the kidneys and ureters. The stones are usually small, but can vary in size from a grain of sand to the size of a golf ball. Kidney stones are quite common, affecting over 5% of Americans and more often in men than women. Recurrence of the disease is widespread and reaches as high as 50%, especially during the summer months. There are five major categories of kidney stones but calcium stones appear to be the most prevalent.
Clinical symptoms of kidney stones range from no pain if the stone is not moving to agonizing pain that has been compared to childbirth. The first sign of a kidney stone is often bloody urine or intense shooting pain in the flank region or the lower abdomen. As the stone moves down the ureter (the tiny tube that connects the kidneys to the bladder), the pain may progress to sharp cramping or become unbearable renal colic. An urge to urinate or burning on urination occurs as the tiny muscles of the ureter attempt to move the kidney stone along. Associated nausea and vomiting or a state of mild shock may be present. Steady, severe pain may be a sign that the stone has lodged. If this is accompanied by fever or chills, it may be an indication of infection and medical attention should be sought immediately.
The cause of kidney stone formation is not always obvious and usually involves a number of factors. Dehydration and a warm climate, as well as a diet high in proteins or oxalate can lead to concentrated urine and the beginning of a kidney stone. Kidney stones are also known to run in families and may be linked to a sedentary lifestyle or immobility. Active stone formers may also be suffering from an abnormality that prevents them from metabolizing calcium and oxalates.
The diagnosis of kidney stones is usually made on the basis of the location and severity of the pain, then confirmed by an x-ray or CT scan. Ultrasounds are also useful and a urinalysis or urine culture may be done to evaluate mineral levels. Blood may be drawn and a white cell count done to ensure that there is no infection present. If any stones are passed in the urine, it is important to collect them for the physician to evaluate and determine their causes.
Treatment of kidney stones is relatively uncomplicated as most stones will pass spontaneously on their own. The focus is preventing infection and minimizing the pain associated with passing the stone. Surgery may be necessary if the kidney stone is larger than 5mm, if it is blocking the flow of urine or causing an infection or if it will not pass on its own and is causing constant pain. A procedure that involves shattering the stone with shock waves is the most common intervention. For large stones, the surgeon may make a small incision in the back and remove the stone directly with a nephroscope. Open surgical procedures to remove kidney stones are reserved as a last resort because of the risk of hemorrhage.
For those who suffer from recurring kidney stones, the key focus should be prevention. Prevention of kidney stones is the best cure and may involve dietary or lifestyle changes. An adequate fluid intake of at least 6-8 glasses of water daily is imperative to wash out minerals and prevent kidney stones from forming. Other preventative strategies include adopting a diet low in protein and sodium, as well as avoiding oxalate-rich foods. It is also important to maintain a diet adequate in dairy foods and calcium. Contrary to what was once thought, recent research has proven that a diet high in calcium may actually help prevent kidney stone formation. Last, thiazide diuretics may be prescribed to increase urine formation and flush the body of any accumulating mineral salts.
Although they can still be painful, kidney stones are no longer the dreaded disease they once were. Most patients have very good prognoses and excellent outcomes. The advance of technology and the focus on prevention has greatly reduced the cost and pain of having kidney stones.
Disclaimer: This information presented should not be interpreted as or substituted for medical advice. Talk to your doctor for more information about kidney stones.
Category: Healthcare Basics