Who gets kidney stones?
Approximately 10-15% of Americans will develop and be affected by kidney stones in their lifetime. Currently, the majority of kidney stones are a result of our diet. The incidence of kidney stones may increase due to dehydration, increased salt intake, increased caffeine intake, increased calcium intake and intake of well water. There are several other metabolic causes which can influence the formation of calculi (stones). There are foods that are high in minerals that could predispose someone to form stones. Traditionally, men were more affected than women, but the gap is narrowing. It is also rare for stones to form in the pediatric population, but unfortunately, this trend is changing as well.
What are some signs and symptoms?
The initial presentation is usually pain. This pain is predominantly felt in the flank area (located just below the ribs on your back) and will often radiate towards the groin. The pain is secondary to the stone obstructing the flow of urine which causes the kidney to swell. Occasionally, these symptoms are accompanied by abdominal pain, nausea, and vomiting. A fever and chills is an indication that there is an infection associated with the stone, and you should seek treatment immediately. Lastly, some stones are found incidentally when a x-ray or a CT scan is done for a different reason.
How can kidney stones be treated?
The answer to this question really depends on the location of the stone and if it is currently causing an obstruction. We will offer you treatment options based on the acuity and symptoms you are having.
1) The best and least invasive option is passing the stone yourself by increasing your intake of water. Most stones less than 4 millimeters can be observed and will likely spontaneously pass. However, there is no known timeframe for when a person may pass a stone(s). The use of an alpha blocker medication may increase the chance of the spontaneous passage of kidney stone(s).
2) Extracorporeal Shockwave Lithotripsy (ESWL) is a non-invasive way to break the stone with sound waves and allow the fragments to pass on their own. Depending on size, number, and the location of the stones, additional ESWL treatments and/or the placement of an ureteral stent may be necessary.
3) Ureteroscopy is a minimally invasive procedure where we can break your kidney stone(s) with a laser, and retrieve the stone through a small scope. Depending on the size, number, and the location of the stones, additional ESWL treatments and/or placement of an ureteral stent may be necessary.
4) Percutaneous Nephrolithotomy (PCNL) is an invasive procedure where a scope is directly inserted into the kidney. This procedure is reserved for large stones.
How to prevent recurrent kidney stone formation?
First, we recommend that patients increase their intake of water. Studies indicate that increasing water intake can dramatically decrease the reoccurrence of kidney stone formation. We recommend drinking approximately 3 liters of fluid per day to maintain urine output of 2-2.5 liters of urine per day. For those patients with reoccurring kidney stones, we recommend specialized blood and urine tests to isolate the cause of your kidney stone formation. Pending these results, we will recommend that our patients make changes in their diet pattern, take medication, or other options.