What are kidney stones?
Kidney stones are just what they sound like: small stones that form inside the kidneys. They form when salts and minerals that are normally in the urine build up and harden.
Kidney stones usually get carried out of the body when you urinate. But sometimes they can get stuck on the way out. If that happens, the stones can cause:
●Pain in your side or in the lower part of your belly
●Blood in the urine (which can make urine pink or red)
●Nausea or vomiting
●Pain when you urinate
●The need to urinate in a hurry
How do I know if I have kidney stones?
If your doctor or nurse thinks you have kidney stones, he or she can order an imaging test that can show the stones.
What if I have kidney stones?
Once we have confirmed the stones, we also order additional type of tests to ascertain type, size and location so that we can create an individual treatment plan to get rid of the stones and also teach you how to prevent kidney stones in future.
Each person's treatment is a little different. The right treatment for you will depend on:
●The size, type, and location of your stone
●How much pain you have
●How much you are vomiting
If your stone is big or causes severe symptoms, you might need to stay in the hospital. If your stone is small and causes only mild symptoms, you might be able to stay home and wait for it to pass in the urine. If you stay home, you will probably need to drink a lot of fluids. Plus, you might need to take pain medicines or medicines that make it easier to pass the stone.
Stones that do not pass on their own can be treated with:
●A machine that uses sound waves to break up stones into smaller pieces. This is called "shock wave lithotripsy." This procedure does not involve surgery, but it can be painful.
●A special kind of surgery that makes very small holes in your skin. During this surgery, the doctor passes tiny tools through the holes and into the kidney. Then he or she removes the stone. This is called "percutaneous nephrolithotomy."
●A thin tube that goes into your body the same way urine comes out. Doctors use tools at the end of the tube to break up or remove stones. This is called "ureteroscopy."
How to prevent kidney stones from forming?
One simple thing you can do is to drink plenty of water. You might also need to change what you eat, depending on what your kidney stones were made of. If so, your doctor or nurse can tell you which foods to avoid. Your doctor or nurse might also prescribe you new medicines to keep you from having another kidney stone.
Please tell me more about what dietary modifications I need to make?
It depends on the type of the stone. Ask us to do 24 hours urine test to understand what dietary contributing factors are responsible. Based on that we can suggest changes.
Some of the generic modifications we suggest are as follows.
From the viewpoint of diet, alterations in fluid, calcium, oxalate, potassium, phytate, animal protein, sucrose, fructose, sodium, and supplemental vitamin C intake may be beneficial. We therefore recommend the following for all patients with calcium oxalate stones:
●Sufficient fluid intake distributed throughout the day to produce at least 2 liters of urine per day, including drinking at night (although it is not essential that the patient wake up several times per night to urinate). This will increase the urine flow rate and lower the urine solute concentration, both of which may protect against stone formation.
To reach this goal, the best strategy is to recommend how much additional fluid the patient should drink based upon his or her 24-hour urine volume. As an example, if the total urine volume is 1.5 liters, then we recommend two additional 8 ounce (240 mL) glasses of fluid each day to reach the goal of at least 2 liters of urine output per day.
●Adequate dietary calcium intake. While excessive calcium intake should certainly be avoided, dietary calcium restriction is not appropriate, as it may increase the risk of stone formation and also lead to reduced bone mineral density. Several servings of dairy or other calcium-rich foods to reach 800 to 1000 mg/day are encouraged.
●Avoiding excessive animal protein in the diet. Although it has not been proven that a low-protein diet will reduce the incidence of stone formation, a high-animal protein diet is a risk factor for renal stones in men and older but not younger women .
●Limiting dietary sodium to 100 mEq/day. A low-sodium diet can enhance proximal sodium and calcium reabsorption, leading to a reduction in calcium excretion.
●Increasing dietary potassium intake, as this is associated with substantially reduced risk in men and women.
●Limiting dietary sucrose and fructose.
●Limiting intake of high oxalate foods and supplemental vitamin C in patients with calcium oxalate stones. However, excessive restriction of oxalate is not likely to be helpful; patients should continue to consume a wide variety of fruits and vegetables.
Drug therapy is indicated if the stone disease remains active (as evidenced by the formation of new stones, enlargement of old stones, or the passage of gravel) or adequate improvements are not realized in urinary chemistries despite attempted dietary modification over a three- to six-month period.
Initial drug therapy varies with the metabolic abnormality that is present:
●Thiazide diuretics for reducing urinary calcium excretion
●Allopurinol for high urine uric acid
●Potassium citrate or potassium bicarbonate for low urine citrate