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Kidney stone
FAQ:
What is a kidney stone?
Kidney stone causes
Kidney stone symptom basics
Other kidney stone symptoms
Kidney stone treatment options
Surgery as kidney stone treatment
Is there a home remedy for kidney stones?
Is cranberry juice a natural kidney stone cure?
Causes of kidney stone pain
How painful are kidney stones?
Removing kidney stones
Using EWSL for kidney stone removal
Other Methods for Kidney Stone Removal
Kidney stone prevention
What is a good kidney stone diet?
What is a
kidney stone?
A kidney stone is a mass that builds up in the
urinary tract in certain individuals.
Kidney stones are one of the most common
disorders of the urinary tract, and develop from
crystals that separate from the urine and build
up on the inner surfaces of the kidney. If the
crystals remain small enough, they will travel
through the urinary tract and pass out unnoticed
while urinating. However, if the crystals
accumulate and form a large stone (or stones),
they can impair the function of the kidney,
obstruct the flow of urine and cause extreme
pain. In these cases, treatment is required. If
left untreated, the kidneys maybe permanently
damaged by an obstructing stone in only a few
days. Stones occur for a variety of reasons
including diet, dehydration (not drinking enough
while doing manual labor or sport), and family
history.
Common symptoms of
stone include:
-
Sharp pain in the abdomen or lower back
-
Blood in the urine
-
Pain when urinating
Your physician will diagnose kidney stones with
the help of urine analysis, x-ray, ultrasound or
CT-scan.
Kidney stones can be as tiny as a grain of sand
or as large as a pebble. Even a very small
kidney stone can trigger severe discomfort.
While kidney stones are rarely life threatening,
they can cause severe pain that can last for
hours. Many women who have kidney stones say the
pain can be as sharp as the pains of
childbirth.
Kidney stone
causes
Kidney stones form when crystals separate from
the urine and build up on the inner surfaces of
the kidney. Most people have
chemicals in their urinary tract that crystals
from accumulating and forming kidney stones. But
for reasons that are still unclear, certain
people don't have the inhibitors that prevent
crystal formation.
Small crystals often pass through the urinary
tract and flow out of the body in the urine. But
not always.
The medical term for stone formation in the
urinary tract is urolithiasis. It may also be
called urinary tract stone disease and
nephrolithiasis.
A kidney stone may also be described according
to its location. If it's found in the ureter,
for instance, is called a ureteral kidney stone.
Kidney stones will sometimes pass into the
bladder and out of the body without being
noticed (although this is rare).
The best way to prevent a kidney stone from
forming is to drink a lot of water, which helps
flush the stone through the urinary tract.
Kidney stone symptom basics
The most common kidney stone
symptom is an aching feeling in the "flank"
region: an area in the back just under the rib
cage and above the hip. Pain severity and region
of the pain may vary depending on such factors
as the location of the kidney stone and the
amount of obstruction the kidney stone is
causing.
Pain from a kidney stone often
comes on quickly and without warning. This
occurs as the stone moves into the urinary tract
and blocks the flow of urine. The pain can be
very sharp, and some people describe it as
"stabbing" sensation. The pain will be so
intense it will cause a person to begin
writhing, arching their back and grabbing the
area around the kidneys. It's also virtually
impossible for someone with a kidney stone to
find a comfortable position. Pain from a kidney
stone can last for hours, so recognizing a
kidney stone symptom and getting quick medical
attention is important.
Another kidney stone symptom
is cramping in the back or in the lower
abdomen. Pain in the groin area is also a
classic kidney stone symptom.
Besides pain, the most
common kidney stone symptom is blood in the
urine.
Other kidney stone symptoms
Any of the following may be a
kidney stone symptom:
-
Feeling the need to urinate often
-
Cloudy urine
-
Evidence of blood in the urine
-
Inability to urinate even though you feel
you need "to go"
-
Nausea
-
Sweating
-
Vomiting
A kidney stone symptom
is often "silent." You don't know you have a
kidney stone until pain begins.
Fever and chills accompanying
any of these kidney stones symptoms may indicate
a kidney infection. If this is the case, you
should contact a doctor immediately.
Kidney
stone treatment options
Kidney stone treatment and
kidney stone prevention often involve the same
strategy: water, water, and more water.
Most kidney stones can pass
through the urinary system with plenty of water
(2 to 3 quarts a day) to help "flush" the stone
down the ureter and into the bladder.
Passing a kidney stone once it's in the bladder
rarely causes much discomfort. Some people
(especially women) don't even realize that the
kidney stone has been "released."
Drinking cranberry juice has
often been mentioned as an effective kidney
stone treatment and preventive measure, but
recent studies suggest it is no more helpful
than lots of water. If you're interested in
learning more about what other visitors to this
website think, you can visit out kidney stone
discussion forum and post a question or comment
on the subject of kidney stone treatment.
Also see kidney stone
treatment: home remedies.
Fortunately, kidney stone
treatment does not usually require surgery. The
doctor may prescribe certain kidney stone
medicine to prevent calcium and uric acid
stones. This treatment controls the amount of
acid or alkali in the urine, which are important
factors in kidney stone formation. The drug
allopurinol may also be useful as a treatment in
some cases of hyperuricosuria.
To control hypercalciuria, and
thus prevent calcium kidney stones, doctors
often prescribe certain diuretics. These drugs
reduce the amount of calcium released by the
kidneys into the urine. This treatment works
best when sodium intake is low.
Patients with hypercalciuria
may be given the drug sodium cellulose
phosphate, which binds calcium in the intestines
and prevents it from leaking into the urine.
This is a rare form of kidney stone treatment
however.
Drinking more fluids is the
typical treatment for cystine kidney stones. But
if this type of treatment is ineffective, a
doctor may prescribe as Thiola and Cuprimine,
which help reduce the amount of cystine in the
urine.
For struvite kidney stones
that have been totally removed, treatment
includes steps to keep the urine free of
bacteria that can cause infection. Urine should
be tested often to make sure that no bacteria
are present.
If struvite kidney stones
cannot be removed, your doctor may prescribe
treatment with a drug called acetohydroxamic
acid, or AHA. AHA is used with long-term
antibiotics to prevent kidney infections that
lead to kidney stone growth.
Is there a home remedy for kidney stones?
The simplest and best home remedy for kidney
stones is water--and lots of it.
Actually, some people have had success in
eliminating kidney stones by drinking lots of
water and then just running up and down the
stairs. It gets the "engine" going. Fluids,
heat, circulation...the system is pumping.
Some experts recommend three or four ounces of
olive oil at night (because of the possibility
of loose bowels). This natural body lubricant
could help pass the kidney stones down the
ureter and into the bladder.
Eating a lime or lemon is also thought to be a
helpful home remedy for kidney stones.
Is cranberry juice a natural kidney stone cure?
For years, conventional wisdom touted cranberry
juice as a home remedy for kidney stones.
Lately, researchers have cast doubt on the
cranberry juice theory. Nonetheless, some
doctors recommend two eight-ounce glasses daily.
The theory is that cranberries are acidic, so
that drinking cranberry juice will acidify your
urine and discourage calcium kidney stones from
forming.
The following herbs are sometimes recommended as
a home remedy to ease the pain and discomfort
that come with kidney stones and kidney stone
passage:
-
Bearberry - Acts as a diuretic and
antiseptic for the urinary tract.
-
Cleavers - Has a history of use as a home
remedy in treatment of congestive kidney
disorders, stones, and urinary infections.
-
Corn silk - A soothing demulcent with mild
diuretic properties.
-
Crampbark - Relaxes smooth muscle and is an
antispasmodic.
-
Gravel root - Named for its traditional use
as a home remedy treatment for kidney stones
and gravel of the kidneys.
-
Kava kava - Has anti-anxiety and sedative
qualities.
-
Khella - Has a long tradition as a home
remedy in the treatment of kidney stones.
Scientific research has demonstrated that
the herb may work as a calcium channel
blocker-type antispasmodic, which targets
and relaxes ureter tissue. This may allow
easier passage of small kidney stones.
-
Seven barks - Has a sedative effect on the
urinary system; used in the treatment of
kidney stones.
-
Stone root - Strong diuretic with a history
of use in acute and preventative treatment
of kidney stones.
Finally, some patients report relief from kidney
stone pain when they take a hot shower or sit in
a tub of warm bath water.
Causes of kidney stone pain
When a tubular structure (in
this case, a ureter that leads from a kidney to
the bladder) is blocked in the body, there can
be a lot of pain as the body tries to unblock
the obstruction. Pain can feel like it's coming
in waves, and these waves of pain of pain
are referred to as "colic."
Kidney stone pain is often
called renal colic. "Renal" is the medical term
for topics related to the kidney. Renal
colic usually occurs when a kidney stone is
being passed.
How
painful are kidney stones?
Anyone who has ever had a
kidney stone will tell you kidney stone pain can
be severe and prolonged. Women who have had
kidney stones sometimes say the intensity of
kidney stone pain is nearly as severe as the
pain of childbirth.
Kidney stone pain usually
appears first in the back or "flank" on either
side of the body (depending on which kidney has
developed a stone). Someone suffering kidney
stone pain usually feels a sharp, cramping
discomfort in the back and side or in the lower
abdomen. Later, pain may spread to the groin. As
the kidney stone moves toward the bladder, a
person may feel an increased need to urinate, or
a burning sensation when urinating.
Severe kidney stone pain may
last a few minutes...or it may go on for hours
as the kidney stone moves and irritates the
lining of the urinary tract or blocks the flow
of urine. Then, for no apparent reason, the pain
stops and may not come back for hours--or days.
If the kidney stone is too big
to pass, the muscles in the wall of the tiny
ureter strain to squeeze the kidney stone along
into the bladder.
During an attack of kidney
stone pain, there may be nausea and vomiting.
Removing kidney
stones
In the last 25 years, a number of non-invasive
methods have been developed for kidney stone
removal. These kidney stone removal procedures
might not be considered "surgery" in the
traditional sense.
Surgery involving invasive techniques usually
isn't needed for kidney stone removal anymore.
Invasive surgery is reserved for cases where
other kidney stone removal approaches have
failed.
Kidney stone surgery is appropriate when:
-
the kidney stone does not pass after a
reasonable period of time and causes
constant pain
-
the kidney stone is too large to pass on its
own or is caught in a difficult place
-
the kidney stone is blocking the flow of
urine
-
the kidney stone is causing ongoing urinary
tract infection
-
the kidney stone is damaging kidney tissue
or causing constant bleeding.
Using EWSL for kidney stone removal
Extracorporeal shockwave lithotripsy (ESWL) is
the most frequently used procedure for kidney
stone removal. This procedure, in effect, can
dissolve a kidney stone.
Shock waves that are created outside the body
travel through the skin and body tissues until
they hit the denser kidney stones. The kidney
stones break down into sand-like particles and
are easily passed through the urinary tract in
the urine.
There are several types of ESWL devices. In one
device, the patient reclines in a water bath
while the shock waves are transmitted. Other
devices have a soft cushion on which the patient
lies. Most devices use either x rays or
ultrasound to help the surgeon pinpoint the
kidney stone during treatment.
For most types of ESWL procedures, anesthesia is
needed but it may be nonetheless be done on an
outpatient basis. Recovery is quick, and most
people resume normal activities in a few days.
Most patients have blood in their urine for a
few days after kidney stones are removed with
ESWL. There can be bruising and minor discomfort
in the back or abdomen from the shock waves.
Doctors usually tell patients to avoid taking
aspirin and other drugs that affect blood
clotting for several weeks before treatment.
This helps avoid complications.
The shattered kidney stone particles may also
cause discomfort as they pass through the
urinary tract. In some cases, the doctor will
insert a small tube called a stent through the
bladder into the ureter to help the kidney
stone fragments pass more smoothly.
Occasionally, the kidney stone is not completely
shattered after one treatment. Additional
treatments may be needed. ESWL may not be the
best kidney stone removal treatment for very
large stones.
Other Methods for Kidney Stone Removal
Percutaneous nephrolithotomy
may be used when the kidney stone is too big or
in a location that does not allow effective use
of ESWL.
In this kidney stone removal procedure, the
surgeon makes a tiny incision in the back and
creates a tunnel directly into the kidney. Using
an instrument called a nephroscope, the surgeon
locates the kidney stone and removes it.
For large kidney stone removal, some type of
energy probe (ultrasonic or electrohydraulic)
may be needed to break the stone into small
pieces. When this type pf kidney stone removal
procedure is used, patients usually have to stay
in the hospital for a few days and may have a
small tube called a nephrostomy tube left in the
kidney during the healing process.
Percutaneous nephrolithotomy has something of an
advantage over ESWL because the surgeon removes
the kidney stone. Fragments are not left to pass
naturally after they've been broken up (which
sometimes doesn't happen).
Ureteroscopic kidney stone removal
is another procedure. Although some kidney
stones in the ureters can be "removed" with
ESWL, ureteroscopy may be needed for mid-and
lower-ureter kidney stones.
The surgeon passes a small fiberoptic instrument
called a ureteroscope through the urethra and
bladder into the ureter. The surgeon then
locates the kidney stone and either removes it
with a cage-like device or shatters it with a
special instrument that produces a form of shock
wave. No incision is needed. A small tube or
stent may be left in the ureter for a few days
to help the lining of the ureter heal.
Before fiber optics made ureteroscopy possible,
physicians used a similar "blind basket"
extraction method. But this outdated technique
should not be used because it may damage the
ureters.
Kidney
stone prevention
The best form of kidney stone
prevention is to be born into a family that's
never had kidney stones.
Because if you have a family
history of kidney stones, you are more likely to
develop kidney stones than someone who doesn't.
If you've already had one
kidney stone, your chances of getting another
kidney stone (and possibly another and another
and another) are about 50-50.
The first step in kidney stone
prevention is figuring out what kind of kidney
stones your body is making, and what's causing
your kidney stones to form. Your doctor can
order laboratory tests, including urine and
blood tests. He or she will also ask about your
medical history, occupation, and eating habits.
If a kidney stone has been removed or passed
(and saved), the lab can analyze it.
Once you know the composition,
kidney stone prevention planning can begin
The most important and easiest
kidney stone prevention strategy is simply to
drink a lot of water. Kidney stones form because
crystals produced in the body aren't flushed out
through the urinary tract. The more water you
drink (up to a point of course), the less likely
you are to ever suffer a kidney stone.
You should try to drink enough
liquid to produce at least 2 quarts of urine in
every 24-hour period.
People who form calcium kidney
stones used to be told to avoid milk, cheese,
and other dairy products or other foods with
high calcium content. But recent studies have
shown that foods high in calcium, including
dairy products, may actually help prevent
calcium kidney stones. Taking calcium in pill
form, however, may increase the risk of
developing stones. You may be told to avoid food
with added vitamin D and certain types of
antacids that have a calcium base.
If you have very acidic urine,
you may need to eat less meat, fish, and
poultry. These foods increase the amount of acid
in the urine.
You can prevent cystine kidney
stones by drinking enough water each day to
dilute the concentration of cystine that escapes
into the urine. This may not be easy, however
since more than a gallon of water may be needed
every 24 hours. One third of that total must be
drunk during the night to keep the flow going.
Doctors recommend that people
who form calcium oxalate kidney stones cut back
on certain foods if their urine contains an
excess of oxalate. Such foods include:
-
beets
-
chocolate
-
coffee
-
cola
-
nuts
-
rhubarb
-
spinach
-
strawberries
-
tea
-
wheat bran
You don't have to give up or
avoid these foods. In most cases, they can be
eaten in limited amounts. But talk to your
doctor about it. See kidney stone diet for more
information.
If you are at risk for
developing kidney stones, your doctor may
perform certain blood and urine tests to
determine which factors can best be altered to
reduce that risk.
Some people will need kidney
stone medicine to prevent kidney stones from
forming.
What
is a good kidney stone diet?
Diet can have a major influence on kidney stone
formation, but before you change your diet--or
your lifestyle--be aware that there are several
kinds of kidney stones. Once you and your doctor
know which kinds of kidney stones you have, you
can create a "kidney stone diet" accordingly.
Also keep in mind: what you eat as part of your
kidney stone diet may not be nearly as important
as what you drink. This is true no matter what
kind of kidney stones you have. 2-3 quarts of
water a day is the best defense against kidney
stones.
Water dilutes the urine and helps to prevent
salts and minerals from clumping together to
form kidney stones.
People who form calcium kidney stones used to be
told to avoid dairy products and other foods
with high calcium content. But recent studies
have shown that foods high in calcium, including
dairy products, may actually help prevent
calcium kidney stones. Taking calcium in pill
form, however, may increase the risk of
developing kidney stones.
Also be careful of other supplements in your
diet. Check with your doctor to see if they are
really necessary.
If you're taking stomach medicine, consult your
doctor. Certain popular antacids are enormously
high in calcium.
Eating a lot of oxalate-rich foods as part of
your diet can also increase the risk of kidney
stones. About 60 percent of all kidney stones
are known as calcium oxalate kidney stones. When
your body is working as it should, it will
excrete oxalate from the fruits and vegetables
in your diet. But if you've had calcium oxalate
kidney stones, it's a tip off that something
isn't working right. So you should restrict your
consumption of oxalate-rich foods in your diet.
These include beans, beets, blueberries, celery,
chocolate, grapes, green peppers, parsley,
spinach, strawberries, summer squash, and tea.
Swedish researchers found that a daily
supplement of magnesium in the diet reduced
kidney stone recurrence by almost 90 percent in
a group of patients. Scientists speculate that
magnesium works because it can bond with
oxalate. But unlike a bond of calcium and
oxalate, the magnesium-oxalate bond is less
likely to form kidney stones.
Vitamin B6 is believed to lower the amount of
oxalate in the urine. One recent study suggests
10 milligrams a day as an appropriate dose to
prevent kidney stones.
Make sure there's some vitamin A in your diet.
Regardless of which kind of kidney stone you've
had, Vitamin A helps keep the lining of the
urinary tract healthy and also helps discourage
the formation of kidney stones. Sweet potatoes
and carrots are high in Vitamin A, as are
apricots, broccoli, cantaloupes, pumpkins,
winter squash, and beef liver.
But be careful with Vitamin A supplements, which
should not be taken without your doctor's
advice. Vitamin A can be toxic in large doses.
People who are inactive tend to accumulate a lot
of calcium in the bloodstream, doctors say.
Exercise helps pull calcium back into the bones
(where it belongs) instead of accumulating in
the urinary tract where they may form kidney
stones.
A protein-rich diet is likely to cause kidney
stones in people who are susceptible. Protein
increases the presence of uric acid, calcium,
and phosphorus in the urine, Excessive protein
is especially hazardous for anyone who has had
calcium kidney stones. Limit your diet to 6
ounces of high protein food a day. This includes
meat, cheese, poultry, and fish.
If you've had calcium kidney stones, you should
cut down on salts: no more than 2 to 3 grams per
day. Not just table salt either. Beware of
pickled foods, and salty foods such as luncheon
meat, snack chips, and processed cheese.
If you tend to develop calcium oxalate kidney
stones, the amount of Vitamin C in your diet can
also be a problem. More than 3 to 4 grams a day
can increase oxalate production and increase the
risk of kidney stones. High-potency supplements
are most dangerous.
Large amounts of vitamin D can lead to excess
calcium. Be wary of foods that are high in
Vitamin D.
There has been some research suggesting that
dietary oxalates found in nuts, chocolate,
dark-green leafy vegetables, rhubarb, beets and
okra, and in
concentrated tomato sauce and jams can increase
the risk of kidney stones. But all the research
isn't in yet. You may want to avoid these foods,
just in case.
Finally, the one clear dietary risk factor for
kidney stone formation is grapefruit juice. It
isn't clear why grapefruit juice is a diet
problem for kidney stones, but study after study
has shown that it is.
Strangely, orange juice is not a problem.
For years, conventional wisdom touted cranberry
juice as a home remedy for kidney stones. The
theory is that cranberries are acidic, so that
drinking cranberry juice will acidify your urine
and discourage calcium kidney stones from
forming.
Lately though, researchers have cast doubt on
the cranberry juice theory, saying that water
works just as well--and you don't get the
calories. Nonetheless, some doctors recommend
two eight-ounce glasses daily. |
