Kidney stones form when the various acids and minerals of the urine are out of balance. When this happens, your urine contains more crystal forming substances, such as calcium, oxalate, and uric acid than available fluid can dilute. At the same time, your urine may be short of substances that keep crystals from sticking together and becoming stones. This creates an environment in which kidney stones are more likely to form.
Usually, kidney stones result in no permanent damage. However, medical treatment can help prevent recurrent stones in people with increased risk. At Alpine Urology, our doctors will identify your type of kidney stone and help you understand what can be done to reduce your risk of developing additional stones.
It is common to see a number of factors, often in combination, create the conditions in which certain people develop kidney stones.
- You are more likely to develop kidney stones if someone in your family has kidney stones.
- If you have already had one or more kidney stones, you are at increased risk of developing another.
- Kidney stones are most common in adults age 40 and older.
- Men are more likely to develop kidney stones than women.
- Not drinking enough water each day can increase your risk of developing kidney stones.
- Significant weight gain and obesity have been linked to an increased risk of kidney stones.
The most common symptoms of kidney stones are blood in the urine or pain. Pain severity and location of pain might vary depending on such factors as stone location and degree of obstruction. Other symptoms include:
- Feeling the need to urinate often
- Inability to urinate (when the stone blocks the urinary tract)
- Nausea and/or vomiting
- Cloudy, foul smelling urine, fever, chills, or weakness might be a sign of a serious infection
Most kidney stones won't require invasive treatment.
- You may be able to pass a small stone by drinking as much as 2 to 3 quarts of water per day and taking an over- the- counter pain reliever such as Ibuprofen or Tylenol.
- If your kidney stones cannot be treated with this conservative approach, our doctors will recommend a treatment that is safe and effective.
- The majority of kidney stones, depending on their size and location, can be removed by minimally invasive techniques such as shock wave lithotripsy (SWL), ureterscopy, or percutaneous surgery.
Hydration is a critical factor in stone prevention. Water is the recommended fluid for hydration. Some people have a hard time drinking pure water and prefer a flavor to their drink. Water may be flavored with lemonade powder, fresh squeezed lemon or other flavor enhancements. The level of fluid intake is important but most important is the amount of voided urine. Your urine should be without yellow color when you void. Ideally a stone patient would void at least 2500 ml daily.
Ideally, calcium goals should be met through dietary calcium sources rather than through calcium supplementation. Studies have found that dietary calcium, that is calcium found in milk, cheese or soy, has a decreased risk of stone formation when compared to calcium supplements.
Calcium citrate is the recommended calcium supplementation if needed. Many people need added calcium and Vitamin D for bone health. The citrate may decrease precipitation of calcium in the urine, and lower stone formation. The citrate may lower uric acid precipitation in the urine and lower stone formation.
Calcium Oxalate Stones
Calcium based stones are the most common type of kidney stone, accounting for 75% of stones. Calcium oxalate stones are comprised of both calcium and oxalate, but may also contain phosphate, uric acid and other components.
General dietary recommendations for prevention of calcium oxalate stones include drinking plenty of water and eating a low sodium, low protein diet. Consuming low amounts of oxalate is sometimes recommended; however, as oxalate is a component of many nutritional food source like spinach and peanuts, it is preferable to try and decrease stone formation through other methods.
It is not advised to decrease dietary calcium intake. In recent studies, restricted calcium diets have actually been shown to increase the risk of calcium based stones.
Calcium Phosphate Stones
General dietary guidelines for restriction of calcium phosphate stones is similar to the prevention of calcium oxalate stones. A high fluid intake, low sodium, low protein diet is recommended for stone prevention.
The main difference is that the restriction of high oxalate containing foods is not as important and the urine pH should not rise above 6.5 or become more basic. Urine pH can be monitored at the Urologist’s office.
Uric Acid Stones
Uric acid stones comprise 5-10% of stones in the United State and Europe. The urine pH is typically below 5.5 or acidic. The high level of acidity in urine causes a somewhat soluble or dissolvable urate salt to become insoluble or undissolvable uric acid, which becomes a uric acid stone.
General dietary guidelines for prevention uric acid stones involves drinking plenty of water throughout the day and taking in a low protein diet.
Any underlying medical conditions like chronic diarrhea, diabetes type II or gout should also be well-controlled to help decrease the rate of uric acid stones.
Struvite stones are stones in the kidneys that can grow large enough to fill the inner portions of the kidney. They may also be called staghorn stones. These stones are often associated with upper urinary tract infections in the kidneys. These infections can be serious and may require hospitalization.
It is important to analyze the urine and determine if the stones are primarily calcium-based or a product of infection. Prevention guidelines are dependent upon the urine analysis.
Cystine stones are found in 1-2% of stone formers and occurs because of a genetic reason. Prevention is aimed at reducing the high level of cystine in urine. General guidelines recommend taking in high quantities of water, decrease sodium and protein consumption. Adding lemon juice to the diet may be helpful.
OUR PHYSICIANS ARE ALL SURGEONS AND CERTIFIED THROUGH THE AMERICAN BOARD OF UROLOGY.