Kidney Stones

Definition

Stone disease is among the most painful and prevalent urological disorders. More than a million kidney stone cases are diagnosed each year with an estimated 10 percent of Americans destined to suffer from kidney stones at some point in their lives. The incidence of urolithiasis, or stone disease, is about 12% by age 70 for males and 5-6% for females in the United States.

Risk Factors

Although historically urinary stones were more common in men, recent studies have suggested a rise in the number of women with urolithiasis. Some of the risk factors for kidney stones include:

  • Age- Stone occurrence is relatively uncommon before age 20 but peaks in the fourth to sixth decades of life
  • Geography- Stones are also more common in certain areas of the country, particularly in the southeastern United States
  • Diet
  • Obesity
  • Dehydration
  • History of a previous stones

There are many different types of urinary stones, but calcium-based stones are by far the most common.

Symptoms

Many people have small kidney stones which are detected by imaging done for other reasons and are completely without symptoms. Stones typically are noticed as they become larger or if they move from the kidney down the ureter (the tube connecting the kidney and bladder) and cause blockage of the kidney. Symptoms may include:
• decreased kidney function
• distension and dilation of the kidney
• spasm of the ureter
• Pain, most commonly felt in the area between the ribs and hip, lower abdomen, and groin
• Renal colic (pain experienced when the stone begins moving down the kidney tube) which can cause nausea, vomiting, blood in the urine, and painful urination
• Occasionally renal colic can be associated with fever and chills, and low blood pressure, signifying a serious infection called sepsis

Diagnosis

Kidney Stones can be diagnosed in multiple ways including:
• History
• Physical examination
• Urinalysis
• X-ray studies such as a CT scan or ultrasound

Treatment

When a stone is symptomatic, it can be treated in a variety of ways. Certain medications will help stones pass through the urinary tract over time. Other times the stone will need to be treated with a surgical procedure. Surgery can be performed by breaking the stone into small pieces with sound waves (or Extracorporeal Shockwave Lithotripsy) in certain instances. Depending on the size, chemical makeup and location of the stone, often scopes are placed into the urinary tract which allows your urologist to destroy the stone with laser energy. In cases of large stones, a more invasive procedure called percutaneous nephrolithotomy is performed through a tiny incision in the back, which allows direct access to the inside of the kidney for removal of the stones. Fortunately, GHS Regional Urology is able to provide the full spectrum of surgical options for the treatment urinary stone disease.

Prevention of future stones is a critical part of the care of patients with urolithiasis. Metabolic evaluations can be performed that dramatically decrease a person’s risk of subsequent stones. General recommendations for stone prevention include increasing fluid intake to more than 2 liters/day, increasing the intake of citrate-containing fluids (such as lemonade and orange juice) and avoiding high sodium intake.

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