Kidney Stones: Preventing Them and Passing Them
Kidney stones are mineral deposits that build up over time as the kidneys remove waste products, minerals, and excess water from our blood.
Kidney stones have many causes and can affect any part of the urinary tract — from the kidneys to the bladder, and even the urethra. Often, stones form when the urine becomes too concentrated, allowing filtered minerals to crystallize and stick together. Below are some of the risk factors for stone formation:
- Family history – Patients with family members who have had kidney stones have a higher chance of getting them as well.
- Not drinking enough fluid – The more fluid a person drinks, the less likely it is that stone-forming minerals will settle in the kidneys and produce stones. It’s worth noting that people who live and work in hot climates or environments or exercise frequently need to drink even more water to replace the fluids lost through sweat.
- Diets high in protein, sodium, and sugar – High protein, sodium, and sugar diets increase the patient’s risk for developing kidney stones.
- Obesity – A large waist size, high BMI, and weight gain have all been linked to the development of kidney stones.
Preventing kidneys stones
Preventing kidneys stones starts primarily with increasing your daily fluid intake. Chronic dehydration is the main risk factor associated with kidney stones. If any of the risks above sound familiar, we urge you to include the following in your lifestyle:
- Drink more fluid – Water and fresh-squeezed lemonade are best. Try to avoid sodas, coffee, and tea. If consuming alcohol, make sure it is done in moderation. Try to aim for a urine output of two liters every day. That’s enough to fill up a large Sprite bottle! Fresh-squeezed lemonade and orange juice are great natural stone prevention fluids, as the citrate in these juices binds to calcium in the urine thus preventing calcium stone formation.
- Change your diet – Limit meat intake, look for low-sodium options when shopping for food, and make sure you get your daily recommended amount of calcium. This will keep oxalate levels in check.
- Exercise and portion control – Being overweight can cause insulin resistance and increased amounts of calcium in urine. Exercise and food portion control are great ways to improve overall health and avoid kidney stones. Consult a doctor before beginning any exercise program.
- Discuss medications with your doctor – Some medications can cause kidney stones to form. Be sure to talk to a doctor about any prescriptions if you are concerned about kidney stones.
- Check your estrogen levels – Low estrogen levels can increase kidney stone risk. It is recommended to get levels checked after starting menopause. This can be done through simple blood work.
Passing kidney stones
Passing a kidney stone can be painful. The pain of stone passage has been compared to that of childbirth. If you think you may be passing a stone, first contact your doctor.
Many small kidney stones can be passed with increased fluid intake, pain medication, and time. It is important to undergo a “trial of passage” under the care of a physician, because if stones become lodged in the urinary tract, they can cause complications. If you have uncontrolled pain, nausea, vomiting, or fevers, a procedure or surgery may be necessary to remove the stone causing your symptoms.
Depending on the level of pain and medical history, we recommend a few things for treatment of kidney stones:
- Being followed by a physician while the kidney stones pass naturally. Drinking plenty of water, combined with pain medication and sometimes an alpha blocker such as tamsulosin is sometimes sufficient to allow small stones to pass without an invasive procedure. Alpha blockers help to relax and open the ureter, hopefully allowing small stones to pass quicker and easier.
- If you and your Urologist decide a procedure is needed, Extracorporeal Shock Wave Lithotripsy may be performed. This is a minimally invasive treatment that uses shock waves to break the stones into many tiny pieces, making them easier to pass. This procedure takes an hour to complete but is an outpatient procedure, meaning the patient will be able to go home the same day.
- Some stones and patients cannot be treated with shock wave lithotripsy, and Ureteroscopy is used, which is a minimally-invasive endoscopic procedure that uses a camera and laser to locate and break up the stone. This is also an outpatient procedure, meaning the patient will be able to go home the same day.
- Very large stones sometimes require a procedure called Percutaneous Nephrolithotomy. This procedure is more invasive, thus is usually reserved for very large stones that fill a significant part of the kidney.
When should you see a doctor?
Passage of many kidney stones is manageable under doctor supervision. The chances of successful stone passage decrease as the stone size increases. Once x-rays have been obtained to determine the size and location of the stone, your doctor can provide a recommendation on which course of action is right for you.
It is important to let your doctor know if any of the following symptoms are experienced:
- Fever or chills – this can be a sign of infection
- Pain that is not controlled by medication
- Inability to urinate or severely decreased urine output
- Inability to hold down food/water
- Uncontrolled nausea/vomiting
- Confusion or intense fatigue
Also, if the patient has a known history of kidney disease or only has one kidney, it is especially important for a medical professional should be involved in the passing of the stone from the very onset of any symptoms.
Get in touch with a urologist today if you think you might be experiencing any of these symptoms.