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Kidney Stones: How Your Doctor Can Help

Updated: May 29


Kidney Stones

Did you know that around 19 percent of men and 9 percent of women will experience at least one kidney stone by the age of 70? This statistic comes from research based on data from the National Health and Nutrition Examination Survey (NHANES). After the first occurrence, more than half of these individuals are likely to develop additional stones within the next decade. Factors such as genetics, diet, environmental influences, and underlying health conditions can increase this risk by altering urine composition.


Kidney stones are most commonly diagnosed following a painful episode, known as "renal colic". To help prevent and manage them, your healthcare provider needs to identify the specific factors that make you susceptible. Let's explore how doctors can offer support!


When It Comes To Stones, Your History Is Important 

Doctor taking medical history

The first step in identifying your risk factors for formation of future stones is to take a detailed history.


Certain conditions like chronic diarrhea, bowel disease, hyperparathyroidism, and granulomatous disorders can contribute to stone formation. Environmental factors, such as hot and dry climates or certain occupations with limited access to water, can also increase your risk.


Diet plays a significant role. Consuming in excess salty foods, animal protein, oxalate-rich foods, while drinking a low amount of water per day and eating calcium-rich foods can be significant risk factors.


Family history can influence your likelihood of developing renal calculi. Stone formers often have relatives with a history of kidney stones. Furthermore, there are a few known genetic conditions that can put someone at risk.


Certain medications and supplements can increase your risk by altering urine chemistry or crystallizing in the urinary tract. Over the counter Vitamin C supplements, TUMS, laxatives, calcium supplements (especially when taken outside meals), and vitamin D supplements are just a few examples of medications that can contribute to kidney stone formation.


It's important to be aware of these risk factors and discuss them with your kidney stone specialist or health care provider to help prevent stones and their associated complications. 


How Urine and Blood Laboratory Evaluation Can Help

Urine Testing

Remember those chemistry experiments from school? Pouring one substance into a beaker, watching it react, transform, sometimes resulting in something completely different? It’s a bit like our bodies, isn’t it? We consume a variety of foods and fluids each day, and through the intricate workings of our kidneys, they’re transformed into urine.


But here’s where it gets interesting: certain factors in our diet and lifestyle can increase the likelihood of kidney stones forming, especially in those with genetic predisposition to forming stones. That’s where comprehensive urine testing comes in.


By analyzing a 24-hour urine collection or a 48- hour urine collection sample we can pinpoint what puts someone at risk for kidney stones and offer tailored advice for prevention and treatment.


But the diagnostic journey doesn't end there. Beyond urine analyses, additional tests such as blood tests unveil underlying conditions exacerbating stone formation.


Why Is "Stone Analysis" Important?

Stone Analysis

Did you save your kidney stone? If you did, this is great! Special laboratories can analyze the composition of a kidney stone even years after it has passed, allowing your doctor to customize the treatment strategy to meet your specific needs.


Kidney stones are hard deposits of minerals that form in the kidneys when urine becomes concentrated, allowing these minerals to crystallize and stick together. They can vary in size, ranging from as small as a grain of sand to as large as a golf ball.


The most common symptom they cause is severe pain as they move through the urinary tract but they can sometimes also cause kidney injury or infection by obstructing the urine flow.


There are several types of kidney stones, each formed from different substances:

  1. Calcium-Based Stones: These are the most common type of kidney stones and are usually made of calcium oxalate, though they can also be made of calcium phosphate (which can present as a larger stone).

  2. Uric acid stones: These form when urine is too acidic and can occur in individuals with conditions like gout or those who consume a high-protein diet, or, rarely in other medical conditions as well.

  3. Struvite stones: Also known as infection stones, these form in response to urinary tract infections and are made of magnesium, ammonium, and phosphate. Patients affected by these type of stones may manifest signs of infection.

  4. Cystine stones: These rare stones form in people with a hereditary disorder called cystinuria, which causes the kidneys to excrete excessive amounts of certain amino acids.

  5. Medication-related stones: Certain medications, can crystallize in the urine and form stones. They are usually detected by stone analysis.


Understanding the type of stones you have, is important for determining the underlying cause and developing an appropriate treatment plan.


The Role of Radiology Testing

CT scan for kidney stone assessment

Individuals with a history of kidney stones should undergo imaging tests at diagnosis and annually thereafter to assess the presence of any residual stones in the urinary tract. Identifying the number of stones is important for determining appropriate treatment or recommendations from healthcare providers.


A kidney doctor may use a computer tomography (CT) scan to find stones. This test is considered to be the standard diagnostic study for someone suspected to have symptoms of kidney stones.


Sometimes, because of the cost of the test or when we are worried about radiation exposure, doctors may suggest other tests like X-rays or ultrasound. Most kidney stones can be seen on X-rays, but very tiny ones might not show up. Ultrasound is an option that doesn't expose patients to radiation, which is good for pregnant women or in select patients who need to have exposure to Xray tests often.


Once we figure out if we are dealing with one or more stones, these radiology tests can help us see if the treatments we suggested are working to prevent new stones. The main goal of treatment is to stop new stones from forming and to keep the ones you have from getting bigger.


Medical Treatment for Reducing the Risk of Stone Formation

There are several treatment options available, each tailored to the individual's unique needs. One approach involves modifying the diet based on the results of a comprehensive 24-hour urine analysis. By identifying specific dietary factors contributing to stone formation, such as high levels of oxalate, uric acid or calcium, or low levels of citrate in the urine, we can make adjustments to mitigate these risks.


Girl drinking water

Fluid intake plays a crucial role in preventing stone formation. Drinking plenty of water increases the flow of urine, promotes higher urine volume and dilution, reducing the concentration of minerals prone to crystallization. This simple yet effective measure can significantly decrease the formation of kidney stones. It is important to note that certain medical conditions, such as congestive heart failure (CHF), may require limitations on fluid intake. It is always recommended to consult with your health care provider to determine if this recommendation is safe for you.


Prescription medications

In cases where dietary and lifestyle changes alone are insufficient, prescription medications are recommended. Medications such as thiazide diuretics or potassium citrate, or other medications, can alter urine composition favorably, inhibiting the formation of crystals and preventing stone growth.


Additional treatment and medical care is indicated for complicated stones, as they often require surgical procedures. 


Conclusion

Kidney stones are a common health concern which can be prevented. By combining different approaches, healthcare professionals can develop comprehensive strategies to lower the risk of kidney stone formation and improve overall kidney health.


Here are the key take away points:

  1. The prevalence of kidney stones is high. It varies by region and demographic factors, but it's estimated that around 9% to 19% of people will experience kidney stones at some point in their lives. The risk may be increasing in recent years due to various factors such as dietary habits, dehydration, and metabolic disorders.

  2. A detailed medical history helps identify specific risk factors like diet, environment, genetics, and medication use. 

  3. Comprehensive urine testing provides valuable insights for personalized prevention and treatment strategies.

  4. Radiological imaging plays a key role in detecting and monitoring kidney stones.

  5. Stones can be prevented through a personalized strategy that includes a healthy diet and medical treatment. Prevention is key!

  6. Urology care may be needed for complicated and larger kidney stones. 

  7. Collaboration with your doctors and adherence to personalized treatment plans are essential for kidney stone management and overall kidney health.

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1 Comment


Very interesting! Thank you for all this precious advice!

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