What is a kidney stone and how do I know if I have a kidney stone?
A kidney stone is a mineral that develops in the drainage system of your kidney, where the urine is deposited after being produced by the kidney. They are most commonly made of a combination of naturally occurring compounds called Calcium and Oxalate. Kidney stones usually develop for months to years with no symptoms, until they move and block off the tube called the ureter, which connects kidney and bladder. Once this happens you may experience the following symptoms:
- severe pain on either side of your back just below your ribs
- pain that travels down towards your genitals
- unable to get comfortable in any position
- blood in the urine
- nausea or vomiting
- feeling the need to urinate frequently and urgently
How common are kidney stones?
Kidney stones are becoming more common, especially in the United States. Approximately one in eleven Americans will develop a kidney stone at least once in their life. Half of people with a kidney stone will have another within 5 years.
I hear many people pass their own kidney stones. Is there a time when kidney stones are an emergency?
If you are experiencing any of the symptoms above or are concerned you may be having a kidney stone, you need to be evaluated by a healthcare provider as soon as possible.
A kidney stone with an infection can be life threatening. If you are having fever and chills or think you may have a urinary tract infection along with the symptoms above, this could represent a life-threatening emergency and requires evaluation in the Emergency Room immediately.
As we are currently in the midst of a pandemic of the COVID-19 virus, the Urology Department of SUNY Upstate has established Urology specific urgent care hours at our 550 Harrison Street location.
How will my kidney stone be diagnosed?
Your healthcare provider will start by obtaining a medical history, physical examination, and possibly blood work and imaging tests; they may check your urine for signs of infection. When passing a kidney stone, your provider will want to know the size and location of the stone, and if it is causing obstruction, known as hydronephrosis, to your kidney. The most common ways of determining this are with a CT scan or ultrasound of the kidneys and traditional X-ray.
Can I pass a kidney stone?
Yes. Most kidney stones are small enough to pass. The American Urological Association recommends that Patients with uncomplicated ureteral stones ≤10 mm should be offered observation, and those with distal stones of similar size should be offered treatment with medicines called α-blockers, which may increase the rate of passing stones.
What treatments are available if I am having a stone during the COVID-19 pandemic?
During these challenging times, you may have heard that elective surgical procedures across the nation have been delayed. Concerning treatment of kidney stones, it is important to know that the American Urological Association states that for patients with obstructing stones and suspected infection, clinicians must urgently drain the kidney with a stent or nephrostomy tube and delay stone treatment. Despite the ongoing COVID 19 pandemic, we are able to perform these procedures in ways to keep you safe. Every patient is unique and you will need to have this conversation with your healthcare provider.
How do I prevent kidney stones?
There are many different kinds of kidney stones, and your doctor will go over specific strategies to prevent kidney stones based upon your unique situation.
For all patients, however, the following things apply:
- Drink water to keep your urine output at 2.5 liters per day (85 Ounces).
- Limit your dietary sodium (salt) intake.
- Do not restrict your dietary Calcium intake. In fact, adding calcium to oxalate rich foods like spinach or nuts can reduce oxalate absorption and prevent kidney stones.
- Try to keep protein (meat, chicken, etc.) to about 4 Ounces per serving (the size of the palm of your hand).
I heard you can blast the stone. How do I know if this is right for me?
Shockwave Lithotripsy uses sound-waves which are passed through the skin to break up a stone. The procedure is non-invasive and successful in a variety of situations. You will likely see debris in your urine after the procedure as the stone fragments pass.
What are other treatment options?
Ureteroscopy is when a urologist uses a tiny, moveable, telescope to inspect the inside of your kidney. This procedure is usually done under general anesthesia or sedation and can be used to diagnose and treat a variety of conditions. For kidney stones, the surgeon can use a laser to break up your kidney stones before removing the pieces with a small basket.
Percutaneous Nephrolithotomy is a procedure, usually done for very large kidney stones, where your urologist will place a small tube in your kidney and then be able to break up your kidney stones using a telescope with a device that breaks up stones and sucks out the pieces at the same time.
I have had a kidney stone in the past. Is my family at increased risk or should they see a urologist?
It depends. The causes of the most common types of kidney stones are not fully understood and there is no single gene responsible for the most common types of kidney stones which are made of Calcium and Oxalate. Your family members may be at increased risk partly due to genetics, but also partly due to shared dietary and exercise habits. Some rare types of kidney stones, such as those made of cystine, are much more strongly impacted by genetics. You should ask your Urologist if they would like to evaluate your family members or refer you for further genetic testing.