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Monday Medical: Causes, treatment, prevention of kidney stones

Mary Gay Broderick
For Steamboat Pilot & Today

Diet and lifestyle changes have increased kidney stone rates during the past few decades, but making healthy choices can help prevent stones from developing in the first place or even lower their re-occurrence.

“About one in every 11 people in the U.S. will get kidney stones during their lifetime,” said Dr. Jamie VanOveren, a urologist in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center.

What is a kidney stone?

A kidney stone is a hard, stone-like object that forms in the kidneys and is made of chemicals and salts found in urine. Most people have enough liquid in their kidneys to wash out these chemicals, but when there is too much waste in too little liquid, crystals can form and increase in size.



When this occurs, a stone could stay stuck in the kidney or travel down the urinary track and become lodged in the ureters. While some smaller stones may pass out of the body in urine without too much trouble, bigger ones can block the flow of urine in the kidney, ureter, bladder or urethra, and cause tremendous irritation.

“Kidney stone pain can be one of the worst a person might ever experience in their life,” said VanOveren. “It can be very debilitating.”



What causes kidney stones?

According to VanOveren, diet and lifestyle factors can put a person at a higher risk of developing kidney stones. Those include:

  • A diet high in animal protein.
  • A diet with too few fruits and vegetables.
  • A diet lacking enough hydration of primarily water.
  • A history of hypertension and diabetes.

Still, even people making healthy choices can find themselves with kidney stones.

“Genetics can play a role,” he said, adding that having family members with kidney stones can make a person more likely to get them.

Historically, kidney stones affect people in middle age, with men at a higher risk than women. In recent years, however, a growing number of women have been afflicted with kidney stones, and physicians suspect that the culprit is a growing obesity rate.

Kidney stone symptoms

Intense flank pain along either side of the body, back pain, nausea, vomiting and blood in the urine are symptoms of kidney stones.

“If you have kidney stones, the pain may fluctuate a little bit, but it’s not going to go away,” said VanOveren. “It requires medical attention and a CT scan to determine a treatment plan depending upon the size and location of the stone.”

He explained that the further down and smaller the stone is, the more likely patients could pass it on their own. A larger stone located higher up near the kidney likely will require intervention.

Treatment options

A patient can take a wait-and-see approach if the stone is on the smaller size and the pain is tolerable. If the patient hasn’t passed the stone within two weeks, or if at any time the patient is in too much discomfort, options include:

  • Lithotripsy, or ESWL, where high-energy shock waves from outside the body break up the kidney stone so it can be passed.
  • Ureteroscopy, during which a scope pulls out or breaks up the stone.

Both techniques are outpatient procedures, and providers will want to examine the stone to understand why a patient developed it to help prevent future ones.

“Typically, there are no long-lasting effects,” said VanOveren. “Kidney function returns to normal, and a person can return to their usual activities, including work and other parts of an active lifestyle, within a few days.”

Prevention

Unfortunately, there is a 50% chance that a person whose had kidney stones will experience a re-occurrence within the next 10 years. But a few changes can make a difference.

  • Keep hydrated and drink 2.5 to 5 liters of water daily.
  • Decrease sodium intake, as a high salt diet can lead to an increase in urine crystals.
  • Consume between 1,000 to 1,200 grams of dairy per day.
  • Limit “oxalate” foods such as peanuts, spinach, chocolate and sweet potatoes, as well as red meat.
  • Increase fruits, vegetables and citrates such as unsweetened lemonade.

“Try and maintain a healthy diet and lifestyle, as those two things can help prevent kidney stones as well as decrease your chance of getting them again,” said VanOveren.

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.


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