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KIDNEY STONES - THE FACTS
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 | | If you know anyone who’s passed a kidney stone, you’ve already heard how dreadfully painful it can be.
Unfortunately, roughly one out of every twenty of us will develop a kidney stone at some point during our lifetime. That makes it a relatively common condition … and means that around 600,000 patients will visit emergency rooms and more than 2.5 million will see other healthcare providers, this year, because of painful symptoms related to kidney stones (the condition properly known as nephrolithiasis or urolithiasis).
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Males tend to develop kidney stones more often than females and Caucasian males develop the condition more often than African American males. Kidney stones develop more frequently as men hit their forties and the likelihood of developing a kidney stone continues to rise until they reach their seventies. Those who’ve had one or more kidney stone’s are more prone to develop them than others. More importantly, though the reasons remain unclear, kidney stones are more common today than they were only a couple of decades ago.
Kidney stones (sometimes known as renal calculi) are essentially hard mineral and or crystalline deposits that have formed within your kidney or urinary tract. They can develop as a result of a number of factors—dehydration, diet or infection to diabetic medications or any condition that results in turbid urine or an increased concentration of oxalate, calcium or uric acid, in your urine. The most common type of kidney stone contains calcium, but the exact composition of a given kidney stone will depend on what caused it.
The stones typically form when particles and minerals within urine crystallize and settle against the inner lining of your kidneys. Over time, those crystallized particles can combine and form a hard mass or stone.
There are Actually Four Types of Kidney Stones:
- Calcium Stones (Calcium and Oxalate or phosphate): Four out of five kidney stones are calcium stones.
- Struvite Stones: More common in women than men, struvite stones are often large.
- Uric Acid Stones: Formed of uric acid, they are a byproduct of protein metabolism.
- Cystine Stones: These stone form in individuals with a hereditary disorder that causes kidneys to excrete an excessive amount of certain cystinuria (amino acids). Cystine stones are rare, representing only a small percentage of kidney stones.
There are a number of factors that can result in a high concentration of any of these substances in the urine. For instance, excess calcium can be the result of ingesting too much vitamin D, using diuretics or having undergone treatment with thyroid hormones. Similarly, struvite stones are often the result of chronic urinary tract infections and uric acid stones may develop if you have a high-protein diet, certain genetic factors or after you've undergone chemotherapy.
Kidney Stones Don’t Always Result in Easily Observable Symptoms
That’s right; kidney stones are frequently revealed when a patient has an X-ray for some unrelated condition or when they receive medical care for other issues, such as chronic urinary tract infections. The pain that’s commonly associated with kidney stones only becomes distressing when the stone breaks free and starts working its way down through, the connecting tube, (the ureter), from the kidney to the bladder.
Of course, if they dislodge and pass while they are still relatively small, kidney stones are eliminated harmlessly—through the urine. In the cases you’ve heard the most about however, it’s a larger kidney stone that slips free and it is therefore unable to pass comfortably through the ureter. As it attempts to, the stone can cause pain and may become an obstruction that blocks the natural flow of urine from the kidney. They’re a common source of pain centered around the groin; flank or abdomen – and can cause blood to appear in your urine.
Symptoms Associated With Kidney Stones Can Vary Depending on the Stone’s Size and Location
Most kidney stones are too small to cause notable or distressing symptoms – as mentioned above. However, if a larger kidney stone passes into the ureter or causes a blockage it can result in symptoms such as:
- Feeling a frequent urge to urinate, or a burning sensation while urinating.
- Severe back pain or back aches on one or both sides.
- Cloudy, bloody or smelly urine.
- Nausea or vomiting – feeling or getting sick.
- Fever and chills.
- Experiencing sudden, unexplained, spasms of debilitating pain (uteric colic or renal) …that will typically originate in the back below your ribcage, and radiate around the abdomen, and sometimes out to the groin area and genitalia.
*The above may also be symptoms of cystitis or a urinary tract infection -- which develop more frequently in young women than kidney stones. If you experience one or more of the symptoms above, seek medical advice.
There Are a Variety of Conditions That Can Cause Kidney Stones to Develop:
The kidneys are fist-sized, bean-shaped, organs located in back of the abdomen (one on each side of the spine). They remove excess fluids—waste and unneeded electrolytes from the blood in the form of urine via the ureter. The ureter carries urine from the kidneys to the bladder; where it is stored until it’s eliminated from the body. The crystals that develop into kidney stones may form if urine becomes too concentrated, too alkaline or too acidic.
Various factors can contribute to those changes in the urine …from the effects of diet, climate, lifestyle, certain medical conditions, heredity, and the aforementioned diabetes related drugs.
For Instance:
- Hypercalciuria (high calcium): Can cause calcium phosphate or calcium oxalate stones to form.
- Gout: Can increase the amount of uric acid in your urine and cause uric acid stones to form.
- Hyperparathyroidism: May also increase your risk of developing a kidney stone.
- Renal Tubular Acidosis: Can increase your risk of developing kidney stones.
- Inherited Metabolic Conditions: Such as cystinuria or hyperoxaluria can increase your risks.
- Certain Drugs: also increase your risk of developing kidney stones. These include diuretics, the protease inhibitor Indinavir (Crixivan), a drug used to treat HIV and even antacids that contain calcium.
If you have inflammatory bowel disease, an ostomy surgery (colostomy, ileostomy, urostomy, stoma) or intestinal bypass surgery; it is also more likely that you will develop a kidney stone during your lifetime.
Remember, relatively small kidney stones can pass into your bladder without resulting in any pain or permanent damage. Even so, it is important to establish the underlying cause of the stone’s development, so that you can take steps to reduce the chances that you’ll form another stone in the future. In some cases, you can prevent or dramatically lessen chances of developing a kidney stone simply by drinking more water or changing your diet.
You can read more about or kidney stones or right here.
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Nabet G.Kasabian MD, FACS
103 East 80th Street (at Park Avenue)
New York, NY 10075
Tel: 212-535-0755
Fax: 212-744-4539
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