Kid­ney stones: Here’s what you need to know

Style Magazine - - Style | Promotion - BY DR DEVANG DE­SAI For more de­tails visit www.toowoom­bau­rol­ogy.com.au or call 4632 8481.

What is the risk of de­vel­op­ing kid­ney stones? Stone dis­ease is very preva­lent.

It is es­ti­mated 10% of the pop­u­la­tion will de­velop stone dis­ease in their life­time.

A per­son who de­vel­ops a kid­ney stone has a 50% risk of de­vel­op­ing an­other stone in the next 10 years. Are there dif­fer­ent types of kid­ney stones? Yes, there are var­i­ous types of stones — cal­cium ox­alate, uric acid, triple phos­phate, cal­cium phos­phate and cys­tine stones. Can some stones be dis­solved with med­i­ca­tion? Uric acid stones that are small can be dis­solved with med­i­ca­tion if they do not cause ob­struc­tion (pain, fever). What if I have re­cur­rent stones? Re­cur­rent stone for­m­ers should get their stone an­a­lysed to eval­u­ate the type of stone.

They must also get a 24-hour urine anal­y­sis to eval­u­ate why they are form­ing re­cur­rent stones. What diet do I need to fol­low to pre­vent re­cur­rent stones? General ad­vice is to drink plenty of water, re­duce salt in the diet and re­duce an­i­mal pro­tein.

It is im­por­tant to have a nor­mal in­take of cal­cium.

A high in­take of an­i­mal pro­tein can in­crease stone for­ma­tion.

Avoid large quan­ti­ties of meat, eggs and dairy prod­ucts.

Do not add salt to your food at the ta­ble. What are the avail­able op­tions to treat uri­nary stones? There are three treat­ment op­tions —

Stones can be treated pro­vided pa­tients do not have a con­cur­rent in­fec­tion.

If there are signs of in­fec­tion (fever, chills, etc) then drainage of the kid­ney as a tem­po­rary mea­sure is nec­es­sary, fol­lowed by de­fin­i­tive treat­ment of the stone at a later date.

ESWL (ex­tra­cor­po­real shock wave lithotripsy) — the stone is bro­ken us­ing sound waves and the re­sul­tant stone frag­ments are passed along with urine.

This pro­ce­dure can be used in small ra­dio-opaque (those seen on x-ray) stones.

ESWL can­not be done in preg­nancy, pa­tients on blood-thin­ning med­i­ca­tion (eg war­farin, xarelto, dabi­ga­tran, clopi­do­grel, bril­lanta), very over­weight in­di­vid­u­als.

Ureteroscopy and lithotripsy – this in­volves pass­ing a fine te­le­scope via the uri­nary tract and frag­ment­ing the stone us­ing ei­ther a man­ual stone break­ing de­vice or a holmium laser. The frag­ments are ei­ther re­trieved us­ing a bas­ket or are small enough to be passed in the urine. This pro­ce­dure can be utilised for most stones.

PCNL (per­cu­ta­neous nephrolitho­tomy) – this in­volves punc­tur­ing the kid­ney via a small hole in the back and ex­tract­ing the stone frag­ments after break­ing the stone. This pro­ce­dure is usu­ally re­served for large stones or stones in ca­lyceal di­ver­tic­ula (small pock­ets in the kid­ney).

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