Kidney stones: Here’s what you need to know
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).