Q&A Topic: Kidney Stones
Warren Bromberg, MD, FACS
Q. What is a kidney stone?
A. Located on either side of the backbone, the two kidneys filter the blood, creating urine which is then propelled down very thin tubes (ureters) to the bladder. A stone is rock-like material formed within the kidney. When a stone passes out of the kidney and enters the ureter, the tube becomes blocked, urine backs up, the kidney swells and pain results. Most stones have a calcium component, and are caused by inadequate fluid intake, an overabundance of calories, and excessive salt intake. Some stones have a uric acid component, and are caused by an excessive intake of meat. Genetics, hormone imbalances, and certain medications can also cause stones. Most stones are less than one-quarter inch in diameter, though some are much larger.
Q. What are the symptoms of a kidney stone?
A. Typical symptoms are waves of agonizing pain; nausea and vomiting; and blood in the urine. More men than women form stones, which typically occur after one’s forties. Non-urgent symptoms can be evaluated by a primary care physician. However, if you experience extreme pain and vomiting, or a fever, go to an urgent care facility, such as a hospital ER. Diagnosis is made by an ultrasound of the kidney or CAT scan of the abdomen. Other diagnostics include a urine sample to test for blood and infection along with blood tests to check uric acid, calcium, and kidney function.
Q. What are my treatment options?
A. A small stone may only take a few days to “pass” from your body through urine. In this circumstance the doctors at Northern Westchester Hospital (NWH), usually treat the symptoms with medication for pain and nausea and allow passage of the stone as an outpatient. Uric acid-type stones can sometimes be dissolved with medication. A large stone blocking a kidney, or a stone associated with an infection, can be life-threatening. At NWH, a urologist may advise one of three surgeries: (a) In an outpatient procedure, external shock waves directed at the stone shatter it and turn it into sand, so it washes from the body; (b) a miniaturized telescope passed up the ureter enables a special laser to break the stone into tiny fragments; or (c) if the stone is very large, a telescope is passed through the back directly into the kidney to fragment the stone and pull it out. NWH has a state-of-the-art facility for managing kidney stones of all types, providing the best option to treat each stone very successfully.
Q. Can kidney stones be prevented?
A. Once a stone is removed, if a person does not change his or her diet or fluid intake, there’s a 70 percent chance another will form. You can start preventing calcium stones by remaining well-hydrated—water, lemonade, green tea, coffee, and fruits are good fluid sources. Also avoid consuming large amounts of dark leafy tea, peanuts, Vitamin C tablets, spinach, kale, and salt. Help your body avoid making the uric acid-type stone by avoiding eating excess meat, whether red meat, chicken, or fish. If you are a recurrent stone maker, your physician may recommend a more complete evaluation and medication.
Learn More About Dr. Bromberg
Co-Director, Institute for Robotic & Minimally Invasive Surgery
Northern Westchester Hospital
Northern Westchester Hospital is a proud member of Northwell Health.