Kidney stones, what’s the solution to this pollution?

Kidney stones

 

Almost 10% of the population is affected but there are simple interventions to help. Kidney stones have even been found in Egyptian mummies so this malady has plagued humanity for quite a while.

 

Usually, you know when you have a kidney stone because the pain is intense and radiates from the flank down to the testicles or labia. You just can’t get comfortable and end up walking into the ER  hunched over. Other conditions may mimic this pain such as an ectopic pregnancy, musculoskeletal conditions and even appendicitis.

 

There may or may not be blood in the urine and fever may be absent as well.

 

Most stones under 5 millimeters will pass on their own. And surprisingly up to 10% of stones that are 1 centimeter (10 milliliters) can pass as well but it may take a month.

 

Fluids are the primary treatment  but certain medications such as tamulosin, may help a stone pass into the urine by relaxing the ureter (the tube to the bladder). Ibuprofen plus acetaminophen (Tylenol) often helps with the pain. Sometimes IV narcotics are required.

 

if the stone doesn’t pass then lithotripsy (shock waves in water under anesthesia) may help to dissolve them or sometimes the stone can be retrieved with a scope.

 

Kidney stones may be increasing with global warming since dehydration is more common and this predisposes to more kidney stones.

 

The most common stone is calcium oxalate followed by calcium phosphate. These 2 stones comprise 75% of all stones. Once again, hydration is the key. Drinking over 2 liters of fluid a day can help dissolve kidney stones.

 

Dietary calcium is quite useful because it binds oxalate in the gut and takes it out of your system.Foods high in oxalates (nuts, spinach, potatoes, tea, and chocolate) can increase the amount of oxalate in the urine so be sure to consume these in moderation.

 

Calcium phosphate stones can be related to hyperparathyroidism (when the gland behind the thyroid produces too much parathyroid hormone), renal tubular acidosis (a kidney condition that causes a buildup of acid in the body), and urinary tract infections.

 

Thiazides diuretics can help with calcium stones because they take calcium out of the urine and direct it back into the blood. These agents are also excellent for high blood pressure as well.

 

Finally potassium citrate, which can be found in fruit juices and lemonade can bind to calcium and remove it from our system.

 

There are other stones too such as uric acid, struvite (magnesium ammonium phosphate) and cysteine (hereditary).

 

Uric acid levels can be reduced with allopurinol or even dissolved by alkalinizing the urine. Infection stones like struvite can be treated with Acetohydroxamic acid (AHA) which acidifies the urine.

 

Dr’s. Rx “Dilution is the solution to the pollution.” Also remember to try and catch the stone with a strainer so that the stone can be analyzed. Treatment is better when you know the type of stone. Kidney stones recur in 50% of people so medicines may need to be utilized in these cases. A urologist can be consulted when a stone will not pass.


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