Kidney Stones 101

What Should I Do If I Have Recurrent Kidney Stones?

Kidney stone disease affects millions of individuals, and is among the top 10 causes of Emergency Room visits, and by far the most costly of all. It causes severe pain and also potentially life-threatening infectious complications, compromise of renal function or even kidney damage or loss.

First, let's take a look at recurrent kidney stones. Research indicates a person who experiences a kidney stone is more likely than others to form another stone in the future. In fact, kidney stones impact approximately 12% of the population during their lifetime, and kidney stone recurrence rates approach 50% at 10 years, according to the American Urological Association.

Kidney stone prevention is important for men and women of all ages. If people prioritize kidney stone prevention, they could reduce the risk of kidney stones.

Is It Possible to Prevent Kidney Stones?

If a person experiences a kidney stone, the risk that he or she will develop another stone in the future increases. Fortunately, there are many ways to limit the risk that kidney stones will become ongoing problems, such as:    

  1. Stay hydrated. Strenuous exercise, hot yoga, and other physical activities cause excessive sweating. Meanwhile, the more a person sweats, the less likely it becomes that he or she will urinate, and this ultimately may increase an individual's susceptibility to kidney stones. Thankfully, staying hydrated while participating in physical activities can help tremendously.

  2. Limit alcohol consumption. Drinking alcoholic beverages not only increases water loss in form of urine and may cause some degree of dehydration, it also may cause a person's uric acid levels in the blood to rise, increasing the likelihood of uric acid kidney stones. Limiting alcohol consumption and drinking water with cocktails enables a person to reduce the risk of developing kidney stones.

  3. Eat calcium-rich foods (yes!). A low-calcium diet increases a person's risk of kidney stones and osteoporosis. Those who consume a diet that contains the required daily amounts of calcium (milk, cheese, and other calcium-rich foods) may be better equipped than others to combat calcium oxalate kidney stones. This may sound paradoxical but studies have proven that limiting calcium intake actually increases kidney stone risk.

  4. Cut down on animal protein. Beef, poultry, and pork are among the foods with the highest concentrations of animal protein – something that increases urine acidity and may lead to the formation of kidney stones. Limiting or avoiding foods high in animal protein may be beneficial, particularly for individuals who want to prevent kidney stones from recurring. 6-8 Oz / day

  5. Avoid too much vitamin C supplements. Research indicates high doses of vitamin C supplements may increase an individual's risk of developing kidney stones. Conversely, vitamin C in food does not carry the same risks. Therefore, individuals should strive to get vitamin C from foods, not supplements.

  6. Increase citric acid intake. Prevents kidney stones and is found in lime and lemon juice, etc.

The aforementioned measures have been shown to reduce an individual's risk of recurrent kidney stones. Yet it is important to note that kidney stones can affect any person, at any time. Despite an individual's best efforts, a person may experience recurrent kidney stones.

For those who need to address recurrent kidney stones, a consultation with a urologist is ideal. A urologist learns about each patient's recurrent kidney stones and offers personalized treatment options. By doing so, a urologist helps kidney stone patients achieve long-term relief.

What Options Are Available to Treat Recurrent Kidney Stones?

A urologist allocates significant time and resources to learn about a patient and offer him or her a personalized surgical treatment to address recurrent kidney stones. Initially, urologists may use dietary changes and medical treatments to address recurrent kidney stones. If these treatments fail to deliver the desired results, a urologist then will explore surgical options with a patient.

Common nonsurgical treatments for recurrent kidney stones:

  • Dietary Changes: A urologist may recommend dietary changes designed to help an individual reduce the rate of kidney stone formation. Recommended dietary changes vary based on the patient and his or her health, and these changes may include an increase in fluid intake, increase in intake of foods that contain citrate, reduction in salt intake, and reduction in red meat consumption.

  • Medical Treatment: Alpha blockers and other medications have been shown to help facilitate the passage of kidney stones lodged in the ureter. Also, kidney stone medications are available to help individuals dissolve existing kidney stones and prevent kidney stones from developing.

Various surgical treatments are available to help patients eliminate kidney stones. A urologist will learn about a patient's kidney stones, medical history, and review other health factors to determine if surgical treatment is a viable option.

Common surgical treatments used to eliminate kidney stones:

  • Utereroscopy and Laser Lithotripsy: Involves the insertion of a small fiber optic device (ureteroscope) through the urethra and bladder and into the ureter; a surgeon uses this device to visualize the stone(s), then extracts the stone via small baskets. The surgeon also uses a laser beam to fragment the larger kidney stones and then remove the pieces. This treatment requires no incisions, and a surgeon may leave a stent in the ureter following surgery to help a person pass any remaining kidney stone particles.

  • Percutaneous Nephrolithotomy (PCNL): Addresses a kidney stone that exceeds 2 cm or larger or a kidney stone that is lodged in a tough-to-reach location. PCNL involves the use of a small incision in the back to insert a tube into the kidney. Next, a surgeon uses several instruments to treat a kidney stone.

  • Extracorporeal Shock Wave Lithotripsy (ESWL): Uses shock waves to dissolve a kidney stone into smaller pieces. ESWL is a simple, quick, and effective treatment, and it generally takes about one hour to perform. During the procedure, a patient first lies down on a water-filled cushion, and a surgeon uses X-rays or ultrasound tests to determine the location of a kidney stone. After a surgeon finds the kidney stone, he or she sends high-energy sound waves through a patient's body. The sound waves do not harm the muscle or skin tissue; instead, they break the kidney stone into smaller pieces that can pass.

Prior to administering any of the aforementioned surgical treatments, a urologist will discuss each procedure with a patient and respond to any concerns or questions. Following surgical treatment, a urologist will provide a patient with a series of recovery guidelines. The urologist may recommend dietary changes and medications to further reduce a patient's risk of recurrent kidney stones and provide kidney stone prevention tips as well.

Schedule a Consultation with Dr. Arash Akhavein, the Kidney Stone Expert at Comprehensive Urology in Los Angeles

Dr. Arash Akhavein is a fellowship-trained endourologist who subspecializes in all kidney stone treatments and especially the cutting edge minimally invasive laser surgical techniques to break and remove stones, mostly outpatient with no need for hospital admission. To find out more, please contact Comprehensive Urology at (310) 278-8330 to schedule a kidney stone treatment consultation with the “stone expert”.

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Written by: Dr. Arash Akhavein

Sydney Sharon