Nephrolithiasis, or a kidney stone, begins with crystallization of minerals from urine into a stone.
Symptoms of Kidney Stones
Typically kidney stones formed in the kidney do not cause many symptoms. If a kidney stone migrates into the ureter, the drainage tube between the kidney and bladder, it can block the flow of urine out of the kidney. The blockage leads to pressure in the kidney and renal colic, an excruciating pain that often starts in the flank and shoots into the lower abdomen or groin in waves. There can also be nausea and vomiting. “Passing a kidney stone” refers to the time in which a stone is making its way through the ureter into the bladder.
Treatment of Kidney Stones
Personalized treatment of kidney stones depends on size, location, hardness, stone type, and symptoms. Options include:
- Observation
- Medications to help with passage and pain
- Medications to dissolve kidney stones
- Extracorporeal Shock Wave Lithotripsy (ESWL): fragmenting stones with a machine using sound waves
- Ureteroscopy with Laser Lithotripsy: passage of small instruments into the urinary tract to fragment and remove stones from the ureter or kidney
- Percutaneous Nephrolithotomy (PCNL): tunneling small instruments through the back directly into the kidney to remove larger stones
- Robotic and laparoscopic surgery to remove very large stones or even the whole kidney
Prevention of Kidney Stones
Prevention of kidney stones involves blood testing, stone composition analysis, and specialized urine testing. Often hydration and dietary changes can be used to prevent stone formation, but in some cases medication can be beneficial.
The doctors at Fore River Urology are skilled in the evaluation, treatment, and prevention of kidney stones. They will review all options, personalized to your individual situation. For an appointment, please call 207-518-6600.
General Dietary Recommendations:
- Drink plenty of fluid: 2-3 quarts/day
- This includes any type of fluid such as water, coffee and lemonade which have been shown to have a beneficial effect with the exception of grapefruit juice and soda.
- This will help produce less concentrated urine and ensure a good urine volume of at least 2.5L/day
- Limit foods with high oxalate content
- Spinach, many berries, chocolate, wheat bran, nuts, beets, tea and rhubarb should be eliminated from your diet intake
- Eat enough dietary calcium
- Three servings of dairy per day will help lower the risk of calcium stone formation. Eat with meals.
- Avoid extra calcium supplements
- Calcium supplements should be individualized by your physician and registered kidney dietitian
- Eat a moderate amount of protein
- High protein intakes will cause the kidneys to excrete more calcium therefore this may cause more stones to form in the kidney
- Avoid high salt intake
- High sodium intake increases calcium in the urine which increases the chances of developing stones
- Low salt diet is also important to control blood pressure.
- Avoid high doses of vitamin C supplements
- It is recommend to take 60mg/day of vitamin C based on the US Dietary Reference Intake
- Excess amounts of 1000mg/day or more may produce more oxalate in the body