|
|
If you have a kidney stone, you may already know how painful it can be. Most kidney
stones
pass out of the body without help from a doctor. But sometimes a stone will not just
go
away. It may even get larger. Your doctor can help.
You should call a doctor when you have
1.Extreme pain in your back or side that will not go away.
2.Blood in your urine.
3.Fever and chills.
4.Vomiting.
5.Urine that smells bad or looks cloudy.
6.A burning feeling when you urinate.
These may be signs of a kidney stone that needs a doctor's care.
Your kidneys are bean-shaped organs, each about the size of your fist. They are located
near
the middle of your back, just below the rib cage. The kidneys are sophisticated trash
collectors. Every day, your kidneys process about 200 quarts of blood to sift out
about 2
quarts of waste products and extra water. The waste and extra water become urine,
which
flows to your bladder through tubes called ureters (YOOR-uh-ters). Your bladder (BLAD-ur)
stores urine until you go to the bathroom.
The wastes in your blood come from the normal breakdown of active muscle and from
the
food you eat. Your body uses the food for energy and self-repair. After your body
has taken
what it needs from the food, waste is sent to the blood. If your kidneys did not
remove these
wastes, the wastes would build up in the blood and damage your body.
In addition to removing wastes, your kidneys help control blood pressure. They also
help to
make red blood cells and keep your bones strong.
A kidney stone is a solid piece of material that forms in the kidney out of substances
in the
urine. A stone may stay in the kidney or break loose and travel down the urinary
tract. A small stone
may pass all of the way out of the body without causing too much pain.A larger stone
may get stuck in a ureter, the bladder, or the urethra. A problem stone can block
the flow of urine and cause great pain.
No. There are four major types of kidney stones.
The most common type of stone contains calcium (KAL-see-um). Calcium is a
normal part of a healthy diet.
Calcium that is not used by the bones and muscles goes to the kidneys. In most
people, the kidneys flush out the extra calcium with the rest of the urine. People
who
have calcium stones keep the calcium in their kidneys. The calcium that stays behind
joins with other waste products to form a stone.
A struvite (STROO-vite) stone may form after an infection in the urinary system.
These stones contain the mineral magnesium (mag-NEE-zee-um) and the waste
product ammonia (uh-MOH-nyuh).
A uric (YOOR-ik) acid stone may form when there is too much acid in the urine.
If
you tend to form uric acid stones, you may need to cut back on the amount of meat
you eat.
Cystine (SIS-teen) stones are rare. Cystine is one of the building blocks
that make
up muscles, nerves, and other parts of the body. Cystine can build up in the urine
to
form a stone. The disease that causes cystine stones runs in families.
Kidney stones may be as small as a grain of sand or as large as a pearl. Some stones
are even
as big as golf balls. Stones may be smooth or jagged. They are usually yellow or
brown.
If you have a stone that will not pass by itself, your doctor may need to take steps
to get rid of
it. In the past, the only way to remove a problem stone was through surgery. Now,
doctors have new ways to remove problem stones. The following pages describe a few
of these methods.
Shock Waves
Your doctor can use a machine to send shock waves directly to the kidney stone. The
shock
waves break a large stone into small stones that will pass through your urinary system
with
your urine. The method does not require cutting open the body.
Two types of shock wave machines exist. With one machine, you sit in a tub of water.
With
the other type of machine, you lie on a table.
The full name for this method is extracorporeal (EKS-trah-kor-POR-ee-ul) shock wave
lithotripsy (LITH-oh-TRIP-see). Doctors often call it ESWL for short. Lithotripsy
is a Greek
word that means stone crushing.
Tunnel Surgery
In this method, the doctor makes a small cut into the patient's back and makes a
narrow
tunnel through the skin to the stone inside the kidney. With a special instrument
that goes
through the tunnel, the doctor can find the stone and remove it. The technical name
for this
method is percutaneous (PER-kyoo-TAY-nee-us) nephrolithotomy
(NEF-row-lith-AH-tuh-mee).
Ureteroscope
A ureteroscope (yoo-REE-ter-uh-scope) looks like a long wire. The doctor inserts
it into the
patient's urethra, passes it up through the bladder, and directs it to the ureter
where the stone
is located. The ureteroscope has a camera that allows the doctor to see the stone.
A cage is
used to catch the stone and pull it out.
Ask your doctor which method is right for you.
The best way for your doctor to find out what kind of stone you have is to test the
stone
itself. If you know that you are passing a stone, try to catch it in a strainer.
Your doctor may ask for a urine sample or take blood to find out what is causing
your stones.
You may need to collect your urine for a 24-hour period. These tests will help your
doctor
find ways for you to avoid stones in the future.
Drink more water. Try to drink 12 full glasses of water a day. Drinking lots of water
helps to
flush away the substances that form stones in the kidneys.
You can also drink ginger ale, lemon-lime sodas, and fruit juices. But water is best.
Limit
your coffee, tea, and cola to one or two cups a day because the caffeine may cause
you to lose
fluid too quickly.
Your doctor may ask you to eat more of some foods and to cut back on other foods.
For
example, if you have a uric acid stone, your doctor may ask you to eat less meat,
because
meat breaks down to make uric acid.
The doctor may give you medicines to prevent calcium and uric acid stones.
Most stones will pass out of the body without a doctor's help.
See your doctor if you have severe pain in your back or side that will not go away.
See your doctor if you have blood in your urine (urine will appear pink).
Drink lots of water to keep more kidney stones from forming.
When you pass a stone, try to catch it in a strainer to show to your doctor.
Talk to your doctor about how to avoid more stones.
American Foundation for Urologic Disease
1128 North Charles Street
Baltimore, MD 21201
Tel: (800) 242-2383
or (410) 468-1800
Web site: http://www.afud.org
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
Tel: (800) 622-9010
or (212) 889-2210
Web site: http://www.kidney.org
Oxalosis and Hyperoxaluria Foundation
12 Pleasant Street
Maynard, MA 01754
Tel: (978) 461-0614
Web site: http://www.ohf.org
The individuals listed here provided editorial guidance or facilitated field testing
for this
publication. The National Kidney and Urologic Diseases Information Clearinghouse
(NKUDIC) would like to thank these individuals for their contribution.
John Aspin, M.D.
The University of Chicago Hospitals
Chicago, IL
Anne Gaddy
Zacchaeus Free Clinic
Washington, DC
Pamela Grigsby, P.A.
Washington Nephrology Associates
Bethesda, MD
Charlotte Szromba, M.S.N., R.N., C.N.N.
The University of Chicago Hospitals
Chicago, IL
Judith Thomas
American Society of Nephrology
Washington, DC
Gail Wick, R.N., B.S.N.
American Nephrology Nurses' Association
Atlanta, GA
National Kidney and Urologic Diseases Information
Clearinghouse
3 Information Way
Bethesda, MD 20892-3580
E-mail: nkudic@info.niddk.nih.gov
Web Site: http://www.niddk.nih.gov/
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a
service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The NIDDK is part of the National Institutes of Health under the U.S. Public Health
Service.
Established in 1987, the clearinghouse provides information about diseases of the
kidneys
and urologic system to people with kidney and urologic disorders and to their families,
health
care professionals, and the public. NKUDIC answers inquiries; develops, reviews,
and
distributes publications; and works closely with professional and patient organizations
and
Government agencies to coordinate resources about kidney and urologic diseases.
Publications produced by the clearinghouse are carefully reviewed for scientific
accuracy,
content, and readability.
This e-text is not copyrighted. The clearinghouse encourages users of this e-pub
to duplicate
and distribute as many copies as desired.
NIH Publication No. 98-4154
March 1998
e-text updated: 27 July 1998
Return
toPatient
Information