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Kidney Stones - What Happens

A kidney stone begins as a tiny piece of crystal in the kidney. When the urine leaves the kidney, it may carry the crystal out, or the crystal may stay in the kidney. If the crystal stays in the kidney, over time more small crystals join it and form a larger kidney stone. Most stones leave the kidney and travel through the urinary tract when they are still small enough to pass easily out of the body. No treatment is necessary for these stones. But larger stones may become stuck in the tubes that carry urine from the kidney to the bladder (ureters). This can cause pain and possibly block the urine from flowing to the bladder and out of the body. The pain often becomes worse over 15 to 60 minutes until it is severe. The pain may ease when the stone no longer blocks the flow of urine, and it often goes away when the stone passes into the bladder. Medical treatment is often necessary for larger stones. The smaller a stone is, the more likely it is to exit the body (pass) on its own. About 9 out of every 10 stones smaller than 5 mm and about 5 out of every 10 stones 5 mm to 10 mm pass on their own.1 Only 1 or 2 out of every 10 kidney stones need more than home treatment The average time a stone takes to pass ranges between 1 and 3 weeks,1 and two-thirds of stones that pass on their own pass within 4 weeks of when the symptoms appeared Almost half of all people who get kidney stones will get more stones within 5 years unless they take preventive measures.3 When you have kidney stones several times over a period of years, the length of time between stones tends to get shorter. It is not possible to predict who will have more stones in the future and who will not Problems that may occur with kidney stones include: An increased risk of urinary tract infection, or making an existing urinary tract infection worse Kidney damage, if stones block the flow of urine out of both kidneys (or out of one kidney, for people who have a single kidney). For most people with healthy kidneys, kidney stones do not cause serious damage until they completely block the urinary tract for 2 weeks or longer Kidney stones are more serious for people who have a single kidney or an impaired immune system or have had a kidney transplant. Stones in pregnant women When stones occur during pregnancy, an obstetrician and urologist should determine whether you need treatment. Treatment will depend on your trimester of pregnancy.5 Stones in children Kidney stones are not common in children. When they occur, it is usually between the ages of 8 and 10. Children with kidney stones may also have a urinary tract infection. Often, children with stones also have other medical problems, such as an abnormally developed urinary system, a metabolic disorder, or genetic risks, such as cystic fibrosis.6

Kidney Stones - What Increases Your Risk
Several factors make it more likely you will get kidney stones. Some of these you can control, and others you cannot.

and oxalate-rich foods. which can result in a greater risk for kidney stones. If you think that your diet may be a problem. In one study.Risk factors you can control Risk factors for both new and recurring kidney stones that you can control include: Fluids you drink The most common cause of kidney stones is not drinking enough water. sodium. or high blood pressure Insulin resistance. Some medicines. Getting your recommended amounts of calcium combined with a low-sodium. and a large waist size increased a person's risk for kidney stones Activity level. gout. such as acetazolamide (Diamox). Drinking grapefruit juice may increase your risk for developing kidney stones Diet. weight gain since early adulthood. can cause kidney stones to form Risk factors you cannot control Risk factors for both new and recurring kidney stones that you cannot control include: Age and gender Men between the ages of 30 and 50 are most likely to get kidney stones Postmenopausal women with low estrogen levels have an increased risk for developing kidney stones. low-protein diet may decrease your risk of kidney stones. Women who have had their ovaries removed are also at increased risk A family history of kidney stones A personal history of frequent urinary tract infections Other diseases or conditions. Try to drink enough water to keep your urine clear (about 8 to 10 glasses of water a day). such as antacids or aspirin . such as inflammatory bowel disease. a high body mass index (BMI). increase your risk for developing kidney stones Weight and weight gain. Read supplement labels carefully. cystic fibrosis. and do not take more than the recommended daily doses Levels of calcium affect your risk of kidney stones. hyperparathyroidism. which can occur because of diabetes or obesity Prolonged bed rest Bladder problems caused by spinal cord injury Medicines used to control other conditions or diseases.7 In older people and younger women. People who are not very active may have more problems with kidney stones Medicine. one study shows that eating more calciumrich foods reduces the risk of kidney stones Diets high in protein. schedule an appointment with a dietitian and review your food choices Vitamins C and D can increase your risk of kidney stones when you take more than the daily recommendations. or indinavir (Crixivan). Weight gain can result in both insulin resistance and increased calcium in the urine. such as dark green vegetables.

such as oxalate. as they often occur in family members over several generations.Treatment Overview Your first diagnosis of kidney stones often occurs when you see your doctor or go to an emergency room because you are in great pain. Risk factors for recurring kidney stones that you cannot control include:10 High levels of minerals. Factors that change your urine balance include: Not drinking enough water. minerals. Your stone may not be causing you pain. you have the same treatment options as noted below. Try to drink enough water to keep your urine clear (about 8 to 10 glasses of water a day).Cause Kidney stones may form when the normal balance of water. About 9 out of every 10 stones smaller than 5 mm and about 5 out of every 10 stones 5 mm to 10 mm pass on their own. the salts. he or she may suggest home treatment. either very high or very low. When you don't drink enough water. Most kidney stones are calcium-type-they form when the calcium levels in your urine change. This changes the way the intestines process calcium and other minerals. In this case. people who have inflammatory bowel disease or who have had surgery on their intestines may not absorb fat from their intestines in a normal way. including: . This is the most common cause of kidney stones Medical conditions. and other substances found in urine changes. a person forms kidney stones because the parathyroid glands produce too much of a hormone.1 Only 1 or 2 out of every 10 kidney stones need more than home treatment. and other substances in the urine can stick together and form a stone. in the urine Low urine output (stasis Low levels of citrate. and your doctor may find it during a routine exam or an exam for another condition or disease. kidney stones can run in families. the more likely it is to pass on its own. Kidney Stones . Most small stones [less than 5 mm] move out of the body (pass) without the need for any treatment other than drinking extra fluids and taking pain medicine. In rare cases. salts. Your doctor may suggest that you wait for the stone to pass and take pain medicine or have a procedure to remove the stone. calcium. such as the kidneys being joined (horseshoe kidneys). Gout is one example. over time Kidney Stones . and uric acid.An abnormal urinary tract. Treatment for your first stone If your doctor thinks the stone can pass on its own. How this balance changes determines the type of kidney stone you have. minerals. Many medical conditions can affect the normal balance and cause stones to form.1 The smaller a stone is. and it may lead to kidney stones More commonly. Not all kidney stones are diagnosed because of immediate symptoms. Citrate helps prevent stone formation in some people Abnormal urine pH. Also. and you feel you can deal with the pain. which leads to higher calcium levels and possibly calcium kidney stones.

such as nonsteroidal anti-inflammatories (NSAIDs). Nonprescription medicine.11 Ask your doctor if one of these medicines can help you.Drinking more fluids. or liver disease and are on fluid restrictions. Open surgery. The surgeon passes a very thin telescope tube (ureteroscope) up the urinary tract to the stone's location. ESWL uses shock waves that pass easily through the body but are strong enough to break up a kidney stone. Your options are: Extracorporeal shock wave lithotripsy (ESWL). about 8 to 10 glasses a day. you may need a small hollow tube (ureteral stent) placed in the ureter for a short time to keep it open and drain urine and any stone pieces. where he or she uses instruments to remove the stone or break it up for easier removal. Try to drink 2 glasses of water every 2 hours while you are awake. This treatment is rarely used . Occasionally. You need to drink enough water to keep your urine clear. See a picture of ureteroscopy . See a picture of nephrolithotomy Ureteroscopy. Your doctor can prescribe stronger pain medicine if needed Your doctor may prescribe medicine to help your body pass the stone. may relieve your pain. The surgeon puts a narrow telescope into the kidney through a cut in your back. Calcium channel blockers and alpha-blockers have been shown to help kidney stones pass more quickly with very few side effects. Ureteroscopy is often used for stones that have moved from the kidney to the ureter. See a picture of ESWL Percutaneous nephrolithotomy or nephrolithotripsy. heart. He or she then removes the stone (lithotomy) or breaks it up and removes it (lithotripsy). This procedure may be used if ESWL does not work or if you have a very large stone. The surgeon makes a cut in the side or the belly to reach the kidneys and remove the stone. If you have kidney. This is the most commonly used medical treatment for kidney stones. If your pain is too severe. or if you also have an infection. talk with your doctor before increasing your fluid intake Not drinking grapefruit juice. Drinking grapefruit juice may increase your risk for developing kidney stones Using pain medicine. your doctor will probably suggest medical or surgical treatment. if the stones are blocking the urinary tract .