The University of Alabama at Birmingham

12/09/2024 | News release | Distributed by Public on 12/09/2024 16:05

What are kidney stones? A UAB expert breaks down the signs, prevention and treatment options for kidney stone disease

Written by: Teresa Hicks
Media contact: Micah Hardge

[Link]Click image to enlarge.
Graphic by: Jody PotterKidney stones can quietly form in the urinary tract, often without any immediate signs or symptoms. While many people recognize kidney stone disease only when pain strikes, it is important to understand that the disease can have subtle, silent signs that go unnoticed.

"About one in 10 people will have a kidney stone in their lifetime," said Kyle Wood, M.D., associate professor in the University of Alabama at Birmingham Department of Urology. "Most people have calcium oxalate kidney stones. When the stone starts to move out of the kidney into the ureter, the tube that connects the kidney to the bladder, this is when people experience significant pain."

These solid crystals develop when certain substances in the urine combine, and the type of stone formed depends on the specific composition of the urine. Identifying the early symptoms is crucial for preventing complications and managing kidney stone disease effectively.

Risk Factors

Kidney stone disease is closely associated with various health conditions, including obesity, diabetes, hypertension, and heart disease. Lifestyle factors, particularly dietary habits, are major contributors to the development of kidney stones. Alabama is part of the Kidney Stone Belt, a section of the country that has higher prevalence of kidney stones.

Wood said people who are dehydrated or do not drink enough fluids are at increased risk.

"If your diet is high in sodium or high in protein, that can also increase your risk," Wood said. "Not eating enough fruits and vegetables can raise your risk as well."

Genetics can contribute to kidney stone disease as people with a family history of kidney stones may have a higher chance of developing them.

Treatments available at UAB
UAB houses a comprehensive kidney stone clinic that takes a personalized approach to patient care, conducting metabolic and dietary evaluations for everyone. The clinic specializes in kidney stone surgeries, with world-renowned surgeons leading the field. UAB focuses on stone disease as a chronic disease that warrants a thorough and thoughtful workup and individualized treatment plan.

Preventative Measures

Staying hydrated is the most important step in preventing kidney stones. Unless limited by a medical condition, aim for around 3 liters (or 96 ounces) of fluid intake daily to keep the kidneys well-flushed. Reducing salt is essential-read food labels carefully and try to avoid high-sodium options, particularly processed foods, which are often loaded with salt.

"Keeping your sodium intake below 2,000 milligrams per day is ideal," Wood said. "Additionally, a balanced diet rich in fruits, vegetables and normal protein levels supports overall kidney health. Regular exercise and maintaining a healthy weight can further reduce the risk of kidney stones and improve overall wellness."

Silent Signs

Most people experience significant pain when a stone enters the ureter. However, because it is so narrow, even small stones can become lodged. When this happens, the urine backs up in the kidney, leading to intense pain often accompanied by nausea and vomiting. Until the stone passes, severe discomfort is common.

"Stones in the kidney that aren't causing a blockage may also result in pain, though sometimes people experience no pain at all," Wood said. "In these cases, the first noticeable symptom might be blood in the urine (sometimes microscopic) or recurrent urinary tract infections."

Kidney Stone Removal

When kidney stones are not obstructing the kidney, causing symptoms, or presenting any risk of harm, monitoring them is often the best approach. However, when a stone is blocking the kidney, is large or numerous, or leads to discomfort and other symptoms, intervention becomes necessary.

Shockwave lithotripsy uses energy generated outside the body, which is directed at the stone to break it into smaller fragments.

Ureteroscopy and stone removal involves using small cameras that are inserted into the urinary tract to locate the stone. Lasers and baskets are used to break it apart and remove it.

Percutaneous nephrostolithotomy involves surgery through the back, using small cameras to access the kidney. It is more invasive and carries a higher risk compared to other methods.

"Sometimes, this intervention involves medication to support the body in passing the stones naturally, easing the process and managing pain," Wood explained. "In other cases, surgical removal may be required to prevent complications and alleviate symptoms."

Shockwave lithotripsy, ureteroscopy and stone removal, and percutaneous nephrostolithotomy are three primary surgical methods used for stone removal, each with its own approach and benefits.

Long-term Management

Managing kidney stone disease long-term can be challenging, especially when it involves daily medications or significant changes to dietary habits. These lifestyle adjustments are often essential to reduce the risk of future stone formation.

"Unfortunately, once a person has experienced a kidney stone, they are at a higher risk of developing another within the next five to 10 years," Wood said. "This makes prevention a crucial focus in the management of kidney stone disease."

By adhering to a tailored treatment plan and making the necessary lifestyle changes, patients can significantly reduce the likelihood of recurrent stones and better manage their condition over time.