Kidney Stone Management in Patients With a Solitary/Single Kidney

Kidney stone treatment is one of the most straightforward parts of a urologist's practice. We have a multitude of treatment options ranging from non-invasive to surgical that can help patients eliminate the pain and, in many cases, become entirely stone-free. Even complex kidney stone situations can be managed through a combination of procedures and lifestyle changes, eliminating years of pain and discomfort. One such story involves our patient Milan, who was able to overcome a lifetime of kidney-stone-related symptoms and infections through advanced management of his kidney stones with Dr. Mithal.

The Challenges of a Solitary Kidney

About 1 in 1,000 babies are born with only one kidney (or two kidneys, but only one that works). Unlike the liver, for example, kidneys do not regenerate once damaged. You have what you have, so keeping your kidneys healthy is critical. Similarly, patients can still live an active, long, and productive life with only one kidney. Whether they were born with a solitary kidney, were donors, or had a disease or trauma that led to the removal of the second kidney, kidney stone management in patients with one kidney takes on a different level of urgency. Our approach to stone removal is somewhat different to ensure that the remaining kidney stays healthy.

This article will discuss the tools urologists use to ensure the single kidney stays healthy.

First and foremost, patients must understand that a single kidney does not require a change in hydration and diet. Staying well hydrated by drinking plenty of water daily, especially during the summer when heat and humidity make us even more dehydrated than usual, is very important. Hydration patterns should not change just because someone has a single kidney. Drink enough to ensure you urinate straw-colored liquid every few hours of the day. Of course, depending on any other potential kidney issues, patients should consult with their urologist and maintain regular appointments to ensure appropriate kidney function and stay abreast of general health, particularly their kidney health.

Dietary concerns should be managed. While many stones are formed by excess calcium in the blood, research shows that too little calcium can similarly cause stone formation. Excess consumption of certain leafy greens like spinach can also lead to kidney stones. These foods are also incredibly healthy and contribute to overall bodily function, so as always, moderation is key. Patients should prioritize their annual physicals, monitor kidney function levels, and ensure that their vitamin and nutrient levels are within range with simple blood testing, as their medical team recommends.

Understand Your Family History of Kidney Stones

It's crucial that patients fully understand their family history of kidney stones so that they can work with their urologist to manage any that may form or prevent them in the first place. Conversations with relatives about their history of kidney stones will offer great insight into what to expect and how to manage kidney stones. Be sure to speak to your urologist to understand how family history may affect your kidney stone prevention and management plan.

Be on the Lookout for Back Pain and Referred Pain

Back pain, especially in the areas of the kidneys, and referred pain that can move into the lower back, groin, or even testes can indicate that a stone has formed and is being passed or may be stuck in the ureter. In these cases, it's best not to wait to pass the stone but instead visit your urologist for a proper diagnosis and treatment plan.

Blood in the Urine

While blood in the urine, known as hematuria, is rarely an emergency, the patient should see their urologist as soon as possible in the case of a solitary kidney. Hematuria often means the kidney stone is being passed, but it could also signal urinary tract infections that must be managed quickly. Any intervention should be performed early, so please don't wait.

Fever

One of the most concerning symptoms of a blocked ureter or kidney outlet is infection. Kidney infections are severe and can cause bacteriosis and sepsis. Infection of the kidney usually means that the outflow of urine has been severely compromised, and this starts a countdown toward kidney failure. Again, do not risk longer-term or permanent kidney issues. If you experience a fever, speak to your doctor to understand more.

Always See a Specialist

Visiting urgent care for many of the above symptoms may be tempting, but a urologic specialist should examine you. There is an unfortunate trend among less experienced practitioners who assume it's a simple UTI without digging deeper. Unfortunately, several potentially more severe problems can cause similar symptoms, including a kidney infection. As such, do not stop at a diagnosis of UTI from a non-urologic specialist. Be sure to make an appointment with a urologist, such as those at Georgia Urology, to learn more.

An X-Ray May Not Be Enough

While calcium-based stones often show up on X-rays, other stones, while less common, may not. Patients with a solitary kidney are usually referred for a CT scan. With a solitary kidney, we want to be safe rather than sorry.

We May Want to Wait

Your urologic team will often watch and track smaller stones over time. This is especially true if the stone is found incidentally and the patient is not experiencing significant symptoms. It is always best to be under the care of a knowledgeable urologist to determine the best course of action.

Early Detection Means Early Treatment

Catching a kidney stone at its earlier manifestation is essential when patients have a solitary kidney. First, it gives us the broadest range of possible treatment options, from ESWL or Extracorporeal shockwave therapy to ureteroscopy or PCNL (percutaneous nephrolithotomy). Your urologist will offer the best treatment option based on your unique situation, with an eye toward minimizing minor trauma to the kidney.

If you are experiencing discomfort and have a solitary kidney, you should contact one of our specialized kidney stone urologists. Georgia Urology is proud to offer a kidney stone hotline at 855-786-6311 to get you an appointment with a specialist as soon as possible (often the next day). Our highly experienced team can get you on track to being stone-free.

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