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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Sunday, July 6, 2008
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Sunday, July 6, 2008
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- What are symptoms of kidney stones?
- What changes in my diet can I make to minimize the recurrence of kidney stones?
- Is there a link between kidney stones and caffeine?
- Are there any risks associated with taking calcium supplements?
- Is there a connection between kidney stones and hydronephrosis?
- What is the treatment for kidney stones?
First, stones usually produce pain, which can be classified as very sharp and spasmodic (as opposed to throbbing). Second, stones are usually associated with some blood in your urine. Third, as kidney stones may block the passage of urine, causing obstruction, they may lead to infection.
First, you need to bring down the level of calcium in your blood. But you need to be careful, because this may result in disturbances in critical organs such as the heart. There are diets designed to minimize kidney excretion of calcium without altering calcium levels elsewhere. Age plays an important part. Growing children have different needs than adults, and adult females have different needs for calcium than post-menopausal women. Second, it is wise to keep your urine as dilute as possible. Kidney stones (calcium oxalate stones) form when the concentration of calcium in the kidney tubules gets to a critical concentration. There is no exact measure for "critical concentration." One way of minimizing the concentration is to always be sure that you have plenty of water to excrete. That means drinking at least 8 glasses of water each day (8 oz per glass).
Drinks with a high level of caffeine (such as cola and coffee) act on the metabolic rate of several organ systems, including the kidneys. It causes the kidneys to promote increased urine flow. When this happens there is a small but significant increase in the concentration of many substances in the blood. These changes result in producing the sensation of thirst. Assuming we have a source of liquid available, we drink more. The mechanism is not perfect, so we drink more than we need. This results in a more dilute urine. Calcium, which is a major component of many types of kidney stones, will be more likely to stay in solution if the urine is dilute and come out of solution if the urine is concentrated. Keeping the calcium in solution reduces the tendency to form stones. That being said, water is still your best bet for keeping your urine dilute.
There is an increased risk of calcium citrate stones associated with taking calcium supplements. The risk is small, but depends on your age. If you have never had calcium citrate kidney stones and are a post-menopausal woman, there is no evidence to indicate that you should worry about kidney stone formation. If there is a family history of kidney stones it would be helpful to have your urine calcium excretion measured to see if it is within the normal range. If you take the Citrical and Evista medications as directed on the labels, there is little if any risk of developing kidney stones if you have never had one. The action of Evista results in calcium being taken up from the blood stream, which minimizes the amount of calcium delivered to the kidney. The normal kidney will make the appropriate adjustments to maintain a normal blood calcium level.
Hydronephrosis develops when a portion of the kidney becomes swollen because urine can't drain into the bladder. Hydronephrosis is not a separate disease, but a physical phenomenon that occurs with many diseases. The uretero-pelvic (UP) junction is the anatomical point where the tube coming from the kidney passes over the hip-bone on its way to the urinary bladder. It is a common place for kidney stones to get trapped when they pass down from the kidney. Obstruction of the ureter at the UP junction by a kidney stone will result in hydronephrosis very rapidly. It is almost always very painful. The pain is felt in the back just below the ribs on the side that is obstructed. This condition needs to be taken care of as quickly as possible. Some kidney stones will pass with out need for surgical treatment but after several hours if the stone does not move intervention is necessary.
The treatment for kidney stones involves drinking about 8 cups of liquid each day to keep the urine from becoming too concentrated. For rather large stones, lithotripsy may be needed. This technique involves using high frequency sound waves to break up the stone. The fragments are then passed with urination. This treatment does not involve surgery, but it is available only in tertiary care medical centers. In general, there may be some short-term injury to the kidney after the procedure. However, the kidney heals within a month or so and there is no permanent injury.
This article is a NetWellness exclusive. 
Last Reviewed: Apr 01, 2004
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Philip W. Hall, 3rd, MD Professor of Medicine Emeritus Office of Medical Education School of Medicine Case Western Reserve University |
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