SYMPTOMS


Everyone knows


about the terrible flank pain associated with kidney stones.



Most of the pain is caused by obstruction of the ureter

causing a backup of urine into the kidney with resultant stretching and dilation of the tissue.

Symptoms

Nausea and vomiting are often present during acute episodes. Some patients may have an urgency to urinate or blood in the urine. Some patients may even have no symptoms at all.

Managing Occasional Symptoms


Even though we have a multitude of treatment options and equipment to successfully treat kidney stones, our goal is to help patients avoid recurrent stones. To achieve this, your Urologist might recommend a change in your diet or a special medication.

Calcium stone formers might be advised to drink more water, avoid salt, decrease oxalate intake and avoid calcium supplements. However, keep in mind that we do not recommend restricting dairy calcium. The dairy calcium has the ability to combine with oxalate in the gut and pass out in the feces. If dairy calcium is not available, the oxalate in the gut will be absorbed and sent to the kidneys, where it can combine with calcium in the urine to form stones. If calcium supplements are necessary for osteoporosis, or other reasons, we recommend calcium citrate instead of calcium carbonate in stone formers.

As mentioned above, we might also recommend decreasing intake of oxalate. This is found mainly in tea, strawberries, spinach, and rhubarb, chocolate/cocoa, wheat bran, nuts, and beets. There are many other foods which contain oxalate in lower amounts and we can provide that list if needed. Patients who have uric acid stones will be advised to drink adequate fluids, but also may be advised to cut back on protein in their diet and may be placed on a medication to help alkalinize their urine, or to prevent the formation of uric acid. For recurrent stone formers, who have failed dietary measures, we have developed a kidney stone prevention clinic. This allows us to more aggressively evaluate the patients with various blood levels of calcium, potassium, uric acid, and others, depending on the situation. We evaluate a detailed medical and dietary history. We may also obtain 24-hour urine collections for metabolic evaluation. Medications, such as potassium citrate, may be utilized, as well as others.

Low Oxalate Diet

The following foods and drinks should be avoided when trying to maintain a low oxalate diet:

• Tea
• Strawberries
• Spinach and rhubarb
• Chocolate / cocoa
• Wheat bran
• Nuts
• Beets

The following foods contain oxalate , but not as much as the products to the left:

• Beans
• Blackberries
• Celery
• Dark leafy greens
• Swiss chard
• Draft beer
• Sweet potatoes
• Eggplant
• White corn grits
• Instant coffee
• Okra
• Leeks
• Soy tofu

Diagnosing Kidney Stones

We currently use a non-contrast CT scan to diagnose most kidney stones. Plain films (KUB) are often obtained and we occasionally utilize renal ultrasound or IVP (intravenous pyelogram)