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KIDNEY STONES 101: Q & A with Dr. Daniel Ballow, Urologist, Baptist Medical Group

1. WHAT ARE KIDNEY STONES?
Kidney stones, simply put, are hard deposits of minerals that grow slowly over months or years. Stones begin as very small particles. But, in some cases, they grow to fill the kidney, collecting system or bladder. – Source: ©2015 Mayo Foundation for Medical Education and Research MC1916rev1115

2. WHAT CAUSES KIDNEY STONES TO FORM?
For most people, the cause of kidney stone formation is dehydration. When a person is dehydrated urine is very concentrated and certain minerals will form a crystal. This crystal then acts like a seed for more mineral to deposit and grows into a kidney stone.

3. ARE THERE DIFFERENT TYPES OF KIDNEY STONES?
While the most common type of kidney stone forms through mineral crystallization as described above, one other type of stone forms differently, the struvite stone. This stone is caused by recurrent urinary tract infections with very specific types of bacteria. These bacteria produce a substance which causes struvite stones to form; they can often be quite large and grow without causing the typical symptoms of pain, nausea and vomiting. The rarest types of
stones are caused by inherited genetic disorders, and people with these types of stone usually start forming them in childhood.

4. WHAT ARE THE SYMPTOMS RELATED TO KIDNEY STONES?
Most people will develop severe pain in the upper abdomen or back and sides (flank pain). The pain can also be associated with nausea and vomiting. In some cases the pain may be vague abdominal pain, bladder pain, or even pain in the groin, scrotum, or vulva. There may be visible blood in the urine, but not always.

5. WHAT KIND OF TESTING DETECTS WHETHER OR NOT A KIDNEY STONE IS PRESENT?
Clinicians typically use plain X-rays, called a KUB (Kidney Ureter Bladder), ultrasound of the kidneys and bladder, or a CT or “CAT” scan. The plain X-ray can detect most stones, but if they are small or made of uric acid, they could be invisible on a KUB. An ultrasound should be the first diagnostic test used for children or pregnant women because it avoids exposing them to radiation. A CT scan is the best test as it will detect all stones, even as small as one millimeter in size.

6. HOW ARE KIDNEY STONES TREATED?
Small stones, five millimeters or less, are usually observed and the symptoms are treated with strong anti-inflammatory medication or sometimes narcotics, anti-nausea medications and aggressive fluid intake. It can normally take one to four weeks for the stone to pass. Sometimes a longer period is needed. If a person is unable to eat or drink, then they may require more urgent surgical treatment which could involve shock wave lithotripsy, ureteroscopy or ureteral stent placement.

7. WHAT CAN YOU DO TO DECREASE YOUR RISK OF GETTING KIDNEY STONES IN THE FUTURE?
• Drink more water! Most urologists recommend a patient who has kidney stones drink enough water to produce 2.5 to 3 liters of urine each day, which will be different for everyone.
• Limit the amount of sodium in your diet. Sodium is not a mineral that is in kidney stones, but it helps encourage their formation. Try to keep sodium intake to 2 to 2.5 grams maximum daily.
• Eat more produce. Increasing your fruit and vegetable intake will cause changes to your urine that helps prevent stone formation.
• Eat smaller portions when you eat meat. Protein from any animal, whether red meat or white meat, can encourage kidney stones to form. When you choose to eat meat, have a smaller serving size.
• For people who have had more than one kidney stone in their adult life, and for anyone under 18 who develops a stone, I recommend additional testing of the blood and urine to find out if there is a correctable cause. Treatment should be guided by an urologist.

To schedule an appointment or to make a referral, please note the following options:
Phone: 850.437.8711
Fax: 850.437.8719
Order Facilitator: Select “Baptist Medical Group – Urology”

To learn more about Dr. Ballow and his approach to urology care, visit
http://www.baptistmedicalgroup.org/doctors/daniel-j-ballow-md