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Kidney Stone Clinic

Kidney Stones are one of the most common disorders of the urinary tract. The National Kidney Foundation reports that one in ten people will have a kidney stone over the course of their lifetime. Our Kidney Stone Clinic is staffed with Nephrology Associates physicians who have specialized in the systematic metabolic evaluation of kidney stones and treating the underlying causes. Their goal is to prevent or reduce the reoccurrence of existing stones.

Patients come to our clinic after they have been diagnosed by their urologist or primary care physician. If the stone needs to be removed surgically, a urologist will perform this procedure.

Kidney stones have a very high recurrence rate.  It is estimated that approximately 60-80% of patients will form another stone within 10 years of the first episode.  Removal of an existing stone does not prevent further stones from forming.

What is a kidney stone?

A kidney stone is formed by small crystals clumping together to form a hard object in the urine.  There are several different crystals that can make up kidney stones.  The most common types are calcium oxalate, calcium phosphate, uric acid and struvite. 

What are the symptoms of a kidney stone?

Stones may be as small as a grain of sand, creating no symptoms. The larger the stone, the more noticeable the symptoms, which include back or lower abdominal pain or discomfort, blood in urine, and passing gravel or a small stone in  the urine.  Stones are associated with urinary tract infection. In these cases, symptoms may include fever and chills, or urine that is cloudy. 

Should I collect my stone when I pass it?

Yes, it is very important for us at the stone clinic to analyze the composition of the stone so we can specifically target the cause. 

What to expect from the “Stone Clinic”

During the initial visit, expect a thorough history that includes your medical history, the number of kidney stones, prior evaluations, family and occupational history. We will also focus on diet, medications and over the counter supplements. We will proceed with a detailed workup including blood tests, urine analysis and a dedicated 24 hour urine collection to assess your underlying predisposition to kidney stones. No invasive tests are performed.

Your treatment will include diet and lifestyle modification. Drinking enough fluid (water), balancing your protein intake with fruits and vegetables, exercise and weight control are critical.  In some circumstance, you will need to take medications to help prevent stone formation. There is not one medication used to treat kidney stones, but rather this is also determined by the type of stone you have.

Are Follow-up visits necessary?

Yes. You will be asked to have blood work, 24 hour urine collection and sometimes follow-up imaging studies.    These tests will indicate whether the medications and diets are working. If you are taking a medication, routine monitoring of blood and urine chemistries is necessary.  You should always get your testing done before your follow up visit.  On occasion you will be asked to provide a dietary log.

Will the medications prescribed at the Stone Clinic interfere with the other medications I am currently taking?

Usually none of the medications prescribed at the clinic will interfere with any other medications you may be taking for other conditions. We take exceptional care to make sure that there are no drug interactions prior to prescribing any treatment for kidney stones.

How can I get in touch with the kidney stone clinic?

Call the office located closest to your home. Be sure to tell our staff you have a kidney stone and wish to be seen by one of our Kidney Stone Specialists. They may ask you if you currently have a kidney stone and if you are having symptoms. If you have not seen one and are symptomatic, we can help refer you to someone. 

Is there anything I can do to help prevent kidney stone formation?

Drink lots of water.  This will help to keep your urine less concentrated and reduce the risk of stone formation.  Your target urine output is 2.5 liters (or 68 ounces of urine) per day and requires that you drink at least that much liquid daily.  This would require a 12 ounce glass of liquid with each meal, in between each meal, at bedtime and during the night.  The amount of liquid you need will vary according to your activity level and environment.  WATER is the preferred liquid.

Reduce salt intake (sodium) if you have calcium stone disease.  You should limit your sodium intake to less than 2000 mg (2 grams) per day

Reduce the amount of animal protein may help.  Most people need only four to six ounces of protein per day which should be eaten together with a balanced diet.

Lose weight if you are overweight

Discuss with the doctor if you wish to take vitamin supplements especially vitamin C, Vitamin D or calcium and mineral supplements, since they can increase the chance of stone formation in some people.  Moderate consumption of calcium is preferred to calcium tablet supplementation.

http://www.kidney.org/atoz/content/kidneystones.cfm