August 01, 2018

Kidney stones

Personalized prevention

Kidney stones

After the painful ordeal of passing a second kidney stone, you'd dearly like to prevent yet another. You've already been drinking more water — what else can you do?

You might be surprised.

In recent years, management of kidney stones has become increasingly more precise and targeted to individual circumstances. Imaging advances are making it easier to tell whether a procedure is needed to remove a stone — and which procedure will result in the best outcome.

Lowering the risk of stones is being helped along by steady advances in understanding the factors that go into stone formation. Discovering the underlying cause of a stone guides a tailored approach to preventing another.

Crystallization

Kidney stones are made up of crystals formed from minerals in the urine. Most of the time — with adequate hydration — urine is diluted and the crystals either don't form or are passed naturally and harmlessly out of the body. In addition, normal urine also contains substances that inhibit crystal formation.

However, there are a number of ways that this balance can be upset. These include an increase in the amount of minerals that end up in the urine, being dehydrated — or when the inhibitors of crystal formation don't work properly or are absent. However it happens, crystals may gradually accumulate, anchor to the inner wall of the kidney and grow into a stone. At some point, the stone may become dislodged and pass from the kidney through the tube (ureter) connecting the kidney to the bladder. Finally, the stone is eliminated from the body when it passes out of the bladder and through the urethra.

Some kidney stones may pass with little or no pain. However, some stones can cause extreme waves of pain. The pain can occur on the side and back, just below...