Stones Disease
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Kidney stone hotline (put in specific phone number for kidney stones) – please call this number to be seen same day or next business day, if you have or suspect a painful kidney stone but DO NOT HAVE fevers, chills, nausea or vomiting.
If having fevers, chills, nausea or vomiting WITH a kidney stone, these symptoms are very serious and you need to be evaluated in the emergency room.
Kidney stones can be very painful. The pain of the stone happens when the stone travels into the ureter, blocks the flow of urine from the kidney, the kidney swells with trapped urine (the swelling is VERY PAINFUL). As the stone moves down the ureter, the blockages comes and goes and so does the pain come and go.
Kidney stones can also cause other symptoms including blood in the urine (hematuria = link to hematuria page) and recurrent urinary tract infections.
Imaging is needed to diagnose a kidney stone and plan for next steps in treatment.
A CT scan is the best imaging modality to diagnose a stone in adults.
Preventing kidney stones
General recommendations:
Drink 2-3L water per day. Best to get a container like 24-32oz water bottle or tumbler to keep track of your fluid intake per day.
Add citrus into your diet. To add citrus, squeeze lemon into your water, add orange juice into your diet. Be careful to monitor the amount of sugar in orange juice.
Maintain a low salt diet – less than 2300mcg per day.
Watch the amount of oxalate in your diet – often oxalate rich foods (example nuts) need to be reduced.
Eat a NORMAL calcium diet. Do not calcium restrict your diet, even if you make calcium stones. Normal calcium diet is 1000-1200mg per day through food or through a calcium supplement. If you are taking a calcium supplement (Citracal or Caltrate), you need to take the calcium with food to improve absorption.
Customized recommendations
Dr. Fronczak recommends getting doing a Litholink (insert Litholink URL), which involves doing collection of urine for 24hrs and getting a blood test to best evaluate the individuals risks for stone formation.
https://litholink.labcorp.com/testing/24-hour-urine-testing
Dr. Fronczak works closely with patients prevent stones.
Treatment for kidney stones
The Success of passing a stone on your own is unpredictable. Here are some stone passage rates published in one study:
Stone width (mm) | Approximate percent of stones that passed | Mean time to stone passage |
1-2 | 85-90% | 8 days |
3 | 83% | 13 days |
4 | 77% | 23 days |
5 | 56% | |
6 | 41% | |
7 | 30% | Unknown |
8 | 21% | |
9 | 3% | |
Chart taken from Wieder, 2014. Urology 10(6):544, 1977 and Am J Roentgenol 178: 101, 2002. J juror, 162:688, 1999 | ||
Even the smallest stone can get stuck and not pass.
Success can be increased by drinking lots of fluids and managing the pain.Sometimes a prescription of tamsulosin can relax the ureter enough to allow the stone to pass.
The providers at Modern Urology are very skilled at surgical treatment of kidney stones.
Options to remove stones include laser lithotripsy, shock wave lithotripsy, and percutaneous nephrolithotomy (PCNL).
Stone treatment is often done at The Stone Center in Denver as well as surgery centers and hospitals.
The treatment options are based on the size of the stone and the location of the stone.
The providers at Modern Urology will discuss the treatment options in detail and together will help you make the decision on how to manage your kidney stone.
A stent is a soft plastic tube that is long (22-30cm).It is long because it needs to go from the bladder all the way up to the kidney. The stents are very narrow in diameter, is hallow, and has a ‘pigtail’ curl at each end so the stent stays in place—one end of the pigtail anchors in the kidney and one end of the pigtail anchors in the bladder.
- Fronczak uses new technology stents that soften in the body and are more comfortable than traditional plastic stents.
- Ureteral stents are placed during a laser lithotripsy procedure, some shock wave lithotripsy procedures, and for any diagnostic ureteroscopy.
- Ureteral stents are also placed when urine is not draining well from a kidney, such as with a ureteral stricture or other anatomical concern of the kidney or ureters or bladder.
- Also if using a stent to manage a long term ureteral stricture, many of the new stents can stay in the body without needing exchange for up to 12 months.
- Most stents for stone procedures are removed in less than 1 week.
Prevention of Kidney Stones
Note: some patients may need to discuss these recommendations with their primary care doctor or cardiologist.
- Drink 2-3 liters (1/2 gallon) of water per day.Best way to accomplish the is to get a container such as a 24-32oz water bottle or tumbler to keep track of your fluid intake.
- Add citrus into your diet.To add citrus, squeeze a quarter of lemon into your water or add orange juice into your routine. Be careful to monitor the amount of sugar intake in the orange juice.
- Maintain a low salt diet – aim for less than 2300mcg per day.
- Watch the amount of oxalate in your diet – often oxalate rich foods (example nuts) need to be reduced if you have high oxalate in your urine.
- Eat a NORMAL calcium diet.Do not calcium restrict your diet, even if you make calcium stones. A normal calcium diet is 1000-1200mg per day through food or through a calcium supplement. If you are taking a calcium supplement (Citracal or Caltrate), you need to take the supplement with food to optimize the absorption of the calcium and also to allow the calcium to grab excess oxalate.
Modern Urology providers work closely with patients to prevent stones.
- We recommend doing a Litholink test which involves doing collection of urine for 24hrs and getting a blood test to best evaluate an individual’s risk factors for stone formation.