$Unique_ID{BRK00813}
$Pretitle{Genitourinary System}
$Title{The Nature of Kidney Stones}
$Subject{kidney stones cause}
$Volume{J-16}
$Log{
Kidney Stones-normal kidney*0004801.scf
Kidney Stones-multiple calculi*0004802.scf
Kidney Stones-stag-horn calculi*0004803.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


The Nature of Kidney Stones


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QUESTION:  I have just recovered from a bout of kidney stones, which
fortunately passed with out my having to have surgery.  We never did get a
look at the stone, but I am now quite curious as to its nature and whether I
may have to go through this thing again.  Can you help?

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ANSWER:  It is really too bad that you didn't manage to recover the stone as
it passed, for the first step in deciding upon future treatments and your
risks of another episode of renal colic, would have been to chemically analyze
the stone.  Statistically the most common composition of renal or kidney
stones is calcium oxylate, which occurs in 65 percent of the cases.  Next most
frequent is struvite (composed of magnesium ammonium phosphate), in 15 percent
of the cases.  Other types of stone include calcium phosphate (5%), calcium
and uric acid (4%), uric acid (4%), and cystine (about 2%).  Calcium stones
are frequent in individuals where the urinary content of calcium is high, with
an output of greater than 300 mg per day.  Struvite stones are seen in
patients with urinary tract infections caused by bacteria that can affect
urea, a chemical normally found in urine.  Uric acid stones are the most
common of the non-calcium stones and are seen in conditions which produce high
levels of uric acid in the urine, such as gout.  Your chances of recurrence
are close to 1 in 10 each year, and 75% of all patients will have at least one
recurrence during their lifetime.  You have a high risk of repeat episodes if
you a middle aged Caucasian male, if there is a family history of renal stones
or gout, or if you have chronic bowel disease or certain kidney disease.  The
good news is that you may never need surgery to rid yourself of these painful
pebbles.  Between 80 to 85 percent of all stones pass by themselves, and the
development of techniques using high power shock waves to disintegrate stones
in the body, has reduced the use of open surgical procedures to less than 5
percent.  Your best course is to have a complete, relatively inexpensive
metabolic evaluation to try and determine the cause of your stones in the
absence of a specimen.  Such an evaluation will provide the information
necessary to plan strategies that prevent recurrence.  In the meantime keep
fluid intake high, so that production of urine exceeds 2 liters a day.  This
will keep the concentration of stone forming materials low and help prevent
another painful incident.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
