What is a Kidney Stone? *A kidney stone is a hard mineral and crystalline
material formed within the kidney or urinary tract. Kidney stones are a
common cause of  blood in the urine** and often severe pain in the abdomen,
flank, or groin. Kidney stones are sometimes called renal calculi.** One in
every 20 people develops a kidney stone at some point in their life.*
*The condition of having kidney stones is termed  nephrolithiasis** or **
 urolithiasis*<http://www.medicinenet.com/script/main/art.asp?articlekey=6649>
.





** *What causes kidney stones?*

*Kidney stones form when there is a decrease in urine **volume or an excess
of stone-forming substances in the urine. The most common type of kidney
stone contains calcium** in combination with either oxalate or phosphate.
Other chemical compounds that can form stones in the urinary tract include
uric-acid** and the amino acid cystine.*
Dehydration* through reduced fluid intake or strenuous exercise** without
adequate fluid replacement increases the risk of kidney stones. Obstruction
to the flow of urine can also lead to stone formation. Kidney stones can
also result from infection in the urinary tract**; these are known as
struvite or infection stones.*
**
*Men are especially likely to develop kidney stones, and whites are more
often affected than blacks. The prevalence of kidney stones begins to rise
when men reach their 40s, and it continues to climb into their 70s. People
who have already had more than one kidney stone are prone to develop more
stones. A family history of kidney stones is also a risk factor for the
development of kidney stones.*
*A number of different conditions can lead to kidney stones:*

   - *Gout*<http://www.medicinenet.com/script/main/art.asp?articlekey=3624>
   * results in an increased amount of uric acid in the urine and can
   lead to the formation of uric acid stones.

   *
   - 
*Hypercalciuria*<http://www.medicinenet.com/script/main/art.asp?articlekey=24224>
   * (high calcium in the urine), another inherited condition, causes
   stones in more than half of cases. In this condition, too much calcium is
   absorbed from food and excreted into the urine, where it may form calcium
   phosphate or calcium oxalate stones.

   *
   - *Other conditions associated with an increased risk of kidney stones
   include 
**hyperparathyroidism*<http://www.medicinenet.com/script/main/art.asp?articlekey=1920>
   *, kidney diseases such as renal tubular acidosis, and some inherited
   metabolic conditions including
**cystinuria*<http://www.medicinenet.com/script/main/art.asp?articlekey=7841>
   * and 
**hyperoxaluria*<http://www.medicinenet.com/script/main/art.asp?articlekey=10792>
   *. Chronic diseases such as diabetes and **high blood
pressure*<http://www.medicinenet.com/script/main/art.asp?articlekey=378>
   * (hypertension) are also associated with an increased risk of
   developing kidney stones.

   *
   - *People with **inflammatory bowel
disease*<http://www.medicinenet.com/script/main/art.asp?articlekey=7536>
   * or who have had an intestinal bypass or ostomy surgery are also more
   likely to develop kidney stones.

   *
   - *Some medications also raise the risk of kidney stones. These
   medications include some diuretics, calcium-containing antacids, and the
   **protease 
inhibitor*<http://www.medicinenet.com/script/main/art.asp?articlekey=5080>
   * Crixivan 
(**indinavir*<http://www.medicinenet.com/script/main/art.asp?articlekey=16215>
   *), a drug used to treat
**HIV*<http://www.medicinenet.com/script/main/art.asp?articlekey=3769>
   * infection. *

What are symptoms of kidney stones? *While some kidney stones may not
produce symptoms (known as "silent" stones), people who have kidney stones
often report the sudden onset of excruciating, cramping pain in their low
back and/or side, groin, or abdomen. Changes in body position do not relieve
this pain. The pain typically waxes and wanes in severity, characteristic of
colicky pain (the pain is sometimes referred to as renal colic). It may be
so severe that it is often accompanied by **nausea and
vomiting*<http://www.medicinenet.com/script/main/art.asp?articlekey=41943>
*. Kidney stones also characteristically cause blood in the urine. If
infection is present in the urinary tract along with the stones, there may
be **fever* <http://www.medicinenet.com/script/main/art.asp?articlekey=361>*and
chills.
*
** How are kidney stones diagnosed? **
*The diagnosis of kidney stones is suspected by the typical pattern of
symptoms when other possible causes of the abdominal or flank pain are
excluded. Imaging tests are usually done to confirm the diagnosis. A **helical
CT scan* 
<http://www.medicinenet.com/script/main/art.asp?articlekey=9626>*without
contrast material is the most common test to detect stones or
obstruction within the urinary tract. Formerly, an **intravenous
pyelogram*<http://www.medicinenet.com/script/main/art.asp?articlekey=4022>
* (IVP; an x-ray of the abdomen along with the administration of contrast
dye into the bloodstream) was the test most commonly used to detect urinary
tract stones, but this test has a greater risk of complications, takes
longer, and involves higher radiation exposure than the non-contrasted
helical CT scan. Helical CT scans have been shown to be a significantly more
effective diagnostic tool than the IVP in the diagnosis of kidney or urinary
tract stones.*
*In **pregnant*<http://www.medicinenet.com/script/main/art.asp?articlekey=33915>
* women or those who should avoid radiation exposure, an
**ultrasound*<http://www.medicinenet.com/script/main/art.asp?articlekey=510>
* examination may be done to help establish the diagnosis.*
**
What is the treatment for kidney stones? **
*Most kidney stones eventually pass through the urinary tract on their own
within 48 hours, with ample fluid intake. Pain medications can be prescribed
for symptom relief. There are several factors which influence the ability to
pass a stone. These include the size of the person, prior stone passage,
prostate enlargement, pregnancy, and the size of the stone. A 4 mm stone has
an 80% chance of passage while a 5 mm stone has a 20% chance. Stones larger
than 9-10 mm rarely pass on their own and usually require treatment.*
**
*Some medications have been used to increase the passage rates of kidney
stones. These include **calcium channel
blockers*<http://www.medicinenet.com/script/main/art.asp?articlekey=19741>
* such as 
**nifedipine*<http://www.medicinenet.com/script/main/art.asp?articlekey=815>
* and alpha blockers such as
**tamsulosin*<http://www.medicinenet.com/script/main/art.asp?articlekey=14862>
*. These drugs may be prescribed some people who have stones that do not
rapidly pass through the urinary tract. *
**
*For kidney stones which do not pass on their own, a procedure called **
lithotripsy*<http://www.medicinenet.com/script/main/art.asp?articlekey=4178>
* is often used. In this procedure, shock waves are used to break up a large
stone into smaller pieces that can then pass through the urinary system. *
*Surgical techniques have also been developed to remove kidney stones. This
may be done through a small incision in the skin (percutaneous
nephrolithotomy) or through an instrument known as an
**ureteroscope*<http://www.medicinenet.com/script/main/art.asp?articlekey=83919>
* passed through the
**urethra*<http://www.medicinenet.com/script/main/art.asp?articlekey=5907>
* and **bladder*<http://www.medicinenet.com/script/main/art.asp?articlekey=2472>
* up into the 
**ureter*<http://www.medicinenet.com/script/main/art.asp?articlekey=5909>
*. *
** How can kidney stones be prevented? **
*Rather than having to undergo treatment, it is best to avoid kidney stones
in the first place. It can be especially helpful to drink more water. (The
National Institutes of Health recommend drinking up to 12 full glasses of
water a day, if you've already had a kidney stone.) Water helps to flush
away the substances that form stones in the kidneys. *
*Depending on the cause of the kidney stones and an individual's medical
history, dietary changes or medications are sometimes recommended to
decrease the likelihood of developing further kidney stones. It is
particularly helpful, if one has passed a stone, to have it analyzed in a
laboratory to determine the precise type of stone so specific prevention
measures can be considered.*


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