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Encyclopedia > Kidney stone
Kidney stone
Classification & external resources
Ultrasonic instrument and kidney stone
ICD-10 N20.0
ICD-9 592.0
DiseasesDB 11346
MedlinePlus 000458
eMedicine med/1600 

Kidney stones, or Renal calculi, are solid concretions (crystal aggregations) of dissolved minerals in urine; calculi typically form inside the kidneys or ureters. The terms nephrolithiasis and urolithiasis refer to the presence of calculi in the kidneys and urinary tract, respectively. Renal calculi can vary in size from as small as grains of sand to as large as grapefruit. Kidney stones typically leave the body by passage in the urine stream, and many stones are formed and passed without causing symptoms. If stones grow to sufficient size before passage — on the order of at least 2-3 millimeters — they can cause obstruction of the ureter. The resulting distention with urine can cause severe episodic pain, most commonly felt in the flank, lower abdomen and groin (a condition called renal colic). Renal colic can be associated with nausea and vomiting due to the embyrological association of the kidneys and the intestinal tract. Hematuria is commonly present due to damage to the wall of the urethra as well as dysuria (when passing stones). Recurrence rates are estimated at about 10% per year. Bladder stones in animals are a common occurrence, especially in domestic animals such as dogs and cats. ... Image File history File links Download high resolution version (3897x2744, 329 KB) Title: Ultrasonic instrument and kidney stone Image ID: 4172 Photographer: Unknown Restrictions: Public Domain Abstract: Photograph-One 5x7 photograph, with a slip of paper taped to the back. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... A calculus is a stone (a concretion of material, usually mineral salts) that forms in an organ or duct of the body. ... Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen which are present in common organic molecules. ... This article or section is in need of attention from an expert on the subject. ... The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... Transverse section of ureter. ... “Hurting” redirects here. ... Flank is a word which might mean any of several different things: A flank is the side of either a horse or a military unit. ... Renal colic is a type of pain commonly caused by kidney stones. ... In medicine, hematuria (or haematuria) is the presence of blood in the urine. ... In medicine, specifically urology, dysuria refers to any difficulty in urination. ...

Star shaped bladder urolith
Star shaped bladder urolith
Staghorn calculus
Staghorn calculus

Contents

Image File history File linksMetadata Download high-resolution version (2048x1536, 1468 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Kidney stone Metadata This file contains additional information, probably added from the digital camera or scanner used to... Image File history File linksMetadata Download high-resolution version (2048x1536, 1468 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Kidney stone Metadata This file contains additional information, probably added from the digital camera or scanner used to... Image File history File linksMetadata Download high-resolution version (1536x2048, 982 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Kidney stone Struvite Metadata This file contains additional information, probably added from the digital camera or scanner used... Image File history File linksMetadata Download high-resolution version (1536x2048, 982 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Kidney stone Struvite Metadata This file contains additional information, probably added from the digital camera or scanner used...

Causes

Kidney stones can be due to underlying metabolic conditions, such as renal tubular acidosis, Dent's disease and medullary sponge kidney. Many centers will screen for such disorders in patients with recurrent kidney stones. Renal tubular acidosis, or RTA, is a medical condition in which the kidneys fail to dispose of a normal amount of acid into the urine, which may lead to acidosis (where the blood becomes too acidic). ... Dents disease was first described by Dent, C. E. and Friedman, M in 1964 when they reported 2 unrelated British boys with rickets associated with renal tubular damage characterized by hypercalciuria, hyperphosphaturia, proteinuria, and aminoaciduria. ...


The most common type of kidney stone is composed of calcium oxalate crystals, and factors that promote the precipitation of crystals in the urine are associated with the development of these stones. Calcium oxalate is a chemical compound that forms needle-shaped crystals. ...


Conventional wisdom and common sense has long held that consumption of too much calcium can promote the development of kidney stones. However, current evidence suggests that the consumption of low-calcium diets is actually associated with a higher overall risk for the development of kidney stones. This is perhaps related to the role of calcium in binding ingested oxalate in the gastrointestinal tract. As the amount of calcium intake decreases, the amount of oxalate available for absorption into the bloodstream increases; this oxalate is then excreted in greater amounts into the urine by the kidneys. In the urine, oxalate is a very strong promoter of calcium oxalate precipitation, about 15 times stronger than calcium. General Name, Symbol, Number calcium, Ca, 20 Chemical series alkaline earth metals Group, Period, Block 2, 4, s Appearance silvery white Standard atomic weight 40. ...


Other types of kidney stones are composed of struvite (magnesium, ammonium and phosphate); uric acid; calcium phosphate; and cystine. Struvite is an ammonium magnesium phosphate mineral with formula: (NH4)MgPO4·6(H2O). ... General Name, symbol, number magnesium, Mg, 12 Chemical series alkaline earth metals Group, period, block 2, 3, s Appearance silvery white solid at room temp Standard atomic weight 24. ... A ball-and-stick model of the ammonium cation Fumes from hydrochloric acid and ammonia forming a white cloud of ammonium chloride Ammonium is also an old name for the Siwa Oasis in western Egypt. ... Above is a ball-and-stick model of the inorganic hydrogenphosphate anion (HPO42−). Colour coding: P (orange); O (red); H (white). ... Uric acid (or urate) is an organic compound of carbon, nitrogen, oxygen and hydrogen with the formula C5H4N4O3. ... Calcium phosphate is the name given to a family of minerals containing calcium ions (Ca2+) together with orthophosphates (PO43-), metaphosphates or pyrophosphates (P2O74-) and occasionally hydrogen or hydroxide ions. ... Chemical structure of cystine formed from L-cysteine (under biological conditions) 3D representation of cystine with the disulfide bond shown in yellow Cystine is a conditionally non-essential crystalline, sulfur-containing amino acid. ...


The formation of struvite stones is associated with the presence of urea-splitting bacteria, most commonly Proteus mirabilis (but also Klebsiella, Serratia, Providencia species). These organisms are capable of splitting urea into ammonia, decreasing the acidity of the urine and resulting in favorable conditions for the formation of struvite stones. Urea is an organic compound with the chemical formula (NH2)2CO. Urea is also known as carbamide, especially in the recommended International Nonproprietary Names (rINN) in use in Europe. ... Binomial name Proteus mirabilis Hauser 1885 Proteus mirabilis is a Gram-negative, facultatively anaerobic bacterium. ... Ammonia is a compound with the formula NH3. ...


The formation of uric acid stones is associated with conditions that cause high blood uric acid levels, such as gout, leukemias/lymphomas treated by chemotherapy (secondary gout from the death of leukemic cells), and acid/base metabolism disorders.


The formation of calcium phosphate stones is associated with conditions such as hyperparathyroidism and renal tubular acidosis.


The formation of cystine stones is uniquely associated with people suffering from cystinuria, who accumulate cystine in their urine. Ë Cystinuria is an inherited autosomal recessive disorder and is characterized by the formation of cystine stones in the kidneys, ureter, and bladder. ...


Clinical presentation and diagnosis

Symptoms of kidney stones include:

  • Colicky Pain: loin - groin, lower back, intense, crippling bouts (may faint)
  • Hematuria: due to damage to wall of ureter and/or urethra
  • Dysuria: when passing stones
  • Oliguria: obstruction of one ureter
  • Nausea/vomiting: embryological link with intestine — stimulates vomiting center

Diagnosis is usually made on the basis of the location and severity of the pain, which is typically colic in nature (comes and goes in spasmodic waves). Radiological imaging is used to confirm the diagnosis and a number of other tests can be undertaken to help establish both the possible cause and consequences of the stone. Ultrasound imaging is also useful as it will give details about the presence of hydronephrosis (swelling of the kidney - suggesting the stone is blocking the outflow of urine). It can also be used to show the kidneys during pregnancy when standard x-rays are discouraged. About 10% of stones do not have enough calcium to be seen on standard x-rays (radiolucent stones) and may show up on ultrasound although they typically are seen on CT scans. In medicine, hematuria (or haematuria) is the presence of blood in the urine. ... In medicine, specifically urology, dysuria refers to any difficulty in urination. ... Oliguria and anuria are the decreased or absent production of urine, respectively. ... Renal colic is a type of pain commonly caused by kidney stones. ...


The relatively dense calcium renders these stones radio-opaque and they can be detected by a traditional X-ray of the abdomen that includes Kidneys, Ureters and Bladder—KUB. This may be followed by an IVP (Intravenous Pyelogram; IntraVenous Urogram (IVU) is the same test by another name) which requires about 50ml of a special dye to be injected into the bloodstream that is excreted by the kidneys and by its density helps outline any stone on a repeated X-ray. These can also be detected by a Retrograde pyelogram where similar "dye" is injected directly into the ureteral opening in the bladder by a surgeon, usually a urologist. Computed tomography (CT or CAT scan), a specialized X-ray, is considered the gold-standard diagnostic test for the detection of kidney stones, and in this setting does not require the use of intravenous contrast, which carries some risk in certain people (eg, allergy, kidney damage). All stones are detectable by CT except very rare stones composed of certain drug residues in urine. The non-contrast "renal colic study" CT scan has become the standard test for the immediate diagnosis of flank pain typical of a kidney stone. If positive for stones, a single standard x-ray of the abdomen (KUB) is recommended. This additional x-ray provides the physicians with a clearer idea of the exact size and shape of the stone as well as its surgical orientation. Further, it makes it simple to follow the progress of the stone without the need for the much more expensive CT scan just by doing another single x-ray at some point in the future. In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... KUB is a TLA for Katholieke Universiteit Brussel In medical ultrasonography, a KUB is an X-ray of the abdomen and pelvis; the acronym stands for kidney, ureter and bladder. ... An intravenous pyelogram (also known as IVP, pyelography, intravenous urogram or IVU) is a radiological procedure used to visualise disturbances of the urinary system, including the kidneys, ureters, and bladder. ... Retrograde Pyelogram is a urology procedure where the physician is trying to find a kidney stone. ... It has been suggested that Synchrotron X-ray tomographic microscopy, X-ray tomography be merged into this article or section. ...


Investigations typically carried out include:

  • Microscopic study of urine, which may show proteins, red blood cells, pus cells, cellular casts and crystals.
  • Culture of a urine sample to exclude urine infection (either as a differential cause of the patient's pain, or secondary to the presence of a stone)
  • Blood tests: Full blood count for the presence of a raised white cell count (Neutrophilia) suggestive of infection, a check of renal function and if raised blood calcium blood levels (hypercalcaemia).
  • 24 hour urine collection to measure total daily urinary volume, magnesium, sodium, uric acid, calcium, citrate, oxalate and phosphate.

This article does not cite any references or sources. ... A full blood count (FBC) or complete blood count (CBC) is a test requested by a doctor or other medical professional that gives information about the cells in a patients blood. ... “White Blood Cells” redirects here. ... Neutrophilia (or neutrophil leukocytosis) is a condition where a person has a high number of neutrophil granulocytes in their blood. ... In medicine (nephrology) renal function is an indication of the state of the kidney and its role in physiology. ... Hypercalcaemia (or Hypercalcemia) is an elevated calcium level in the blood. ... An oxalate (called also: ethanedioate) is a salt or ester of oxalic acid. ... Above is a ball-and-stick model of the inorganic hydrogenphosphate anion (HPO42−). Colour coding: P (orange); O (red); H (white). ...

Treatment

An 8-mm kidney stone.

90% of stones 4 mm or less in size usually will pass spontaneously, however the majority of stones greater than 6 mm will require some form of intervention. In most cases, a smaller stone that is not symptomatic is often given up to 30 days to move or pass before consideration is given to any surgical intervention as it has been found that waiting longer tends to lead to additional complications. Immediate surgery may be required in certain situations such as in people with only one working kidney, intractable pain or in the presence of an infected kidney blocked by a stone which can rapidly cause severe sepsis and toxic shock. Image File history File links Download high-resolution version (846x924, 205 KB) Robert R. Wal its a 6x8mm kidney stone that passed naturally without any medical intervention I, the creator of this work, hereby release it into the public domain. ... Image File history File links Download high-resolution version (846x924, 205 KB) Robert R. Wal its a 6x8mm kidney stone that passed naturally without any medical intervention I, the creator of this work, hereby release it into the public domain. ...


One modern medical technique uses a ureter stent (a small tube between the bladder and the inside of the kidney) to provide some relief of a blocked kidney. This is especially useful in saving a failing kidney due to swelling and infection from the stone. This tubing allows urine to drain from kidney and in some cases medicine to be injected directly. Ureter stents vary in shape and size, but most are designed to allow urine to drain and be retained for some length of time as infections reside and as stones are dissolved or sonar blasted. Most stents can be removed during a final office visit. This can range from little associated pain to extreme pain.


Management of pain from kidney stones varies from country to country and even from physician to physician, but may require intravenous medication (eg, narcotic or nonsteroidal anti-inflammatories) in acute situations. Similar classes of drugs may be effective orally in an outpatient setting for less severe discomfort. Intravenous ketorolac has been found to be quite effective in many cases of acute renal colic to control the pain without the need for narcotic medications. Ketorolac is a non-steroidal anti-inflammatory drug that is related to aspirin and ibuprofen. Most acute kidney stone pain will last less than 24 hours and not require hospitalization. Patients are encouraged to strain their urine so they can collect the stone when it eventually passes and send it for chemical composition analysis. Ketorolac or ketorolac tromethamine (marketed as Toradol® - generics have been approved) is a non-steroidal anti-inflammatory drug (NSAID) in the family of propionic acids, often used as an analgesic, antipyretic (fever reducer), and anti-inflammatory. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Aspirin, or acetylsalicylic acid (IPA: ), (acetosal) is a drug in the family of salicylates, often used as an analgesic (to relieve minor aches and pains), antipyretic (to reduce fever), and as an anti-inflammatory. ... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Ipren or Ibumetin (Sweden), Ibuprom (Poland), IbuHEXAL, Moment (Italy...


In many cases non-invasive Extracorporeal Shock Wave Lithotripsy or (ESWL) may be used. Otherwise some form of invasive procedure is required; with approaches including ureteroscopic fragmentation (or simple basket extraction if feasible) using laser, ultrasonic or mechanical (pneumatic, shock-wave) forms of energy to fragment the stones. Percutaneous nephrolithotomy or open surgery may ultimately be necessary for large or complicated stones or stones which fail other less invasive attempts at treatment. A lithotriptor is a medical device used in the non-invasive treatment of kidney stones (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver). ... Experiment with a laser (US Military) In physics, a laser is a device that emits light through a specific mechanism for which the term laser is an acronym: Light Amplification by Stimulated Emission of Radiation. ... Ultrasound is sound with a frequency greater than the upper limit of human hearing, approximately 20 kilohertz. ... In surgery, percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an open approach where inner organs or tissue are exposed (typically with the use of a scalpel). ... Lithotomy from Greek for lithos (stone) and thomos (cut), is a surgical method for removal of calculi, stones formed inside certain hollow organs, such as the bladder and kidneys (urinary calculus) and gallbladder (gallstones), that cannot exit naturally through the urethra, ureter or biliary duct. ... “Surgeon” redirects here. ...


A single retrospective study in the USA, at the Mayo Clinic, has suggested that lithotripsy may increase subsequent incidence of diabetes and hypertension,[1] but it has not been felt warranted to change clinical practice at the clinic.[2] The study reflects early experience with the original lithotripsy machine which had a very large blast path, much larger than what is used on modern machines. Further study is believed necessary to determine how much risk this treatment actually has using modern machines and treatment regimens. Main campus in downtown Rochester, Minnesota. ...


Calgranulin

Crystallization of calcium oxalate (CaOx) appears to be reduced by molecules in the urine that retard the formation, growth, aggregation, and renal cell adherence of calcium oxalate. By purifying urine using salt precipitation, preparative isoelectric focusing, and sizing chromatography, some researchers have found that the molecule calgranulin is able to inhibit calcium oxalate crystal growth.[3] Calgranulin is a protein formed in the kidney. Frost crystallization on a shrub. ... This article or section is in need of attention from an expert on the subject. ...


Given the large amounts of calcium oxalate in the urine, and considering its potency, calgranulin could become an important contribution to the normal urinary inhibition of crystal growth and aggregation. If so it will be an important tool in the renal defense against kidney stones. There are very few or no other articles that link to this one. ...


Prevention

Preventive strategies include dietary modifications and sometimes also taking drugs with the goal of reducing excretory load on the kidneys:[4]

  • Drinking enough water to make 2 to 2.5 liters of urine per day.
  • Aquaretics
  • A diet low in protein, nitrogen and sodium intake.
  • Avoiding excess Vitamin C, especially Vitamin C supplements.
  • Restriction of oxalate-rich foods and maintenance of an adequate intake of dietary calcium. There is equivocal evidence that calcium supplements increase the risk of stone formation, though calcium citrate appears to carry the lowest, if any, risk.
  • Taking drugs such as thiazides, potassium citrate, magnesium citrate and allopurinol, depending on the cause of stone formation.
  • Depending on the stone formation disease, vitamin B-6 and orthophosphate supplements may be helpful, although these treatments are generally reserved for those with Hyperoxaluria. Cellulose supplements have also shown potential for reducing kidney stones caused by hypercalciuria (excessive urinary calcium) although today other means are generally used as cellulose therapy is associated with significant side effects.

Although it has been claimed that the diuretic effects of alcohol can result in dehydration, which is important for kidney stones sufferers to avoid, there are no conclusive data demonstrating any cause and effect regarding kidney stones. However, some have theorized that frequent and binge drinkers create situations that set up dehydration, (alcohol consumption, hangovers, and poor sleep and stress habits). In this view, it is not the alcohol that creates a kidney stone but it is the alcohol drinker's associated behavior that sets it up.[5] The liter (spelled liter in American English and litre in Commonwealth English) is a unit of volume. ... Aquaretics is a term referring to herbal diuretics. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... General Name, Symbol, Number nitrogen, N, 7 Chemical series nonmetals Group, Period, Block 15, 2, p Appearance colorless gas Standard atomic weight 14. ... For sodium in the diet, see Edible salt. ... Wikipedia does not yet have an article with this exact name. ... Potassium Citrate may be used to control Uric acid kidney stones. ... Allopurinol is a white, powdery drug used primarily to treat conditions arising from excess uric acid, most notably chronic gout. ... A diuretic (colloquially called a water pill) is any drug or herb that elevates the rate of bodily urine excretion (diuresis). ... Dehydration (hypohydration) is the removal of water (hydro in ancient Greek) from an object. ... A hangover, medically termed veisalgia, is the after-effect following the consumption of large amounts of one drug or another. ...


One of the recognized medical therapies for prevention of stones is thiazides, a class of drugs usually thought of as diuretic. These drugs prevent stones through an effect independent of their diuretic properties: they reduce urinary calcium excretion. Nonetheless, their diuretic property does not preclude their efficacy as stone preventive. Sodium restiction is necessary for clinical effect of thiazides, as sodium excess promotes calcium excretion. Though some have said that the effect probably fades after two years or so of therapy (tachyphylaxis), in fact it is only randomized controlled trials lasting 2 years or more that show the effect; there is really no good evidence from studies of calcium metabolism that the thiazide effect does not last indefinitely. Thiazides are the medical therapy of choice for most cases of hypercalciuria (excessive urinary calcium) but may not be suitable for all calcium stone formers; just those with high urinary calcium levels. Thiazides are a class of drug that promote water loss from the body ((diuretics)). They inhibit Na+/Cl- reabsorption from the distal convoluted tubules in the kidneys. ...


Allopurinol (Zyloprim) is another drug with proven benefits in some calcium kidney stone formers. Allopurinol interferes with the liver's production of uric acid. Hyperuricosuria, too much uric acid in the urine, is a risk factor for calcium stones. Allopurinol reduces calcium stone formation in such patients. The drug is also used in patients with gout or hyperuricemia, but hyperuricosuria is not the critical feature of uric acid stones. Uric acid stones are more often caused by low urine pH. Even relatively high uric acid excretion will not be associated with uric acid stone formation if the urine pH is alkaline. Therefore prevention of uric acid stones relies on alkalinization of the urine with citrate. Allopurinol is reserved for patients in whom alkalinization is difficult. For patients with increased uric acid levels and calcium stones, alloprinol is one of the few treatments that has been shown in double-blinded placebo controlled studies to actually reduce kidney stone recurrences. Dosage is adjusted to maintain a reduced urinary excretion of uric acid. Serum uric acid level at or below 6 mg/dL is often the goal of the drug's use in patients with gout or hyperuricemia. Allopurinol is a white, powdery drug used primarily to treat conditions arising from excess uric acid, most notably chronic gout. ... Uric acid (or urate) is an organic compound of carbon, nitrogen, oxygen and hydrogen with the formula C5H4N4O3. ... Hyperuricosuria is a medical term used to refer to the excretion of excessive amounts of uric acid in the urine. ...


Potassium citrate is also used in kidney stone prevention. This is available as both a tablet and liquid preparation. The medication increases urinary pH (makes it more alkaline), as well as increases the urinary citrate level, which helps reduce calcium oxalate crystal aggregation. Optimal 24 hour urine levels of citrate are thought to be over 320 mg/liter of urine or over 600 mg per day. There are urinary dipsticks available that allow patients to monitor and measure urinary pH so patients can optimize their urinary citrate level.


Though caffeine does acutely increase urinary calcium excretion, several independent epidemiologic studies have shown that coffee intake overall is protective for stones.[citation needed]


Measurements of food oxalate content have been difficult and issues remain about the proportion of oxalate that is bio-available, versus a proportion that is not absorbed by the intestine. Oxalate-rich foods are usually restricted to some degree, particularly in patients with high urinary oxalate levels, but no randomized controlled trial of oxalate restriction has been performed to test that hypothesis.


For those patients interested in optimizing their kidney stone prevention options, it's essential to have a 24 hour urine test performed. This should be done with the patient on his or her regular diet and activities. The results can then be analyzed for abnormalities and appropriate treatment given.


Though not a "cure", ease can sometimes be found during "mild" pain by walking (if possible), preferably in cold air. Some pain relief may also be derived by soaking in a hot tub of water.


Risk of high-protein diet

A high protein diet might be partially to blame. Protein from meat and other animal products is broken down into acids, including uric acid. The most available alkaline base to balance the acid from protein is calcium phosphate (hydroxyapatite) from the bones (buffering). The kidney filters the liberated calcium which may then form insoluble crystals (i.e., stones) in urine with available oxalate (partly from metabolic processes, partly from diet) or phosphate ions, depending on conditions. High protein intake is therefore associated with decreased bone density as well as stones. The acid load is associated with decreased urinary citrate excretion; citrate competes with oxalate for calcium and can thereby prevent stones. In addition to increased fluid intake, one of the simplest fixes is to moderate animal protein consumption. However, despite epidemiologic data showing that greater protein intake is associated with more stones, randomized controlled trials of protein restriction have not shown reduced stone prevalence. In this regard, it is not just dietary calcium per se that may cause stone formation, but rather the leaching of bone calcium. Some diseases (e.g., distal renal tubular acidosis) which cause a chronically acidic state also decrease urinary citrate levels; since citrates are normally present as potent inhibitors of stone formation, these patients are prone to frequent stone formation. A high protein diet is often recommended by bodybuilders and nutritionists to help efforts to build muscle and lose fat. ... Acids and bases: Acid-base reaction pH Self-ionization of water Buffer solutions Systematic naming Acid-base extraction Acidity function Proton affinity Acids: Strong acids Weak acids Superacids Lewis acids Mineral acids Organic acids Bases: Strong bases Weak bases Superbases Lewis bases Organic bases edit In chemistry, a base is... General Name, Symbol, Number calcium, Ca, 20 Chemical series alkaline earth metals Group, Period, Block 2, 4, s Appearance silvery white Standard atomic weight 40. ...


Famous sufferers

  • French Renaissance essayist Montaigne suffered from kidney stones. British statesman Samuel Pepys also suffered from kidney stones and was operated on, pre-anesthesia, to remove a large stone which he carried with him and used to try to persuade fellow sufferers to endure the painful surgery. His contemporary, John Wilkins, Bishop of Chester, could not face the prospect and died as a result.
  • Dutch blacksmith Jan de Doot is remembered for having his portrait painted with the large stone that he removed from himself in 1651.
  • The eleventh President of the United States, James K. Polk, suffered from kidney stones which prevented him from receiving a formal education until the age of eighteen
  • Author Isaac Asimov suffered from kidney stones, and wrote about how his pain was treated with morphine, saying that he feared becoming addicted to morphine if he ever needed it again.
  • Astronauts often get kidney stones because of an increase in the amount of calcium in their blood due to a loss of bone density in zero gravity.
  • In his book A Year At the Movies, Mystery Science Theatre 3000 writer/performer Kevin Murphy describes his ordeal with a kidney stone: "Being gut-stabbed with a dirty spoon in a prison cafeteria is less painful."
  • Lyndon B. Johnson suffered from kidney stones at various times in his life. See Woods, LBJ: Architect Of American Ambition.
  • While DJ'ing at a student event, British DJ John Peel passed a kidney stone, and then proceeded to auction it off for charity at the same event.
  • On October 19, 2005, while working on the set of Boston Legal, actor William Shatner was taken to the emergency room for lower back pain. He eventually passed a kidney stone, but recovered and soon returned to work. Shatner sold his kidney stone in 2006 for $75,000 to GoldenPalace.com. The money will go to a housing charity. [1]
  • Minnesota Twins catcher Joe Mauer has also suffered from kidney stones. When asked about it he stated, "I don't wish that on anyone."
  • John Hart, signer of the Declaration of Independence, died of kidney stones.
  • Peter Baulman (Australia) had a kidney stone removed from his right kidney in December 2003 at The Gold Coast Hospital, Southport, Queensland, Australia, weighing 356 g (12.5 oz) and measuring at its widest point, 11.86 cm (4.66 in). It holds the Guinness world record for largest and heaviest kidney stone removed from a human being.
  • Tim Snead, humanitarian and environmentalist

Centuries: 4th century BC - 3rd century BC - 2nd century BC Decades: 320s BC 310s BC 300s BC 290s BC 280s BC - 270s BC - 260s BC 250s BC 240s BC 230s BC 220s BC 276 BC 275 BC 274 BC 273 BC 272 BC - 271 BC - 270 BC 269 BC 268... Centuries: 4th century BC - 3rd century BC - 2nd century BC Decades: 320s BC 310s BC 300s BC 290s BC 280s BC 270s BC - 260s BC 250s BC 240s BC 230s BC 220s BC 275 BC 274 BC 273 BC 272 BC 271 BC - 270 BC - 269 BC 268 BC 267... Epicurus (Greek ) (341 BC, Samos – 270 BC, Athens) was an ancient Greek philosopher and the founder of Epicureanism, a popular school of thought in Hellenistic Philosophy that spanned about 600 years. ... A fortnight is a unit of time equal to two weeks: that is 14 days, or literally 14 nights. ... Hermarchus (in Greek EρμαρχoÏ‚), sometimes, but incorrectly, written Hermachus. ... Diogenes Laërtius, the biographer of the Greek philosophers, is supposed by some to have received his surname from the town of Laerte in Cilicia, and by others from the Roman family of the Laërtii. ... Michel Eyquem de Montaigne (February 28, 1533 - September 13, 1592) was an influential French Renaissance writer, generally considered to be the inventor of the personal essay. ... Samuel Pepys, FRS (23 February 1633 – 26 May 1703) was an English naval administrator and Member of Parliament, who is now most famous for his diary. ... John Wilkins. ... There are very few or no other articles that link to this one. ... Charles Michael Chuck Palahniuk (IPA: )[1] (born February 21, 1962) is an American satirical novelist and freelance journalist of Ukrainian ancestry born in Pasco, Washington. ... Stranger Than Fiction: True Stories (published in the United Kingdom under the title Nonfiction) is a non-fiction book by Chuck Palahniuk, published in 2004. ... James Knox Polk (November 2, 1795–June 15, 1849) was the eleventh President of the United States, serving from March 4, 1845 to March 4, 1849. ... Isaac Asimov (January 2?, 1920?[1] – April 6, 1992), IPA: , originally Исаак Озимов but now transcribed into Russian as Айзек Азимов) was a Russian-born American Jewish author and professor of biochemistry, a highly successful and exceptionally prolific writer best known for his works of science fiction and for his popular science books. ... Morphine (INN) (IPA: ) is a highly potent opiate analgesic drug and is the principal active agent in opium and the prototypical opiate. ... For other uses, see addicted. ... Astronaut Bruce McCandless II using a manned maneuvering unit outside the U.S. Space Shuttle Challenger in 1984. ... From left to right, Crow T. Robot, Joel Robinson, and Tom Servo. ... Mystery Science Theater 3000s Michael J. Nelson (left) and Kevin Murphy at an Exoticon 1 convention panel in Metairie, Louisiana, November 1998. ... The United States House of Representatives (or simply the House) is one of the two chambers of the United States Congress; the other is the Senate. ... John Dennis Denny Hastert (born January 2, 1942) is an American politician. ... “LBJ” redirects here. ... “Peel Sessions” redirects here. ... is the 292nd day of the year (293rd in leap years) in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... Boston Legal is an American dramedy television series that began airing on ABC on October 3rd, 2004. ... William Alan Shatner (born on March 22, 1931) is a Canadian actor who gained fame for playing James Tiberius Kirk of the USS Enterprise in the television show Star Trek from 1966 to 1969 and in seven of the subsequent movies. ... goldenpalace. ... Major league affiliations American League (1901–present) Central Division (1994–present) Current uniform Retired Numbers 3, 6, 14, 29, 34, 42 Name Minnesota Twins (1961–present) Washington Nationals/Senators (1901-1960) Other nicknames The Twinkies Ballpark Hubert H. Humphrey Metrodome 1982-present Metropolitan Stadium (1961-1981) Griffith Stadium (1903-1960... Joseph Patrick Mauer (born April 19, 1983) is a catcher in Major League Baseball for the Minnesota Twins. ... Reggaeton (also spelled Reggaetón, and known as Reguetón and Reggaetón in Spanish) is a form of urban music which became popular with Latin American (or Latino) youth during the early 1990s and spread over the course of 10 years to North American, European, Asian, and Australian audiences. ... Efrain Finez Nevarez (better known as Tito El Bambino) is a reggaeton singer from Puerto Rico. ... Karl Pilkington (born September 23, 1972 in Manchester) is an English, Sony Award-winning radio producer and personality best known for producing and co-presenting The Ricky Gervais Show on the radio station XFM. On October 3, 2006, Pilkingtons first book The World of Karl Pilkington was released, featuring... John Hart John Hart (about 1713–May 11, 1779), was a signer of the United States Declaration of Independence as a representative of New Jersey. ... Monument of Tycho Brahe and Johannes Kepler in Prague Tycho Brahe, born Tyge Ottesen Brahe (December 14, 1546 – October 24, 1601), was a Danish nobleman from the region of Scania (in modern-day Sweden), best known today as an early astronomer, though in his lifetime he was also well known... Georges-Louis Leclerc, Comte de Buffon, by François-Hubert Drouais (1727-1775). ... Captain Myles Standish Kt. ... Pilgrims is the name commonly applied to early settlers of the Plymouth Colony in present-day Plymouth, Massachusetts. ... Seal of Plymouth Colony Map of Plymouth Colony showing town locations Capital Plymouth Language(s) English Religion Puritan, Separatist Government Monarchy Legislature General Court History  - Established 1620  - First Thanksgiving 1621  - Pequot War 1637  - King Philips War 1675–1676  - Part of the Dominion of New England 1686–1688  - Disestablished 1691... ... The Pulitzer Prize is an American award regarded as the highest national honor in print journalism, literary achievements, and musical composition. ... Arthur Buchwald (October 20, 1925 – January 17, 2007) was an American humorist best known for his long-running column that he wrote in The Washington Post, which in turn was carried as a syndicated column in many other newspapers. ...

Fictitious sufferers

  • In the sixth season episode of Seinfeld, titled "The Gymnast," Kramer suffers from a kidney stone that he describes as "a stony mineral concretion, formed abnormally in the kidney. And this jagged shard of calcium pushes its way through the ureter into the bladder. It's forced out through the urine!" At the end of the episode, he passes the stone while in the washroom at a circus. His screaming is so loud that not only can everyone in the stadium hear him, but the tightrope walker even loses his balance and falls.
  • In third episode of season five of Friends, entitled "The One Hundredth", Joey suffers from kidney stones while at the hospital for Phoebe giving birth to the triplets.
  • In the 15th episode of the second season of Deadwood, Al Swearengen is diagnosed with a bladder stone, which has him crippled on the floor in pain, suffering from septic shock. He eventually passes the stone, thus avoiding being subjected to crude surgery with a 2 in 10 survival rate.
  • A sketch in Family Guy includes Muddy Waters as he plays in the bathroom screaming, trying to pass a kidney stone.
  • In an episode of Duckman, Duckman passes a kidney stone at his doctor's office. Upon examining it, the doctor touches it, and exclaims, "Ouch! I've never been cut by a urine sample before."
  • In an episode of Reba, Brock, Reba's ex-husband, gets a kidney stone.
  • In Neal Stephenson's Baroque Cycle, protagonist Daniel Waterhouse has a lithotomy performed by Robert Hooke to remove a bladder stone. His mentor, John Wilkins, dies of a bladder stone after refusing treatment in order to enable him to complete a particular work.

Seinfeld is an Emmy Award-winning American sitcom that originally aired on NBC from July 5, 1989, to May 14, 1998, running a total of 9 seasons. ... The Gymnast is the ninety-second episode of the hit sitcom Seinfeld. ... Cosmo Kramer is a fictional character on the United States based television sitcom Seinfeld (1989–1998), played by Michael Richards. ... For the use of the word in a general sense, see Friendship. ... The One With the Triplets is the 3rd episode of season 5 of the sitcom Friends. ... Joseph Joey Francis Tribbiani, Jr. ... This article does not cite any references or sources. ... Deadwood is an American television drama series that premiered in March 2004 on HBO. The series is a Western set in the 1870s in Deadwood, Dakota Territory. ... The Gem Theater circa 1878. ... Family Guy is an Emmy award winning American animated television series about a nuclear family in the fictional town of Quahog (IPA or ), Rhode Island. ... McKinley Morganfield (April 4, 1915 – April 30, 1983), better known as Muddy Waters, was an American blues musician and is generally considered the Father of Chicago blues. He is also the actual father of blues musician Big Bill Morganfield. ... This article does not cite any references or sources. ... Reba is an American sitcom starring country music singer Reba McEntire. ... Daniel Waterhouse is a fictional character from Neal Stephensons The Baroque Cycle, a series of novels: Quicksilver, The Confusion and The System of the World. ... John Wilkins. ...

See also

A drawing of the human kidney from Grays Anatomy. ... Urinary retention also known as ischuria is a lack of ability to urinate. ... This article or section is in need of attention from an expert on the subject. ... Retrograde Pyelogram is a urology procedure where the physician is trying to find a kidney stone. ... Ë Cystinuria is an inherited autosomal recessive disorder and is characterized by the formation of cystine stones in the kidneys, ureter, and bladder. ... An intravenous pyelogram (also known as IVP, pyelography, intravenous urogram or IVU) is a radiological procedure used to visualise disturbances of the urinary system, including the kidneys, ureters, and bladder. ...

References and notes

  • Coe FL, Evan A, Worcester E (2005). "Kidney stone disease". J Clin Invest 115 (10): 2598-608. PMID 16200192. 
  1. ^ Krambeck AE, Gettman MT, Rohlinger AL, Lohse CM, Patterson DE, Segura JW (2006). "Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup". J Urol 175 (5): 1742-7. PMID 16600747. 
  2. ^ Ed Edelson. "Kidney Stone Shock Wave Treatment Boosts Diabetes, Hypertension Risk - Study suggests link, but doctors say it's too early to abandon this therapy", HealthFinder, National Health Information Center. 
  3. ^ http://ajprenal.physiology.org/cgi/content/abstract/275/2/F255 Calcim Oxalate crystallization experiment
  4. ^ Goldfarb DS, Coe FL (1999, Nov 15). "Prevention of recurrent nephrolithiasis". Am Fam Physician 60 (8): 2269-76. PMID 10593318. 
  5. ^ Rodman, John, S (May, 1997). "No More Kidney Stones". Prevention. 

External links


  Results from FactBites:
 
Kidney stone - Wikipedia, the free encyclopedia (2026 words)
Kidney stones, also known as nephrolithiases, urolithiases or renal calculi, are solid accretions (crystals) of dissolved minerals in urine found inside the kidneys or ureters.
Kidney stones typically leave the body in the urine stream; if they grow relatively large before passing (on the order of millimeters), obstruction of a ureter and distention with urine can cause severe pain most commonly felt in the flank, lower abdomen and groin.
Kidney stones are usually asymptomatic until they obstruct the flow of urine.
Kidney Stones (Renal Stone) - causes, symptoms and treatment information on MedicineNet.com (574 words)
Kidney stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin.
Kidney stones form when there is a decrease in urine volume or an excess of stone-forming substances in the urine.
Kidney stones associated with infection in the urinary tract are known as struvite or infection stones.
  More results at FactBites »

 
 

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