QUESTION: I have just recovered from a bout of kidney stones, which fortunately passed without 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?
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 oxalate, 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 noncalcium 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.
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.
