KIDNEY STONES. Information Leaflet. Your Health. Our Priority.

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1 KIDNEY STONES Information Leaflet Your Health. Our Priority.

2 Page 2 of 6 Introduction Kidney stones can develop in one or both of the kidneys. They are quite common and usually affect people who are between 30 and 60 years of age, men are twice as likely to develop kidney stones as women. What is a kidney stone? There are four main types of kidney stone: Calcium stones are made from calcium and phosphate or calcium and oxalate. Struvite stones contain magnesium and ammonia and are often horn shaped and quite large. Uric acid stones are usually smooth, brown and softer than other forms of kidney stones. Cystine stones are often yellow and resemble crystals rather than stones. Kidney stones come in a variety of shapes, sizes and colours. Some resemble grains of sand, while in rare cases, others can grow to the size of a golf ball. How does a kidney stone form? Kidneys remove waste products from the blood into urine, but occasionally, they can form crystals that collect around the inside of the kidney. The crystals may gather over time to form a hard stone-like lump. This is a kidney stone. A small stone might travel painlessly through the system and pass unnoticed as you pass urine. This is a silent stone.

3 Page 3 of 6 However it is fairly common for a stone to block part of the urinary system, such as the ureter or the urethra (the tube that carries urine from the bladder to the outside of the body).if this happens, you may experience severe pain in your abdomen or groin. A blockage in the urinary system can lead to infection, kidney damage or sometimes kidney failure. Causes The exact cause of kidney stones is unknown. They are usually formed following a build-up of a substance in the body, such as calcium, ammonia, uric acid or cystine. Certain medical conditions, such as cancer or kidney disease, can also increase your risk of developing kidney stones. This is usually due to the treatment for these conditions. You are also at greater risk of developing kidney stones if: you are dehydrated or do not drink enough fluids, you eat a high protein, low fibre diet, you are inactive or bed-bound, kidney stones run in your family, you have had a kidney stone previously, only one kidney works, if you have had an intestinal bypass or a disease of the small intestine such as Crohn s disease (inflammation of the gut). There is also evidence that certain medication, such as aspirin, antacids, calcium and vitamin D supplements, may increase your risk of developing a kidney stone. Diagnosis Your GP will usually be able to diagnose a kidney stone from your symptoms. However, a number of different diagnostic techniques may be used to help confirm the diagnosis or to identify precisely where a kidney stone is. These include: an x-ray, ultrasound, computerised tomography (CT) scan, or an intravenous urogram (IVU) also known as an intravenous pylogram (IVP). An IVU is a technique that involves injecting a dye into a vein in your arm and watching the kidneys filter it out into the urine. The dye shows up on an X-ray, which will highlight any points in the filtration process that are blocked. Other tests that may be performed if you have kidney stones include: Blood Tests- to check that your kidneys are working properly and to check the levels of chemicals that could cause kidney stones, such as calcium, Urine tests- to check for infections and pieces of stones. Examination of any stones-which you pass in your urine.

4 Page 4 of 6 You can catch a kidney stone by urinating through some gauze or a stocking. Having a stone to analyse will make a diagnosis easier and it will enable your Doctor to determine which method of treatment will benefit you most. Treatment If you have a kidney stone, the type of treatment that you will need will depend on the type of stone that you have. Small Kidney Stones Most kidney stones will be small enough to be passed in your urine. However, this may still cause pain and may need to be treated using painkillers. If you experience severe pain, you may need stronger painkillers and be treated at hospital. The pain from smaller kidney stones usually lasts a couple of days and goes when the stone has been passed. Large kidney stones If a kidney stone is too big to be passed naturally, you may need treatment to remove it another way. This could include: Extra Corporeal Shockwave Lithotripsy (ESWL)-this involves using X-rays or ultrasound to pin-point where a kidney stone is. A machine then sends shock waves of energy to the stone to break it in to smaller pieces, so that they can be passed in your urine. Percutaneous nephrolithotomy (PCNL)-this involves using a thin telescopic instrument called a nephroscope, which is passed through an incision in your back leading to your kidney. The stone is then either pulled out or broken into smaller pieces by a laser or using ESWL. Ureteroscopy- this involves passing a long thin telescope called a ureterscope, through your urethra (the water pipe) into your bladder and up into the ureter to where the stone is stuck. The surgeon may either gently remove the stone using another instrument, lasers or ESWL to break the stone up into small pieces so that it can be passed naturally in your urine. Surgery If none of the other methods of removing your kidney stone are suitable, it may need to be removes using traditional surgery. This will involve making an incision in your back in order to gain access to both your ureter and kidney so that your stone can be removed. Prevention Drink plenty of water, to dilute your urine. The colour of your urine indicates how dilute it is, the darker it is, the more concentrated it is. After not urinating for a long time, overnight for example, it will be a dark yellow. You should drink at least 6-8 glasses (1-2 litres) of water a day. People who have had a kidney stone, are encouraged to increase their fluid intake to 2-3 litres each day in order to flush out waste products that can cause more stones to develop. Drinks such as tea, coffee and fruit juice can count towards your fluid intake, but water is the healthiest option and is best for preventing kidney stones. You should also make sure that you

5 Page 5 of 6 drink more than the recommended daily amount when it is hot or when you are exercising, in order to replenish fluids that are lost through sweating. Diet If your kidney stone is caused by an excess of calcium, you may be advised to reduce the amount of oxalates in your diet. Oxalates prevent calcium from being absorbed by your body, so it can accumulate in your kidney and form a stone. Foods that contain oxalates include: Beetroot Asparagus Rhubarb Chocolate Berries Leeks Parsley Celery Almonds, peanuts and cashew nuts, Soy products, Grains such as oatmeal, wheat germ and whole wheat. You should not reduce the amount of calcium in your diet unless your GP recommends it. To prevent developing a uric acid stone, you should reduce the amount of meat, poultry and fish in your diet. You may also be prescribed medication to change the levels of acid or alkaline in your urine. Medication If you have a kidney stone, medication is usually prescribed for pain relief or to prevent infections from developing. However, some medication may need to be reviewed by your GP if it is thought to be causing your kidney stone. The type of medication that your GP prescribes will depend on the type of kidney stone that you have. For example, if you have previously had a Struvite stone, you may need to take antibiotics to prevent bacteria from a urinary tract infection infecting your kidney and creating a stone. Your Doctor will be able to give you more advice about how to prevent urinary tract infections. Contact us Stockport Tel: Tameside Tel: /6696 Macclesfield Tel:

6 Page 6 of 6 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number URO52 Publication date May 2016 Review date May 2018 Department Urology Location Stepping Hill Hospital