What is it?

• Nephrolithiasis (nef-ro-lih-thi-uh-sis) is another name for kidney stones. Kidney stones are also called renal calculi (kal-kew-lie). They are rock-like pieces that are usually very small, like a grain of sand. But some kidney stones are the size of small pebble rocks. They usually form in the kidneys and get stuck in one of the 2 ureters (yer-ih-ters). Kidney stones cause pain and block the urine flow. You may have more than 1 stone.
• Kidney stones are more common in 20 to 30 year olds. But anyone can have kidney stones at any age. Men get kidney stones more often than women.
• The urinary system is made up of the kidneys, bladder, and ureters. The kidneys are bean-shaped organs that remove unwanted chemicals and waste from your blood. These wastes are turned into urine by the kidneys. The kidneys are in the back of the abdomen (belly) on either side of the spine. The ureters are tubes that carry urine from the kidneys to the bladder. The bladder is a hollow, round organ that holds urine until it leaves the body.

Causes:

Kidney stones are caused by a buildup of uric acid, calcium, or phosphate in your urine. Not drinking enough water and other liquids may cause you to have kidney stones. You may be more likely to have kidney stones if you have urine infections or gout. Some rapid weight loss diets can also increase the risk of kidney stones.

Signs and Symptoms:

The most common sign of kidney stones is sudden pain in the middle of your back that moves to either side. The pain may come and go and can be very bad. You may see blood in your urine that will look pink or red. It may hurt when you urinate. You may feel sick to your stomach (nausea) or vomit (throw up). If your stone has caused an infection, you may have fever and chills.

Wellness Recommendations:

Drink 8 or more glasses (soda pop can size) a day of water. This will keep your urine clear and is the best way to decrease having another kidney stone.

Medical Care:

You may be treated at home and the stone will pass on its own during urination. You may need an ultrasound or a x-ray called an IVP to look for the stone. A urine and blood sample may be sent to the lab for tests. If the stone does not pass, you may need surgery to remove it. You may need to have lithotripsy to break it apart. With lithotripsy, shock waves are used to break up the kidney stones. Medicine, diet changes, and other treatments may be used to prevent kidney stones. You may have a blood test to check your parathyroid glands if you regularly have kidney stones. If this gland is overactive, it can raise your blood calcium levels and increase your risk of having kidney stones.

Dietary Measures:

• Decrease your intake of oxalate-rich foods, such as spinach and rhubarb.
• Decrease your salt intake. Salt causes the amount of calcium in the urine to increase.
• Eat more vegetables. Vegetarians have fewer kidney stones than others.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

Supplements:

Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

Talk to your caregiver if:

• You would like medicine to treat nephrolithiasis.
• Your symptoms have not gone away or improved by these self-help measures
• You have bad pain.
• You have questions about what you have read in this document.

SEEK CARE IMMEDIATELY IF:

• You have a very high temperature.

Care Agreement:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss your treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

References:

1. Curhan GC, Willett WC, Rimm EB et al: Prospective study of beverage use and the risk of kidney stones. Am J Epidemiol 1996; 143(3):240-247.

2. Curhan GC, Willett WC, Speizer FE et al: Intake of vitamins B6 and C and the risk of kidney stones in women. J Am Soc Nephrol 1999; 10:840-845.

3. Johansson G, Backman U, Danielson BG et al: Effects of magnesium hydroxide in renal stone disease. Journal of Am Coll Nutr 1982; 1:179-185.

4. Liebman M & Chai W: Effect of dietary calcium on urinary oxalate excretion after oxalate loads. Am J Clin Nutr 1997; 65(5):1453-1459.

5. Massey LK, Roman-Smith H & Sutton RA:. Effect of dietary oxalate and calcium on urinary oxalate and risk of formation of calcium oxalate kidney stones. J Am Dietet Assoc1993; 93:901-906.

6. Mitwalli A, Ayiomamitis A, Grass L et al: Control of hyperoxaluria with large doses of pyridoxine in patients with kidney stones. Int Urol Nephrol 1988; 20(4):353-359.

7. Muldowney FP, Freaney R& Moloney MF: Importance of dietary sodium in the hypercalciuria syndrome. Kidney Int 1982; 22:292-296.

8. Nicar MJ, Peterson R & Pak CY: Use of potassium citrate as potassium supplement during thiazide therapy of calcium nephrolithiasis. J Urology 1984; 131(3):430-433.

9. Robertson WG, Peacock M & Marshall DH: Prevalence of urinary stone disease in vegetarians. Eur Urol 1982; 8:334-339.

10. Suphakarn VS, Yarnnon C & Ngunboonsri P: The effect of pumpkin seeds on oxalcrystalluria and urinary compositions of children in hyperendemic area. Am J Clin Nutr 1987; 45(1):115-121.