Kidney Stones

• A kidney stone is a hard deposit of minerals or a collection of crystals that forms in the kidney and looks like a stone.
• These stones can sometimes block the flow of urine, which can cause pain or blood in the urine.
• Chance of another stone People who have one kidney stone have approximately a 50% chance of having another stone in the next 10 years.
• Family history People with a family history of kidney stones are 2-times more likely to get a kidney stone than someone without a family history.

• This is similar to what happens when you are mixing a powdered drink: too much powder and too little water means it won’t be well mixed and powder (like stones) will be left over.
• Not drinking enough fluid is important and may cause stones to grow.

• There are many different kinds of kidney stones.
• Prevention and treatment advice usually depends on the type of stone.
• Capturing the stone through urine will allow the stone to be sent to the laboratory to determine the type of stone.

Most common types

Calcium oxalate
For calcium oxalate stones, there may be too much calcium and oxalate in the urine.
There also may be a low level in the urine of a naturally occurring kidney stone preventer called citrate.

Calcium phosphate
For calcium phosphate stones, there may be too much calcium and too little acid in the urine.

Less common or rare types

Uric acid
For uric acid stones, there is usually too much uric acid.

Cysteine
For cystine stones, there is too much cystine – an amino acid. An abnormal inherited gene causes this type of stone.

Struvite
For struvite stones, there is usually infection in the urine.

Mixed types

Some stones are a mixture of various types.

• If the urine oxalate is high, then patients need to follow a low oxalate diet.
• High oxalate foods include spinach and rhubarb.
• Moderate oxalate foods include potatoes and nuts.
• If these are eaten, also drink a lot of fluid and consider eating at the same time food with calcium such as milk or yogurt.
• Take medicine to reduce urine acid levels.
• If the urine acid level is high, you can ask us for prescription pills to help reduce it.
• But if the acid level is low there is not much than can be done to raise it.
• Take medicine for low urine citrate.
• Adding more citrate to the urine by taking potassium citrate pills can help prevent stones in people with low urine citrate or even with normal urine citrate levels.

Work with your doctor

• The most effective treatments require a dedicated plan based on the urine test results.
• Our team may ask you to collect all your urine for a whole day to measure the specific components in the urine.
• It may be helpful to do this 24-hour collection more than 1 time.
• Depending on the results, there are things patients and we doctors can do that can be helpful to prevent new stones, or prevent existing stones from growing bigger.

Drink liquids

• Drinking more liquid (when our team advises)—just about any kind of liquid is fine, except for sugar-sweetened beverages like soda.
• The goal is to drink enough that your body will make at least 3 litres of urine each day.

Change your diet

• For calcium stones, if the urine calcium is high, patients need to eat a low sodium and low animal protein diet.
• If this is not effective, then a pill called a thiazide diuretic can reduce the amount of calcium in the urine.
• Patients should not eat a low calcium diet as this treatment does not work. It will also cause calcium from bones to go out in the urine and weakens bone system.

• Nephrologists are doctors who specialize in kidney medicine and focus on stone prevention.
• Urologists are doctors who are trained as surgeons and help remove existing stones and can also prescribe treatments for prevention.
• Both types of doctors work together to prevent and treat kidney stones.