How does the kidney filter blood?

How does the kidney filter blood?Many people do not realize how vital their kidneys are to their overall health until an issue arises and they need to seek medical care. Knowing what your kidneys do and how they function can go a long way toward maintaining good health before a problem occurs or understanding the treatment process once you are under a urologist’s supervision.

What Do My Kidneys Do?

Your kidneys are basically your body’s filtration system. Every minute, approximately half a cup of blood flows through them. As the blood flows through, waste products are removed, as is excess water; the levels of minerals and salt are also adjusted if need be. Although around 150 quarts of blood are filtered by your kidneys every day as it continually cycles through your body, only about 1-2 quarts of urine are produced from the waste products and excess water. The urine then flows to the bladder through a tube called the ureter.

How Do My Kidneys Work?

Inside each kidney, there are about a million tiny filtration units called nephrons. The nephrons are made up of a filter called a glomerulus and a tube called a tubule. Blood flows through the glomerulus, where waste and excess water or minerals are filtered out. The tubule then sends the filtered substances to collect in the kidneys before flowing through the ureter to the bladder, while the newly-filtered blood is returned to the rest of the body. There are so many nephrons in your kidneys that even if more than half of them are no longer working, you may not notice any issues or symptoms.

What Happens If Something Goes Wrong?

Many things can occur to interrupt the function of your kidneys. Warning signs of kidney disease include an increased need to urinate, especially at night, blood in the urine, foamy urine, cramping muscles and swollen ankles and feet. These are all signs that something could be wrong with the filtration system in your kidneys, causing issues with fluid and electrolyte levels in your body.

Another common problem is kidney stones. When there is a buildup of certain waste products in the kidneys and not enough fluid to flush them out, these waste products can crystallize and form stones that cause extreme pain as they leave the body. If you suspect you are dealing with kidney stones, kidney disease, or other problems with your urinary system, it’s important to talk to a doctor right away, like the urologists at St Pete Urology, who will be able to diagnose any issues and help you and your kidneys return to normal healthy function as soon as possible.

For more information, visit the St Pete Urology website.

Why Do I Keep Getting UTIs?

Urinary tract infections (UTIs) are caused by bacteria or E.coli in the organs of the urinary tract — the kidneys, ureters, urethra and the bladder. Most UTIs affect the urethra and the bladder alone. While UTIs affect both men and women, the rate of prevalence and recurrence is higher among women, with about 50 percent of all women expected to contract the infection at least once in their life time and 20-30 percent expected to suffer a recurrence.
The high prevalence of UTIs among women is attributed to the fact that the urethra in women is shorter than in men. The urethra in women is placed closer to both the anus and the vagina. Bacteria from the anus and those that enter the vagina during intercourse have only to travel the short length of the urethra to reach the bladder. Besides gender, the other risk factor for UTIs for both genders is advanced age.

Causes of recurrence

A case of UTI is said to be recurrent or persistent if a patient contracts at least four infections in a period of one year. Recurrence of UTIs occurs almost solely among women. Other than the positioning of the urethra in their bodies, this recurrence may be caused by factors such as:

1. Failure to complete a dose of antibiotics. Once the benefits of taking the prescribed antibiotics start to manifest, some patients stop taking the drug because they think the UTI has cleared. Urologists discourage this behavior and advise patients to complete the dose to reduce the chances of any left over bacteria causing a recurrence.

2. Sex is a risk factor. Sexually active women face a higher risk of contracting a UTI because of the transmission of bacteria during intercourse. The risk can be reduced by urinating before and after sex or by taking an antibiotic before or after sex if a doctor prescribes it.

3. Post-menopausal hormonal changes. Menopause lowers estrogen levels in women causing an imbalance in the bacteria in the vagina. This makes women susceptible to infection and recurrence. A urologist can prescribe a vaginal estrogen cream to remedy the problem.

Women are genetically predisposed to contracting UTIs, both because of their anatomy and hormonal changes as they get older. But UTIs in women are highly treatable and are only rarely very serious. If anyone experiences persistent infections, she should seek the advice of expert urologists, such as those found in St. Pete Urology. The experienced specialists at St. Pete Urology can offer consultation, diagnosis and treatment for any UTI problems. For more information, visit the “St Pete Urology” site.

What Can You Do To Reduce The Risk of Having Kidney Stones

Kidney stones are hard, crystallized minerals that form in the kidneys that may spread to other organs in the urinary tract such as the bladder and the ureter. They form when urine becomes so concentrated with minerals that the minerals crystallize and harden. Often stones are formed from a fusion of calcium and oxalate or phosphorus. Symptoms of kidney stones include trouble passing urine, excruciating pain when passing urine, pain in the groin, below the ribs and in the abdomen, blood in the urine and frequent urination. While reports indicate that the prevalence of kidney stones has grown in modern times, the condition still remains a preventable one.

Ways of preventing Kidney Stones

1. Cut down on sodium intake
A heavy sodium intake causes a proportionate increase in the amount of calcium in urine, creating a good chance of kidney stone formation. Processed and canned foods are known to contain high amounts of sodium. It is advisable to reduce one’s consumption of such foods.

2. Staying hydrated
Drinking enough water and other fluids is one of the best and easiest ways to prevent kidney stones. Water dilutes urine, making it less concentrated. A shortage of fluid in the body translates into just a little concentrated urine. Urine salts are more likely to crystallize and form stones because there is insufficient water to dissolve them.

3. Consumption of foods rich in calcium
Even if most stones have aspects of calcium, calcium rich foods such as milk and cheese prevent the likelihood of kidney stone recurrence. This is because the levels of oxalate, which is a stone forming mineral, increase with decreasing levels of calcium. Calcium should be maintained at a good level.

4. Cut down on the intake of animal proteins and fructose
Organ meats, red meat, seafood and poultry contain a compound known as purine which contributes to the formation of kidney stones, specifically uric acid stones. The same goes for foods with high fructose, with corn syrup specifically being one to avoid. Managing the intake of these foods should go a long way in preventing stones from forming.

In addition to watching one’s diet, medical professionals advise that people should obtain a good amount of exercise to prevent weight related disorders such as obesity.

Kidney stones are very painful and, in this instance, there is no question that prevention is much better than cure. If you discover that you have kidney stones, you should seek medical attention immediately. For those interested in prevention only, reading up on the subject can offer practical ways to avoid having kidney stones. The staff of specialists at St. Pete Urology also are able to help with diagnosis, prevention and treatment of kidney stones. For more information, visit the St Pete Urology website.

How can I prevent recurrent kidney stones

Kidney stones occur when tiny crystals form and stick together as solid masses in urine. Often, due to increased concentration of various chemicals in urine, crystals form and then grow into larger masses that move through the urinary tract. As they move, the stones may get stuck somewhere along the tract and block urine flow, causing pain. Most kidney stones are a combination of calcium with either oxalate or phosphate, but stones also may form when uric acid levels increase in urine as a result of protein metabolism.

Preventing kidney stone recurrence

For many people who have had a kidney stone, it is not a one-time thing. In fact, in about 50 percent of those who have had a stone, another one will appear within 7 years if no preventive measures are in place. At St Pete Urology, we ensure that our patients take the necessary steps to prevent a recurrence. That is why, after treatment, we conduct a special urine test on our patients to find out why the stone formed in the first place. Using the results of the test, we guide our patients on how best they can avoid a recurrence.

Some of the measures we recommend to avert kidney stone recurrence include:

1. Drinking enough water

Water dilutes urine, reduces the concentration of substances in it and prevents kidney stones. To prevent recurrent kidney stones, you should endeavor to drink enough fluid to pass at least 2 liters of urine per day. Increased fluid intake that is distributed throughout the day decreases kidney stone recurrence by about 50 percent and with virtually no adverse effects.

For better results, you may add orange juice or lemonade to the water so there is increased citrate in the fluid to block stone formation. Medication such as allopurinol, citrate or a thiazide diuretic can be taken with the fluid to minimize the chance of kidney stone recurrence. However, if you are already drinking that much fluid before your kidney stones, you should not increase your fluid intake.

2. Making dietary changes

Once you are treated for kidney stones, we will recommend that you reduce your intake of eggs, seafood, poultry, red meat and other animal protein. These foods increase uric acid levels while also reducing citrate levels in the body, which can trigger a recurrence of kidney stones. That is why after treatment for kidney stones, we recommend that you should cut down your daily meat portions to a size no larger than a pack of playing cards. Likewise, you should avoid foods such as chocolate, strawberries, wheat bran, beets, spinach, tea, rhubarb and most nuts that contain oxalate or the phosphate containing colas that may trigger kidney stone recurrence.

3. Increasing calcium intake

Oxalate levels may rise and trigger kidney stones if the level of calcium in the diet is low. So after treatment, it is important to ensure that you increase your calcium intake to match your age. For example, if you are a man 50 and older, you should get 1,000 milligrams of calcium every day, together with 800-1000 IU (international units) of vitamin-D to ensure your body absorbs the calcium properly. With increased dietary calcium, you can prevent a recurrence of kidney stones.

4. Reduced sodium intake

Kidney stones may recur if there is a lot of sodium in your diet because increased sodium leads to high concentration of calcium in urine. So after treatment for kidney stones, we usually recommend that you lower the amount of sodium in your diet, limiting your total daily sodium to 2,300 mg. But if sodium was responsible for your previous kidney stones, then we recommend that you should take at most 1,500 mg of sodium per day. Such a low level of sodium also will be good for your heart and your blood pressure.

Those are some of our most common recommendations for averting kidney stone recurrence. As you might have noticed, they are not complicated things to do, but they do require some commitment. For more information on prevention and treatment of kidney stones, visit the “St Pete Urology” site.

3 Effective Minimally Invasive Surgical Treatment For Kidney Stones

Over the last 15 years, kidney stone prevalence has doubled in United States. Today, roughly 1-in-10 Americans will have a kidney stone attack at some point during their lifetime. When they occur, kidney stones can cause agonizing and unbearable pain in the back and side, and may sometimes trigger nausea and vomiting. You can pass a stone by drinking plenty of water — taking pain medications to control the discomfort as you wait for the stone to pass. But if you have a large stone or one that’s causing complications, then a more extensive treatment may be necessary to remove the stone.

Minimally-invasive surgical treatments

At St Pete Urology, we offer surgical treatment for kidney stones, focusing on minimally-invasive procedures even for the largest stones. Most operations for smaller stones can be done as same-day surgeries, giving patients greater flexibility and a faster return to their work and other routine activities. For larger stones, the planning and execution of the procedures may take a little more time, but with the use of small incisions only large enough to allow insertion of thin tubes, fiber-optic lights, cameras and other tiny surgical tools, we are able to ensure significantly less pain, less scarring, shorter hospital stay, faster recovery and increased accuracy than with traditional open surgery for the stones.

There are three main minimally-invasive techniques for removal of kidney stones. The least invasive being extracorporeal shockwave lithotripsy, followed by ureteroscopy then lastly percutaneous nephrolithotomy. The choice of a surgical technique depends on multiple factors, including the type of stone, size and location, medications taken by the patient, other medical problems the patient may have, and patient preferences.

Extracorporeal Shockwave Lithotripsy (ESWL)

This is the most popular option for treating small and medium-sized stones. Performed in an outpatient setting with the patient placed under general anesthesia, ESWL is the least invasive and takes 20-30 minutes to be completed. During the surgical procedure, intense sound waves are focused on the kidney stone, shattering the stone with minimal effect on surrounding tissue. Smaller pieces of stones that are produced get washed out of the urinary system with the normal flow of urine, often with slight or no discomfort. ESWL is a highly effective treatment for most stones that form in the kidney or ureter.

Advantages of ESWL include:

  1. It’s an outpatient procedure so patients return home after a few hours.
  2. It offers excellent success rate with most small-sized and medium-sized stones.
  3. It doesn’t require incisions or invasive techniques.
  4. It has minimal postoperative discomfort.
  5. It has a fast and easy scheduling.

Limitations of ESWL include:

  1. It’s ineffective for stones that are very hard or resistant to breakage by shockwaves.
  2. It’s not appropriate for stones that are invisible on X-ray such as uric acid, monohydrate and cystine stones.
  3. It’s not ideal for larger stones or those located in the lower part of the urinary tract.
  4. It’s not appropriate for patients with certain conditions or using certain medications, such as pregnant women or patients on blood thinning medications.

Ureteroscopy

Ureteroscopy is another surgical procedure often used to treat small and medium-sized stones. The advantage it offers over ESWL is that it can treat kidney stones occurring in any part of the urinary tract. It’s a same-day procedure done after the patient is placed under general anesthesia. The procedure involves passing a small scope via the urinary opening and into the bladder then into the ureter. Once the stone is reached, it is targeted with laser so that it’s broken down into smaller pieces that are extracted out of the system or into pieces of dust left to wash out with normal urine.

Ureteroscopy is a little bit more invasive than ESWL, but it’s preferred in situations where kidney stones are too hard to respond to ESWL, or for stones that are invisible on X-ray. Ureteroscopy is also a better choice than ESWL when stones are located in the lower portion of the urinary tract, especially the region near the bladder. After the procedure, a small tube — a stent — is temporarily placed into the urinary system to help drain the kidney. The stent is totally internal, and is usually removed 3-10 days after the procedure. Stent removal is a quick and easy process done in the doctor’s office and without anesthesia.

Advantages of ureteroscopy are:

  1. Great results for small-sized and medium-sized stones.
  2. It’s an outpatient procedure.
  3. No incisions are necessary.
  4. Fast and easy scheduling.
  5. Done without stopping the use of blood-thinning medications.
  6. Effective for stones that are resistant to ESWL.

Limitations of ureteroscopy are:

  1. It’s not effective for very large stones.
  2. In some rare instances, scopes may not reach the stones.
  3. Many patients find the stents placed after the procedure a source of unease and discomfort.

Percutaneous Nephrolithotomy (PCNL)

For kidney stones that are exceptionally large, complex or several small stones bundled in one kidney, percutaneous nephrolithotomy (PCNL) is the most appropriate treatment. Conducted by a urologist, often assisted by an interventional radiologist, PCNL is typically an inpatient procedure requiring an overnight hospital stay. During the procedure, the urologist and radiologist collaborate to open a direct channel into the kidney’s drainage system via a small incision made in the back, often not larger than a dime.

After making the incision, the urologist uses a set of specialized tools to break the stones into pieces, which are then plucked out or vacuumed out of the kidney. With the procedure completed, a drainage stent or tube is left in place for temporary drainage of the kidney. For stones that are unusually large or complicated, the urologist may schedule a second “clean-up” surgery. In most cases, patients leave the hospital after PCNL within 24 hours of the procedure. And despite PCNL being a more invasive procedure than ureteroscopy and ESWL, it remains an effective and safe treatment that sees a high level of patient satisfaction.

Advantages of PCNL are:

  1. It is the gold standard treatment for very large or really complex stones.
  2. It is the most appropriate surgery for patients with a number of small stones bundled in one kidney.
  3. It clears most kidney stones fully in one procedure.
  4. It is highly safe and effective.

Limitations of PCNL are:

  1. A drainage tube or stent is necessary after the procedure, which may be uncomfortable for most patients.
  2. It is not appropriate for patients on blood-thinning medications.
  3. It is more invasive and so an overnight stay in hospital is a necessity.
  4. Though it clears most stones in one procedure, a repeat procedure may be necessary for the largest or most complex stones.

At St Pete Urology, we perform hundreds of minimally-invasive surgeries for kidney stones every year. We have several surgeons with extensive training, skill and experience in ESWL, ureteroscopy and PCNL, delivering excellent outcomes even for the most difficult kidney stones. Our collaborative, compassionate and patient-centered approach to care also means our patients enjoy utmost comfort and convenience throughout their procedures. So if you have symptoms of what you suspect to be kidney stones, don’t hesitate to come see us. We fix kidney stones safely and effectively. For more information on the prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

How To Treat Kidney Stones?

When certain minerals are in excess in the body, they accumulate in urine. The urine becomes more concentrated as the levels of minerals and salts increase, particularly when the body is not well hydrated. As a result, hard masses of minerals and salts called kidney stones — often made of uric acid or calcium — form inside the kidney and can travel to other areas of the urinary tract. About 1-in-11 Americans will have a kidney stone at some point in their lifetime, but stones occur more often in men, people with diabetes and those who are obese.

Stones come in different sizes

Kidney stones vary in size. While some may be as small as a fraction of an inch and others only a few inches across, some stones can be very large and may take up the whole kidney. Smaller stones tend to remain in the kidney and rarely cause pain as they pass out of the body. In most cases they are not noticed until the kidney stones pass into the ureter. But larger stones may block urine flow, cause pain and result in urinary tract problems. Fortunately, the stones rarely cause permanent damage, and there are effective treatments for them.

Pain due to kidney stones

Pain is the most common characteristic and frequent symptom of kidney stones. Although the pain associated with stones varies from person to person, it can be quite intense and agonizing when it occurs — accounting for over 1 million visits to the emergency room every year. Many women who have had the condition attest that the pain is worse than the cramps and spasms of childbirth; others say it’s like being stabbed with a knife. The pain is felt along the side and back and below the ribs, though it may radiate to the belly and groin area with the movement of the stone along the urinary tract. It also generally occurs in waves, each wave lasting a few minutes, before disappearing and coming back.

Treatment of kidney stones

At St Pete Urology, we admit many patients in our emergency department because of painful kidney stones. Some patients also present with symptoms such as nausea, vomiting and hematuria (blood in urine). We determine how to manage kidney stone disease depending on the location and severity of the stones. For patients with small stones — several millimeters in size — we may allow time for the stones to pass without intervention. In that case, a patient is given pain medication, advised to drink plenty of water and waits for the stones to pass, under our close observation. But for large stones or complex ones causing problems such as severe pain, infection or kidney failure, we usually intervene to remove the stones.

Types of treatments

We often intervene to remove kidney stones that fail to pass spontaneously, are affecting kidney function, are accompanied by too much pain to wait for their passage, are blocking the flow of urine or are causing repeated infections. The interventions involve tiny or no incisions, minimal pain and a short time off work. At St Pete Urology, the treatments we commonly provide for kidney stones are extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy.

1. Extracorporeal Shockwave Lithotripsy (ESWL)

ESWL (Extracorporeal Shockwave Lithotripsy) is the use of highly-focused sound waves released and focused from outside the body to crush kidney stones. The intense waves are able to reduce the stones into sand-like granules that can pass normally in urine over a few weeks. Before ESWL, patients are given a sedative or placed under regional or general anesthesia and ultrasound or X-rays used to pinpoint the location of the stones.

The procedure takes about 1 hour, but larger or more complex stones may need several ESWL treatments. Patients return home the same day and are able to resume normal activities in 2-3 days. Shockwave lithotripsy is not used for hard stones, such as cystine, struvite, and some types of calcium phosphate and calcium oxalate stones. It’s also not ideal for stones larger than 1 inch in diameter and for pregnant women.

2. Ureteroscopy (URS)

For some kidney stones, especially those located in the kidney and ureter, ureteroscopy is the preferred treatment. The treatment involves passing a small fiber-optic instrument called ureteroscope into the urethra and bladder, then into the ureter. The telescopic instrument enables the urologist to see the stone and to use a small, basket-like device to pull out a smaller stone. For larger stones that can’t be removed in one piece, the urologist uses laser or a similar stone-breaking tool to shatter the stone into smaller pieces.

Flexible ureteroscopes are used for stones located in the kidney and upper ureter while rigid ones are used when stones are located in the lower ureter near the bladder. During the procedure, you are placed under general anesthesia to keep you comfortable. A stent (or small tube) is left in the ureter to keep it open and drain urine from the kidney and into the bladder, but it’s completely within your body and doesn’t require an external urine collection bag. You can return home the same day and resume normal activities in 2-3 days, but the stent must be removed in 4-10 days to avoid infection and potential loss of kidney function.

3. Percutaneous nephrolithotomy (PCNL)

Percutaneous nephrolithotomy (PCNL) is the most appropriate treatment for larger or more complex kidney stones. It’s also the best treatment if several small stones are bundled up in one kidney. During the procedure, the surgeon makes a half-inch incision in the side or back and then guides a nephroscope (rigid telescope) through the incision and into the area of the kidney where the stone is located. Using the nephroscope, the urologist reaches the stone with instruments that fragments it into pieces that are then suctioned out. The ability to suction tiny pieces of stone from the urinary tract makes PCNL the best treatment option for larger stones.

PCNL is performed with the patient under general anesthesia. The procedure requires hospitalization and you are discharged after 24 hours but resume normal activities after 1-2 weeks. Usually at the end of the procedure a tube is placed in the kidney to help drain urine into a bag outside the body. The tube remains for a few days or just overnight. Before you are discharged from hospital, the urologist may do X-rays to check if any pieces of stone remain. The nephroscope may be inserted again if any stone fragments are detected to remove the leftover fragments and to make sure you are completely free of the condition.

At St Pete Urology, we have experienced urologists, specialized equipment and highly-skilled support personnel to help us deliver excellent outcomes for patients with kidney stones. We use both surgical and non-surgical methods to tackle this painful condition, including the minimally-invasive procedures of shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy, robotic surgical procedures, advanced imaging technology, medications and dietary changes. For us, the goal is not only to cure kidney stones but also to prevent a recurrence — striving to make your first stone surgery your last. So if you have symptoms of kidney stones or want advice on how to avoid this painful condition, come see us for help. For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

How To Pass Kidney Stones?

Passing a kidney stone is an agonizing and traumatic experience. It’s something you wouldn’t wish for anyone, even your worst enemy. And you will want to do anything to avoid going through the ordeal again. Sadly, kidney stones are bound to recur in about 50 percent of people who have had them, often within 10-15 years if preventive measures are not taken. They occur more frequently in men than women and may lead to serious complications if not dealt with promptly, effectively and appropriately.

Triggers of kidney stones?

Kidney stones typically develop when the concentration of certain substances such as oxalate, uric acid and calcium are high enough in urine to form crystals. Once crystals are formed in the kidneys, they grow larger and solidify into “stones.” Most kidney stones (about 80-85 percent) are made of calcium while the others are uric acid stones occurring in people whose urine PH level is low.

Symptoms of kidney stones

Once they are formed, kidney stones can dislodge and move down the ureter, obstructing urine flow. As a stone moves through the ureter, it causes periods of severe, excruciating pain, including pain in the flank — pain occurring on one side of your body between the back and the stomach. In some cases, there may be nausea, vomiting and blood in urine. When the stones move beyond the ureter and toward the bladder, they are usually accompanied by bladder pressure, groin pain and frequent urination. If you have any of these symptoms, check with your primary care physician for help. The doctor most likely will do a urinalysis and an abdominal X-ray, renal ultrasound or CT scan to ascertain whether you have kidney stones and determine their number and size.

Allowing kidney stones to pass

It usually takes many weeks to a few months for kidney stones to pass spontaneously. The length of time to pass a stone depends on its size and location. As you wait for the stone to pass, you can use over-the-counter painkillers, such as acetaminophen (Tylenol), naproxen (Aleve) or ibuprofen (Motrin IB or Advil) to reduce the discomfort. Your doctor may prescribe an alpha blocker to help relax your ureter muscles and ensure the stone passes faster and with minimal pain.

For kidney stones that are too big to pass or are accompanied by very severe pain, surgical removal may be necessary. Your doctor may undertake a procedure called ureteroscopy, where a tiny endoscope (a device fitted with a small video camera and various tools fixed at the end of a long tube) is inserted into the bladder, then up the ureter to reach the stone. This is done while you’re under general anesthesia. Once the stone is reached, it’s broken down into smaller fragments and removed.

How can you prevent kidney stones?

Kidney stones are common and often recur in people who have had them. That’s why you should take the necessary steps to prevent them from forming. Some of the strategies to prevent kidney stones include:

1. Drink enough water: If you can produce 2 to 2.5 liters of urine every day, then you’re 50 percent less likely to have kidney stones than a person who produces less urine. To help you maintain such a level of urine production every day, you should drink about 8-10, eight-ounce glasses (roughly 2 liters total) of water every day.

2. Avoid high-oxalate foods: It is okay to eat foods with moderate to low quantities of oxalate, such as berries and chocolate. But you should avoid high-oxalate foods like almonds, beets and spinach, which will raise oxalate levels in your body.

3. Keep sodium in check: A diet with a lot of sodium can cause kidney stones because it increases the quantity of calcium that’s present in urine. Limit your total daily sodium intake to below 2,300 milligrams (mg). If you have had a previous incident of kidney stones due to the amount of sodium in your diet, then you need to reduce your daily sodium intake to about 1,500mg.

4. Take some lemons: Lemons provide citrate, a citric acid salt, which binds to calcium and prevents kidney stone formation. If you drink a cup of lemon juice concentrate that’s diluted in water each day, or just pure juice from two lemons, you will boost your urine citrate and reduce your risk of kidney stone.

5. Reduce your consumption of animal protein: If you’re prone to kidney stones, you should reduce your intake of animal proteins. Eating too much of eggs, meat and seafood, among other animal proteins, increases uric acid levels in the body and promotes the formation of stones. While you don’t have to avoid proteins altogether, you can opt for plant-based proteins instead.

Kidney stones are a painful and distressing condition that’s better prevented than treated. That’s why at St Pete Urology, we not only provide a variety of safe and effective kidney remedies, but also offer information to our patients so they can take action to prevent the stones from occurring. For those with stones, we offer extracorporeal shock-wave lithotripsy, ureteroscopy with either holmium or EHL Laser, ureteral stent and percutaneous nephrolithotomy, among other remedies. Don’t suffer in silence. If you suspect you have kidney stones, contact us so we can help you. For more information on the prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

Foods That Can Cause Kidney Stones

You have a role in preventing kidney stones. By being cautious with what you eat and drink you can manage to stay free of the stones. One of the easiest ways to prevent kidney stones is to drink plenty of liquid, mainly water. In fact, unless you have trouble with your kidneys, drinking six to eight 8-ounce glasses of water every day is a proven way to prevent stones. Talk with your doctor about the quantity of liquid you should drink and begin right away. Another way to prevent kidney stones is to lose weight since being overweight increases the risk of the stones. Have your meals planned by a dietician and take the necessary steps to lose excess weight.

What if you have already had kidney stones?

You will need to talk to your doctor to find out which type of kidney stones you had. Depending on the type of stone, you’ll need to change your diet to prevent the recurrence of similar stones in the future. The most common types of kidney stones are calcium oxalate stones, calcium phosphate stones, uric acid stones and cystine stones. You can prevent them by making certain changes in how much calcium, oxalate, sodium and animal protein are in the foods you eat. Working with a dietician who is an expert in kidney stone management and prevention can help you greatly.

1. Dietary steps to prevent calcium oxalate stones

If you’ve had calcium oxalate stones, then you’ll need to reduce the amount of sodium, oxalate and animal protein in your diet while keeping your calcium consumption optimum. Speak with your doctor and also with a dietician about the food sources to avoid and how much of oxalate, sodium, calcium and animal protein you should take.

To reduce the amount of oxalate in your urine, avoid the following foods:

  • a. Spinach
  • b. Wheat bran
  • c. Nuts and nut products
  • d. Peanuts — which are legumes, but are rich in oxalate.
  • e. Rhubarb

To reduce the amount of sodium in your diet:

  • a. Reduce your salt intake
  • b. Avoid packaged, canned and fast foods, which often contain sodium
  • c. Avoid food condiments, seasonings and meats, which are often rich in sodium

To limit the amount of animal protein you eat, reduce the following in your diet:

  • a. Eggs
  • b. Chicken, beef, pork, particularly organ meats
  • c. Milk, cheese, and the other dairy products
  • d. Shellfish and fish

Remember, you’ll still need to get enough protein even as you limit the amount of animal protein. Just replace the meat and animal protein with other protein sources such as dried peas, lentils, white beans, which are plant-based and low in oxalate. Your doctor and dietician can guide you on the total protein you should eat and what portion of the protein should come from animal or plant-based sources.

Optimal calcium

To prevent calcium oxalate stones, you need to have enough calcium in your diet. While you may assume that increased calcium would increase your risk of kidney stones, that’s not true. Actually, in the right quantities, calcium combines with other substances in your digestive tract and prevents stone formation. You should check with your doctor about how much calcium you need to prevent a recurrence of calcium oxalate stones and to develop strong bones. Also find out from your dietician the best food sources of calcium for you. It’s often recommended that calcium be obtained from low-oxalate, plant-based sources like cereals, calcium-fortified juices, breads, some types of beans and some types of vegetables.

2. Dietary steps to prevent calcium phosphate stones

Just like calcium oxalate stones, the prevention of calcium phosphate stones requires that you reduce the amount of sodium and animal protein in your diet while ensuring that you get enough calcium. Talk to your doctor about the dietary changes you should make. A dietician who is expert in kidney stones can help you with exactly how much sodium, calcium and animal protein to include in your diet.

To reduce the amount of sodium in your diet:

  • a. Reduce your salt intake
  • b. Avoid packaged, canned and fast foods, which often contain sodium
  • c. Avoid food condiments, seasonings and meats, which are often rich in sodium

To limit the amount of animal protein you eat, reduce the following in your diet:

  • a. Eggs
  • b. Chicken, beef, pork, particularly organ meats
  • c. Milk, cheese, and the other dairy products
  • c. Shellfish and fish

Consider replacing the above sources of animal protein with plant-based ones such as:

  • a. Soy foods, like tofu, soy nut butter and soy milk
  • b. Legumes, such as dried peas, lentils, beans and peanuts
  • c. Sunflower seeds
  • d. Nuts and nut products, like cashews, cashew butter, almond butter, almonds, pistachios and walnuts.

Talk to your doctor and dietician about the total quantity of protein to eat and how much should be from animal foods or plant-based sources.

Optimal calcium

To prevent calcium phosphate stones, you’ll also need enough calcium in your diet. While it may seem that having calcium in your diet may cause calcium stones, taking the right amount of calcium helps eliminate various substances responsible for stone formation from your digestive tract. So talk to your doctor to find out how much calcium would help you maintain strong bones and prevent calcium phosphate stones. Also ask your doctor or dietician about the appropriate food sources for calcium. Getting calcium from plant-based sources such as cereals, breads, calcium-fortified juices, some types of beans and some types of vegetables will help you prevent the stone formation.

3. Dietary steps to prevent uric acid stones

For uric acid stones, increased intake of animal protein will increase your risk of developing the stones. The animal proteins to limit in your diet include:

  • a. Eggs
  • b. Chicken, beef, pork, especially organ meats
  • c. Shellfish and fish
  • d. Cheese, milk, and the other dairy products

In order to ensure that you get enough protein every day, replace the animal proteins with plant-based ones such as:

  • a. Legumes like beans, lentils, dried peas and peanuts
  • b. Soy foods like tofu, soy nut butter, soy milk
  • c. Sunflower seeds
  • d. Nuts and nut products like cashews, cashew butter, pistachios, walnuts, almonds, and almond butter

Speak with your doctor about how much total protein you should include in your diet every day and how much of that should come from plant-based or animal-based sources.

For uric acid stones, being overweight is also a major risk factor. So consider losing weight to prevent a recurrence of the stones.

4. Dietary steps to prevent cystine stones

The most important lifestyle change you’ll need to make to prevent cystine stones is drinking plenty of liquids, mainly water. Speak with your doctor about how much water you should drink, especially if you’ve had kidney failure.

Tips for limiting the amount of sodium in your diet

Most Americans take in too much sodium which increases their risk of kidney stones. An adult should consume not more than 2,300 mg of sodium a day — remember that one teaspoonful of table salt contains 2,325 mg of sodium. To prevent a recurrence of calcium phosphate or calcium oxalate stones, use the following guideline to limit the amount of sodium you consume:

  • a. Check the Percentage Daily Value (%DV) of sodium on the label of the food products you buy. A %DV of 20 percent or more is high while a %DV of 5 percent or less is low.
  • b. Write down the quantity of sodium you consume every day.
  • c. Always try to find out the sodium content of the food you eat.
  • d. Cook your meals from scratch — avoid canned vegetables and soups, fast and processed foods and lunch meats as they often contain a lot of sodium.
  • e. Buy foods labeled: salt free, sodium free, low sodium, very low sodium, light in sodium, less or reduced sodium, unsalted, no salt added, or lightly salted.
  • f. Check food labels for hidden sodium and sodium-rich ingredients such as sodium nitrate, sodium nitrite, sodium alginate, monosodium glutamate (MSG), disodium phosphate, sodium bicarbonate, and baking soda (contains sodium bicarbonate and other chemicals).

Looking for more information on prevention and treatment of kidney stones? At St Pete Urology, we treat ureteral and kidney stones as safely, painlessly and effectively as possible. We also equip our patients with the information they need to prevent the recurrence of the stones. Talk with us about your symptoms, fears or concerns and we can help find the best plan for you. For more information, visit the “St Pete Urology” site.

How To Manage The Pain Of Kidney Stones?

Marked by an agonizing, excruciating and intolerable pain, kidney stones account for over 1 million annual emergency room visits in the United States. The pain usually starts in the upper flank, as a sudden twinge on the side, escalates to the loins and migrates to the front of the body. The sharp stabbing pain of kidney stones is worse than childbirth pain and quickly makes it impossible to function. It is important for you to know how to prevent kidney stones and how to deal with the pain if you get the stones.

What are kidney stones?

Kidney stones are small, hard pebble-like lumps formed when there are high levels of various minerals in urine. The minerals and other substances crystallize and form hard masses before they can be flushed away. Classic stones are a blend of calcium and oxalate (an organic acid found in urine), but lumps of uric acid, calcium phosphate and other substances also may form. A stone may sit in the kidney or ureter with little or no pain. But often when the stone leaves the kidney or gets stuck in the ureter, it blocks the flow of urine and causes pain.

Symptoms of kidney stones

When a kidney stone moves around in the kidney or gets lodged in the ureter, it may block the passage of urine. Such a blockage causes:

  1. Sharp, stabbing pain on the side or in the back.
  2. Painful urination.
  3. Pain episodes that come and go.
  4. Blood in urine.
  5. Fever, nausea and vomiting in case of an infection.

Kidney stones are perhaps the most painful condition known. In fact, most patients with stones often find themselves in the hospital emergency department. In all cases of pain due to suspected kidney stones, urologists first rule out other possible causes of pain, such as bowel, gynecologic and musculoskeletal problems. The presence of kidney stones is confirmed by X-rays or CT scans. Blood and urine tests also may be used to assess the levels of various stone-forming substances in your system.

Managing Pain Due To Kidney Stones

Once it is confirmed that you have kidney stones, the urologist will give you intravenous painkillers to relieve pain. You then will be sent home with oral drugs (such as acetaminophen, aspirin, diuretics, and antibiotics) to use as you wait for the stone to pass out of your system. Drinking plenty of water, taking hot showers, sitting in a warm water tub and taking drugs that dilate the ureter will bring relief and allow the stone to pass. Eventually the agony will end when the stone passes out.

Smaller stones are more likely to pass on their own. In fact, 80 percent of kidney stones are usually less than 4 mm in diameter and typically pass on their own, though that takes up to 31 days. It is more difficult for larger stones to pass on their own. Stones of 4-6 mm in diameter tend to pass on their own 60 percent of the time while those larger than 6 mm only pass out 20 percent of the time. Therefore in most cases, a non-invasive or minimally-invasive medical procedure is necessary to remove stones larger than 4 mm and those stuck in the ureter.

Surgery for Kidney Stones

Non-obstructive stones rarely cause pain. So surgery is not necessary when kidney stones are not causing any obstruction. And even if they cause pain, medications are usually sufficient. But surgery is required when there is bothersome flank pain and imaging evidence of one or more obstructive stones.

Common surgical treatments include:

  1. Shockwave lithotripsy: A simple outpatient procedure in which sound waves are directed on kidney stones, breaking them into smaller pieces capable of passing on their own in urine.
  2. Ureteroscopy: An outpatient procedure for small-to-medium stones in which a small tube (ureteroscope) is inserted into the urinary tract and used to pull out stones or to direct laser to the stones to break them into smaller pieces.
  3. Percutaneous nephrolithotripsy: A procedure in which the urologist makes a small incision in the back and directly into the kidney, using the incision to access and remove stones. It is the most effective method for very large kidney stones.

Preventing Kidney Stones

Lifestyle changes can help you to avoid having kidney stones. For instance, drinking at least two-and-a-half liters of water every day will help you to achieve a daily urine production of two liters, which prevents stones. Fluids such as coffee and citrus juices also are very effective in preventing kidney stones. Citrus (especially from lemon and grapefruit) makes urine more alkaline and reduces the risk of almost all kinds of stones. But you must avoid sugary juices, as the sweetener in them may increase your risk of having stones and undo the good effects of the juice.

If you have had a bout of kidney stones before, you have a greater risk of getting stones. So depending on the chemical constituents of your first kidney stones, you may have to limit intake of certain foods, such as sugar, salt, proteins and dairy products. For calcium oxalate stones, you will have to cut down the amount of meat, eggs, shellfish, peanuts, spinach, chocolate, sweet potatoes, rhubarb and beetroot from your diet. For uric acid stones, taking allopurinol (a gout medication) will help prevent future episodes. Potassium citrate pills and thiazide family of diuretics (indapamide, chlorthalidone and hydrochlorothiazide) are also effective in preventing all calcium-based stones.

Looking for advice or help with kidney stones? At St Pete Urology, we offer timely and accurate advice, diagnosis and treatment of kidney stones. Our multidisciplinary, compassionate, patient-centered approach will ensure you get the best possible care. Don’t suffer the pain of kidney stones for a day more while we can help you get quick relief. For more information, visit the “St Pete Urology” site.

What foods to avoid with kidney stones?

When substances found in urine become so concentrated, they can combine to form solid masses called kidney stones. For instance, calcium in urine can combine with phosphorous or oxalate to form calcium phosphate and calcium oxalate crystals respectively. Likewise, the buildup of uric acid in urine following protein metabolism can lead to uric acid crystals. Since the urinary tract is not functionally adapted to expel solid matter, the stones become very painful to pass. Fortunately, the risk of formation of kidney stones can be reduced through dietary measures.

So what should you eat and drink to avoid getting these painful stones?

1. Drink copious amounts of water
Taking large quantities of fluid, particularly water, can significantly reduce the risk of kidney stones. Water dilutes urine and lowers its concentration, minimizing the possibility of the chemicals combining to form stones. Just make sure to drink 12 glasses or more of water every day.

2. Eat more calcium-rich foods
Calcium combines with oxalate and eliminates it. Therefore, low calcium intake allows your oxalate levels to rise while increased intake reduces the quantity of oxalate in urine. It is advisable that you get calcium from food and not from supplements (as supplements increase the risk of kidney stones). Recommended sources of calcium include cottage cheese, other types of cheeses, yogurt, milk (cow’s milk, goat’s milk, fortified soy milk and lactose-free milk), legumes, dark green vegetables, calcium-set tofu, seeds, blackstrap molasses and nuts. Intake of foods rich in vitamin D every day can ensure that the body absorbs more calcium. There are several foods fortified with vitamin D, but you also can get this vitamin from egg yolks, cheese and salmon.

3. Increase your citrus intake
Citrus provides naturally occurring citrate which is effective in stopping or reducing the formation of kidney stones. You can get citrate from citrus fruit, citrus juice, oranges, grapefruit and lemons.

Which types of food should you avoid?

1. Limit your salt intake
Increased sodium levels promote the buildup of calcium in urine. Hence, it is important to avoid adding too much salt to your food and to check all labels on processed foods to control the amount of sodium you take. Whenever possible, instruct that no salt be added in the foods you order in hotels or restaurants. Vegetable juices may contain high quantities of sodium, so check what you drink.

2. Reduce intake of animal protein
Most animal sources of protein increase the level of uric acid and reduce the level of citrate in urine. Citrate is important in preventing stone formation. Therefore, you should avoid eating large quantities of red meat, poultry, chicken, pork, eggs and fish which contain large quantities of citrate. Instead of animal proteins, you should turn to alternatives such as Greek yogurt, quinoa, hummus, tofu (bean curd) and chia seeds. Make sure to discuss what types of protein you should eat with your doctor.

3. Minimize the quantity of oxalate-rich foods
Oxalate-rich foods can increase the development of kidney stones. So if you are at greater risk or already have had stones before, then you should either eliminate or reduce the quantity of oxalates. But if you have to eat oxalate-rich foods, always follow or combine them with a calcium source to ensure the oxalate is bound to calcium during digestion and prevented from reaching the kidneys. Foods with high quantities of oxalate include beets, chocolate, nuts, tea, spinach, swiss chard, sweet potatoes and rhubarb. Speak with your doctor to determine the limits of oxalate-rich foods you should have in your diet.

4. Cut down sugar intake
High levels of added fructose and sucrose can increase the risk of stones. You should reduce or eliminate the amount of added sugar you take, particularly in processed foods, cakes, fruits, soft drinks, juices, agave nectar, honey, cane sugar, crystallized fructose, corn syrup and brown rice syrup.

5. Avoid cola drinks
Cola contains high quantities of phosphate, a chemical that promotes kidney stone formation. Avoiding colas will therefore reduce your risk of kidney stones.

Dietary tips for avoiding kidney stones

Once you have kidney stones for the first time, the risk of a recurrence increases drastically unless you take the necessary steps to prevent them. For instance, you can take medications prescribed by your doctor to prevent the stones. Likewise, you can begin to watch keenly what you drink and eat. It is also important that tests are run on the stones you currently have to determine what type they are in order to clearly define appropriate steps for preventing a recurrence. Strategies for preventing recurrence of kidney stones include:

  1. Drinking at least 12 glasses of water every day.
  2. Drinking citrus juices, like orange juice.
  3. Reducing the amount of animal protein you take.
  4. Reducing the amount of added sugar, salt and products rich in fructose corn syrup.
  5. Avoiding drinks and foods high in phosphates and oxalates.
  6. Eating a calcium-containing food at every meal, at least 3 times a day.
  7. Avoiding foods or drinks that dehydrate the body, such as alcohol.

Kidney stones can cause a lot of pain and discomfort. But with slight dietary changes, occurrence of the stones can be effectively prevented or managed. Keeping your body hydrated, pairing oxalate-rich foods with calcium and avoiding foods high in sugar and salt are crucial dietary steps for preventing kidney stones.

At St Pete Urology, we apply a range of treatments, such as lifestyle, dietary, medical and surgical interventions to ensure the best outcome possible for our patients. At our center, most patients with kidney stones are seen by specialists, taken through 24-hour urine studies and blood tests, and given the right treatment depending on the type and cause of their stones. Our urologists are experts in shock-wave lithotripsy (SWL), ureteroscopy and percutaneous nephrolithotomy, among other treatments for relieving pain and restoring a normal, pain-free life. We also develop preventive plans for our patients, giving them a clearer picture of why the stones develop and the necessary changes they should make to prevent them, including dietary, lifestyle and medications to take. For more information on the diagnosis, treatment, prevention and follow-up care for kidney stones, visit the “St Pete Urology” site.