Metabolic Evaluation and Treatment for Kidney Stone Disease

Our Goal- Getting you 100% stone free

At Chesapeake Urology, our kidney stone disease experts have one goal - to get you stone free and keep you that way. For our specialists, the passing or surgical removal of a kidney stone is only the beginning of the journey that focuses on medical management and prevention of future kidney stones. 

Our kidney stone specialists are unique in that they focus on your longterm health, developing an individualized plan for prevention that spans a lifetime. A key component of this health strategy is the metabolic work-up. 

Stone disease can rarely be cured, but it can be well managed by following a formulated plan for prevention.

Learn about metabolic evaluation and prevention of kidney stones here.

Meet Chesapeake Urology's specialists in metabolic evaluations for kidney stone disease

What are kidney stones?

Kidney stones are small, hard crystals or deposits that form inside your kidneys when salts and other minerals in your urine bond together. Stones often vary in shape and size, with some growing to be quite large.  Some stones stay in the kidneys causing little to no symptoms, and others may pass through the urinary tract, causing painful symptoms as the deposit move down the ureter (the thin tube that leads to the bladder). Some people are able to pass the stone without surgical intervention, but in some cases, surgery to remove the stone may be necessary. 

Types of Kidney Stones

kidney stones

Photo courtesy of: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health


Symptoms of kidney stones

If painful symptoms persist, it's important to contact your urologist for diagnosis and immediate treatment. When a kidney stone has passed into the urinary tract, symtoms may include:

  • Severe pain, usually located in the side or the back; pain may spread to the abdomen and the groin area as well
  • Urinary symptoms such as painful urination, urinary urge, and frequent need to urinate
  • Blood in the urine and/or foul smelling urine
  • Nausea and/or vomiting
  • Fever if the stone has caused an infection


Who is at risk for developing kidney stones?

While anyone can produce kidney stones, certain people are more at risk for developing stones than others. Causes and risk factors for kidney stones include:

  • A family history of stone disease, especially in first degree relatives
  • Dehydration - lack of fluids can cause salts and other minerals in the urine to stick together to cause kidney stones
  • Certain diets - diets high in protein, salt, oxalates (such as spinach, chocolate, nuts), excess vitamin C or D can increase your risk of developing kidney stones
  • Certain medical conditions - gastric conditions such as inflammatory bowel disease, Crohn's disease and chronic diarrhea affect the way your body absorbs water and calcium, which increases levels of stone-forming substances in your urine
  • Metabolic diseases (such as hyperparathyroidism or gout)
  • Obesity has been linked to higher incidences of stone formation


Non-surgical options for small kidney stones

Patients with smaller stones are typically able to pass the stones through the urinary tract with the aid of the following:

  • Pain relievers – Your doctor may recommend over the counter pain relievers (ibuprofen, acetaminophen) to relieve some discomfort of passing a small stone
  • Medication – Alpha blockers can help relax the muscles in the ureter, which will help you pass a small stone with less pain
  • Increased fluid intake – Drinking an increased amount of water (up to three quarts) may be recommended to help flush out the stone from the urinary tract


Treatment options for large kidney stones

Some kidney stones are too large to pass through the urinary system and may cause painful symptoms or even urinary tract infections. In this case, your doctor may recommend surgical procedures that include:

  • Shock wave lithotripsy (SWL) – shock waves are used to break the stone(s) into very small particles that can be passed through the urine.
  • Ureteroscopy/renoscopy with laser lithotripsy/stone extraction
  • Percutaneous nephrolithotomy – this surgical procedure removes kidney stones through a small incision in the back under general anesthesia in a hospital or surgical center. This procedure is often a preferred method of getting patients stone free for future management of kidney stone disease and has a high success rate of about 90%. Following the procedure, your doctor will order a CT scan to make sure no stones remain in the kidney or urinary tract.

Whenever possible, your doctor will collect the passed or surgically removed kidney stones to have them analyzed in a lab to determine the type of stones your body has made.  This analysis will aid your physician in developing a personalized treatment and prevention plan for the future.