Kidney Stones

Presented By:Mary Jane Concengco, BSN, RN, NP Resident

UCF Nursing Graduate Studies, 2010-2011A Community Project

In collaboration with Shepherd’s Hope

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Learning Objectives

• By the end of this presentation, you will:• Know what a kidney stone is• Know the signs & symptoms of kidney stones• Know what the medical & surgical treatments

are for kidney stones• Know how to prevent kidney stones from

recurring

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What my kidneys do?

• 2 kidneys located near the middle of our back, below our ribcage

• Kidneys are like “trash collectors.”

• The waste and excess water become urine.

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• It is a hard solid lump that is formed inside the kidney.

• It can be the size of a grain of sand or it can be bigger.

• It is made from the waste products in the urine.• A kidney stone may stay in the kidney or it may travel

down the urinary tract, sometimes with or without pain.

• If its big enough it can get stuck and block the flow of urine and cause A LOT of PAIN.

• .

What is a Kidney Stone?

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• Family history• Common in men than women• Ages of 40-70 years old• Common in Caucasians than African-Americans• History of radiation • Immobility because of illnesses• Have metabolic disorders

Risk Factors: Things You Can’t Change

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Other Risk Factors areIf you:

• Have poor fluid intake, especially water.

• Eat a high protein, high salt, and low fiber diet

• Use calcium, vitamin C and D supplements

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Key Points about Kidney Stones

• You did not do anything wrong to get kidney stones.

• Sometimes we are just stone formers.

• Most stones pass on their own, without us even knowing we have them.

• But if the stones are too large to pass, it can cause infection, and obstruction of urine flow, which then can lead to kidney failure.

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Signs and Symptoms • Call your provider if you have the following signs:

• Extreme pain in your back or side that will not go away

• Fevers, sweats, and/or chills• Cloudy or bloody urine• Nausea & vomiting• Urine that smells bad• A burning feeling when you urinate• You feel like you have to go to the bathroom

more frequently

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• X-ray – KUB (kidney, ureters, and bladder)• Renal Ultrasound• CT scan of Abdomen and Pelvis• IVP – Intravenous Pyelogram• Once diagnosed having a kidney stone, further

work up will be done to identify the type of stone it is.

• Tests include: 24 hr. urine collection, blood work for Calcium, phosphorus, uric acid, and parathyroid hormones

How do kidney stones get diagnosed?

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Types of Kidney Stones• If able, try to catch the stone (by straining your

urine), and bring it to your provider to have it analyzed in the lab.

• There are 5 types of stones:

• Calcium – is the most common type• Struvite• Uric Acid• Cystine• Mixed (calcium oxalate/calcium phosphate)The prevention and management is all dependent with

what type of stone you have.

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Surgical Management• If you have a stone that will not pass by

itself, you may need to have your stone removed by the following treatments done by a Urologist:

• Shock Waves – Extracorporeal Shock Wave Lithotripsy (ESWL)

• Tunnel Surgery – Percutaneous Nephrolithotomy

• Ureteroscopic Stone Removal

• Open Surgery

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Medical Management• Initially: Observing and monitoring

• Provide pain control with medications

• After work up has been completed the following medications may be prescribed:

• Potassium Citrate

• Allopurinol

• Thiazide, such as HCTZ

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• Drink 8 to 12 full glasses of water a day. • Drink 2 glasses/cups/drinks of dark colored drinks per

day, such as: juices, cola, coffee, tea (hot or ice), draft beer.

• Limit your salt intake to 1 tsp. per day. • Eat up to 2 servings (size of your palm) of meat per day. • Have only 3 servings/day of dairy products (milk, yogurt,

cheese).• Limit your foods that are high in oxalates, such as

strawberries, cranberries, raspberries, green beans, spinach, rhubarb, beets, nuts, tofu, wheat bran, and chocolate.

Prevention of RecurrenceRENAL STONE DIET

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RECAP• Remember you did not do anything wrong to

get kidney stones.• A kidney stone can be very painful, and

needs to be treated quickly to prevent complications such as infection, obstruction or renal failure.

• Some dietary changes may help reduce the chance of recurrence. 50% will still have recurrence within 10 years.

• We must live a life in moderation, too much of anything isn’t always better or good. Balance!

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American Academy of Family Physicians. (2010). What you should know about kidney stones. Retrieved from http://familydoctor.org/online/famdocen/home.html on Nov. 1, 2010.

Buttaro, T.M., Trybulski, J., Bailey, P.P, & Sandberg-Cook, J. (2008). Primary care: A collaborative practice. 3rd ed. Philadelphia: Mosby.

National Institute of Diabetes and Digestive and Kidney Diseases. (2007). What I need to know about Kidney Stones. Retrieved on Nov. 5, 2010 from http://kidney.niddk.nih.gov/kudiseases/pubs/stones_ez/index.htm

National Kidney and Urologic Diseases Information Clearinghouse (2009). Diet for Kidney Stone Prevention. Retrieved on Nov. 5, 2010. from http://kidney.niddk.nih.gov/kudiseases/pubs/kidneystonediet/index.htm

References:

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Thank you.

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