November 7, 2018

Kidney stones affect about 600,000 Americans each year.  In fact, one out of every 11 Americans will experience a kidney stone sometime in his or her lifetime.

Kidney stones are pebble-like objects (not real stones) that are made up of mostly salts and proteins in the body.  They form in a kidney and can cause pain when the stone passes out of the kidney, into the ureter (the tube that drains urine from the kidney into the bladder), blocking the flow of urine.

"Pain is often what drives patients to come to the emergency room," said Dr. Ryan Fitzwater, urologist.  "Most stones treated at CAMC are less than 1 centimeter in size and can be treated on an outpatient basis with medications to ease the pain and help the stone move through the ureter more easily."

CAMC offers an expedited process for patients with kidney stones to provide quicker care along with a follow-up clinic to explore what caused the patient to develop kidney stones in the first place.

CAMC has a fast-track protocol for kidney stone patients who come to the emergency room but do not need admitted to the hospital.  Within 24 hours of initial treatment in the ER, advanced practice providers from CAMC Urology review CT scans and other test results and evaluate the patient to determine whether surgical intervention is necessary.  If surgery is needed, the providers will schedule the patient for a procedure as soon as possible.

"When a patient gets that sudden onset of pain, they want something done now," Fitzwater said.  "But not every stone needs treated immediately depending on its size and location."

Stones that can't be passed and cause persistent pain for a longer period of time might require surgery.  Treatment is determined by size of the stone and its location in the urinary tract.

The two most common procedures for treating kidney stones are shocking, or extracorporeal shock wave lithotripsy (ESWL), and ureteroscopy, both of which can be performed as outpatient procedures.

ESWL involves "blasting" the stone with sound waves to break it into smaller pieces that can pass through the urinary tract.

During a ureteroscopy, a surgeon inserts a thin, flexible scope into the bladder and ureter to look for kidney stones or other signs of trouble.

For kidney stones that are too large (usually larger than 2 centimeters), too numerous or too dense to be treated by ESWL or ureteroscopy, percutaneous nephrolithotomy (PCNL or stone extraction) is a minimally-invasive method of removing stones through an incision in the back.

"After a patient is treated and considered stone-free, many want to know how to prevent them," Fitzwater said.  "That's why we offer the CAMC Kidney Stone Center, which is a multidisciplinary clinic with urologists and a nephrologist focused on stone treatment and access in our community."

Watch: Dr. Fitzwater describes CAMC’s new SWIFT kidney stone care.

Because a kidney stone is usually a sign of an underlying condition that needs corrected, such as a high protein diet or dehydration, doctors at the Kidney Stone Center perform tests to see what may have led to the development of kidney stones and how to decrease the chances of developing more stones in the future.

"It's improving access to care for patients for earlier stone intervention and treatment," Fitzwater said.

For more information, visit CAMC's Kidney Stone Center.

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