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BackTable / Urology / Topic / Condition

Kidney Stones

Kidney stone disease, or nephrolithiasis, is becoming increasingly prevalent worldwide. Crystal concretions formed within the kidneys are called kidney stones. Stone may also form in the ureter or urinary bladder, and the location of stone formation influences the symptoms that follow. These stones may be made up of calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid, or cystine. Calcium oxalate stones formed at Randall’s plaque are the most common. Kidney stones increase risk of end-stage renal failure and developing chronic kidney diseases, cardiovascular diseases, and diabetes. Some symptoms of kidney stones include renal colic, flank pain, urinary tract infections, blood urine, and dilation of the kidney.

Kidney Stones Condition Overview

Learn more on the BackTable Urology Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on Kidney Stones and how to build your practice by listening to the BackTable Urology Podcast, reading exclusing BackTable Articles, and following the work of our Contributors.

Ep 9 Tips & Tricks for Percutaneous Nephrolithotomy (PCNL) with Dr. Margaret Pearle and Dr. Aditya Bagrodia
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Kidney Stones Diagnosis

Kidney stones are confirmed with laboratory testing and imaging studies. Stone analysis is especially important in diagnosing patients with cystine, uric acid, infection-induced, drug-induced, and ammonium urate kidney stones. Laboratory tests include blood profiles and a urine metabolic evaluation while imaging studies are usually performed with CT. Systemic and environmental influences should be identified during kidney stone diagnosis so they can be addressed during treatment, if possible. Systemic influences include intestinal disease, primary hyperparathyroidism, recurrent urinary tract infection, and medullary sponge kidney.

Kidney Stones Podcasts

Listen to leading physicians discuss kidney stones on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #152

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This week on BackTable Urology, Dr. Ben Chew, professor and clinical researcher with the University of British Columbia, provides valuable insights on laser treatments for kidney stones.

First, Dr. Chew provides a comprehensive overview of the current landscape of laser treatment for kidney stones. Dr. Silva and Dr. Chew then discuss the unique characteristics of different laser types, such as the Holmium and the Thulium lasers. Dr. Chew also covers critical safety considerations, like maintaining low intravenous pressure, using cold irrigation, and taking breaks during sustained laser treatment. Additionally, they delve into emerging technology, such as the use of electromagnetic guidance, for more accurate laser application.

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Episode #146

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In this episode, Dr. Suzette Sutherland and Dr. Alana Desai from the University of Washington discuss the management of urinary tract stones in pregnant patients, considerations for ureteroscopy, and consequences of radiation exposure in the fetus.

First, the doctors underscore the importance of ultrasound as the first line imaging modality to minimize fetal exposure to radiation. Dr. Sutherland and Dr. Desai also delve into nausea and pain management options, recommended diets for prevention of stone formation during pregnancy, and the necessity of involving a multidisciplinary team in such cases. The episode concludes with a remarkable case study from Dr. Desai’s experience.

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Episode #132

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This week on BackTable Urology, Dr. Jose Silva and Dr. David Sas, a pediatric nephrologist at the Mayo Clinic-Rochester, discuss clinical presentation and prevention of kidney stones in children as well as workup of metabolic diseases.

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Episode #131

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This week on BackTable Urology, Dr. Manoj Monga (UC San Diego) invites Dr. Margaret Pearle (UT Southwestern) to discuss kidney stone prevention with lifestyle changes and medical therapy.

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Episode #104

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In this episode of BackTable Urology, urologist Dr. Manoj Monga (UC San Diego) and clinical nutritionist Dr. Kristina Penniston (UW Madison) discuss the role of diet in kidney stone prevention and how urologists can partner with dietitians to create integrated stone clinics.

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Episode #84

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In this episode of BackTable Urology, Dr. Jose Silva interviews Dr. Jason Wynberg, director of endourology at NYU Langone Health in Brooklyn, about his percutaneous nephrolithotomy (PCNL) technique and innovations.

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Episode #69

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In this episode of BackTable Urology, Dr. Jose Silva and Dr. Stephen Nakada, chair of urology at the University of Wisconsin, discuss indications and benefits of extracorporeal shock wave lithotripsy (ESWL).

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Episode #edición-esp-02

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Dr. Jose Silva y Dr. Fernando Cabrera, urologista de Cleveland Clinic en Florida, hablan sobre el diagnóstico y tratamiento de cálculos renales y ureterales. Los doctores discuten cuáles pacientes necesitan la intervención, los métodos quirúrgicos para romper los cálculos, y consejos sobre cada tipo de terapia.

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Episode #13

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UT Southwestern endourologist Dr. Jodi Antonelli shares her tips and tricks for difficult ureteroscopy cases. Listen to learn about pre-op and post-op medication, dealing with large prostates and narrow ureters, variations in baskets, access sheaths, and ureteroscopes, dusting vs. basket retrieval, and performing ureteroscopies on pregnant women.

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Episode #9

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Dr. Margaret Pearle, the Vice Chair of Urology at UT Southwestern Medical Center, joins us to discuss percutaneous nephrolithotomy (PCNL). Dr. Pearle shares advice on pre-operative urine culture analysis, CT scans, percutaneous access, and placing a ureteral stent vs. a nephrostomy tube

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Kidney Stones Treatment

The most common kidney stone treatments are shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Treatment selection is based on the location and complexity of the kidney stones. Options to prevent a recurrence of nephrolithiasis are available and should address the cause of stone formation in order to be effective. Adjusting diet and increasing fluid intake are essential. While there is no drug that cures and prevents recurrent kidney stones, thiazide diuretic, alkali, or allopurinol treatments can be used to reduce recurrence.

Kidney Stones Articles

Read our exclusive BackTable Urology Articles for quick insights on kidney stones, provided by physicians for physicians.

A Clinician's Guide to Kidney Stone Prevention: Protein, Collagen & Oxalate Management

Clinical dietician Dr. Kristina Penniston delves into the intricate relationship between dietary factors and kidney stone prevention, focusing on protein sources, collagen, and oxalate management.

Sodium & Stone Formation: A Fluid Approach to Kidney Stone Prevention

Dr. Kristina Penniston, expert clinical dietician, and Dr. Manoj Monga, renowned urologist, speak on the importance of fluids, including the different types available, and sodium restriction as pivotal components of kidney stone prevention.

Balancing Kidney Stone Risk with Weight Loss: Dietary Challenges Explored

Dr. Kristina Penniston, a clinical dietician specializing in kidney stones, and urologist Dr. Manoj Monga delve into the intricate relationship between diet, kidney stone risk, and weight management. They discuss challenging dietary scenarios, including post-gastric bypass hyperoxaluria, malabsorptive diseases like Crohn's, and the effects of medications like topiramate on stone formation.

Kidney Stone Management: A Dietician's Perspective on Passage & Prevention

Expert clinical dietician, Dr. Kristina Penniston delves into the intricacies of kidney stone prevention, with a primary focus on the pivotal role of diet and the essential collaboration between urologists and dieticians.

PCNL nephrostomy tube placement for kidney stones

PCNL is a minimally invasive surgical procedure that is used to remove large or complex kidney stones. Urologist Dr. Margaret Pearle explains when nephrostomy tube placement is appropriate and how they can stabilize post-operative bleeding.

PCNL Surgery Procedure Steps & Techniques for kidney stones

PCNL surgery is a minimally invasive alternative to open kidney stone surgery to remove kidney stones. Urologist Dr. Margaret Pearle shares her PCNL procedure steps and techniques and discusses the complications of PCNL surgery.

References

[1] Alelign, T., & Petros, B. (2018, February 4). Kidney Stone Disease: An update on current concepts. Advances in Urology. Retrieved December 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5817324/
[2] Miller, N. L., & Lingeman, J. E. (2007, March 3). Management of Kidney Stones. BMJ (Clinical research ed.). Retrieved December 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1808123/
[3] Sakhaee, K., Maalouf, N. M., & Sinnott, B. (2012, March 30). Clinical review. Kidney stones 2012: pathogenesis, diagnosis, and management. The Journal of clinical endocrinology and metabolism. Retrieved December 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387413/

Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Podcasts

Laser Options for Kidney Stones: A Clinician’s Guide with Dr. Ben Chew on the BackTable Urology Podcast)
Urolithiasis in Pregnancy: Balancing Risks & Management with Dr. Alana Desai on the BackTable Urology Podcast)
Metabolic Workup for Pediatric Stone Patients with Dr. David Sas on the BackTable Urology Podcast)
No Stone Unturned: Kidney Stone Prevention with Dr. Margaret Pearle on the BackTable Urology Podcast)
Dietary Modifications for Kidney Stone Prevention with Dr. Kristina Penniston on the BackTable Urology Podcast)
Perfecting Rectal Spacer Placement for Optimal Care with Dr. Neil Taunk on the BackTable Urology Podcast)

Articles

A Clinician's Guide to Kidney Stone Prevention: Protein, Collagen & Oxalate Management

A Clinician's Guide to Kidney Stone Prevention: Protein, Collagen & Oxalate Management

Sodium & Stone Formation: A Fluid Approach to Kidney Stone Prevention

Sodium & Stone Formation: A Fluid Approach to Kidney Stone Prevention

Balancing Kidney Stone Risk with Weight Loss: Dietary Challenges Explored

Balancing Kidney Stone Risk with Weight Loss: Dietary Challenges Explored

Contributors

Dr. Jodi Antonelli on the BackTable Urology Podcast

Dr. Jodi Antonelli

Dr. Fernando Cabrera on the BackTable Urology Podcast

Dr. Fernando Cabrera

Dr. Ben Chew on the BackTable Urology Podcast

Dr. Ben Chew

Dr. Alana Desai on the BackTable Urology Podcast

Dr. Alana Desai

Dr. Stephen Nakada on the BackTable Urology Podcast

Dr. Stephen Nakada

Dr. Margaret Pearle on the BackTable Urology Podcast

Dr. Margaret Pearle

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