April 30, 2014
News Review From Harvard Medical School -- Problems after Kidney-Stone Treatment
Many people treated for kidney stones may have problems afterward that send them to the hospital, a new study finds. Researchers looked at data on 93,000 U.S. patients who received treatment for kidney stones. About 14% had problems that required a hospital stay or emergency room treatment during the next 30 days, the study found. The average cost of treating these problems was $30,000. The study looked at 3 types of treatment. Shock-wave lithotripsy uses shock waves, applied outside the body, to break up the stones. The pieces then pass out of the body through urine. Uteroscopy uses instruments attached to a long tube to find the stone and break it up. The pieces are removed with a tiny basket or through the urine. Percutaneous nephrolithotomy is used for larger stones. Instruments inserted into a small incision in the kidney are used to break up and remove the stone. This is the treatment that involves an overnight hospital stay. Problems after treatment may include pain, bleeding and infection, according to the Urology Care Foundation. Damage to the urethra, kidney or nearby organs are relatively rare. The journal Surgery published the study. HealthDay News wrote about it April 29.
By Reena L. Pande, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Kidney stones seem so simple and uncomplicated. These tiny stones develop from collections of crystals that form in the urine. There are several kinds of kidney stones. Calcium is a major component.
But a new study shows that treatment of kidney stones can result in costly complications. A new study found that these problems occur in about 14% of patients who have treatment for kidney stones. The study looked at information from more than 93,000 patients in the United States. About 14% developed a complication that required either hospitalization or emergency care within 30 days of the treatment.
The three major treatments studied were shockwave lithotripsy, ureteroscopy and percutaneous nephrolithotomy.
The average cost of caring for patients who developed these problems was found to be between $30,000 and $47,000.
What Changes Can I Make Now?
Kidney stones may cause no symptoms at all. When symptoms occur, they may include:
- Belly and flank pain that comes and goes in waves
- Blood in the urine
Several factors increase the risk of developing kidney stones. They include dehydration and a poor diet. How can you manage these risk factors and keep kidney stones from forming? You can take several preventive measures.
- Drink plenty of liquids.
- Maintain a regular intake of calcium, but don't take in too much. About 1,000 to 1,200 milligrams per day should be about right.
- Limit sodium (mostly salt) and vitamin C in your diet.
- Limit meat in your diet.
- Limit or avoid carbonated soft drinks.
If you have kidney stones, one of the simplest treatments is simply to watch and wait. Certainly there's no need for urgent treatment for people who have kidney stones but no symptoms. Many people will pass kidney stones on their own, with minimal discomfort.
However, larger stones can be more difficult to pass. They may require more invasive procedures. These procedures usually involve breaking down the stone into small pieces using shock waves, ultrasound or a laser. The pieces can then be removed or pass out of the body through the urine.
What Can I Expect Looking to the Future?
Kidney stones are common. Fortunately, preventive measures may help you to avoid getting a kidney stone.
In some cases, a procedure may be necessary to break up and remove kidney stones. And although these procedures are generally quite safe, problems can arise.
In the future, we will need to find better and safer procedures to manage kidney stones. For now, the focus should remain on prevention.