KIDNEY STONE EDUCATION & IDENTIFICATION

HOW COMMON ARE KIDNEY STONES?

Have you ever heard that passing a kidney stone is more painful than giving birth? Each year, more than 1 million people in the U.S. rush to the emergency room with pain caused by a kidney stone. Kidney stones (Renal Lithiasis, Nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. It is estimated that nearly 1 in 11 people will develop kidney stones sometime during their life.

FIND YOUR KIDNEY STONE TYPE

Calcium Oxalate Kidney Stones

Calcium Oxalate Kidney Stones

Calcium Oxalate kidney stones are the most dominant stone type and represent roughly 70% of all kidney stones formed. These stones form largely due to dietary imbalances often in combination with inherited genetic diseases. There are 8 different types of Calcium Oxalate kidney stones.
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Calcium Phosphate Kidney Stones

Calcium Phosphate Kidney Stones

Calcium Phosphate kidney stones are the second most prevalent type of stone and commonly plague pregnant women. They represent roughly 16% of all kidney stones formed. For CaP stones to form, urine pH must be more than 6. There are 5 different types of Calcium Phosphate kidney stones.
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Uric Acid Kidney Stones

Uric Acid Kidney Stones

Uric Acid kidney stones are the third most common type of kidney stone and represent roughly 10% of all kidney stones. These stones form as a result of acidic urine (pH of less than 5.5) in combination of excess uric acid in the body. There are 4 different types of Uric Acid kidney stones.
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Cystine Kidney Stones

Cystine Kidney Stones

Cystine kidney stones are rare and account for only 2% of all stones formed. These stones form as a result of an inherited genetic disorder called Cystinuria. There is no cure for this disorder; only actions that can slow down formation. There are 2 different types of Cystine kidney stones.
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Protein-Based Kidney Stones

Protein-Based Kidney Stones

Protein-based kidney stones are very rare and account for less than 1% of all stones formed. These stones form as a result of: chronic kidney or urinary tract infections (UTI), elevated levels of protein in the urine, or end-stage renal failure. There are 3 different types of Protein-Based kidney stones.
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Drug-Related Kidney Stones

Drug-Related Kidney Stones

Drug-related kidney stones are another rare type of stone and account for less than 1% of all stones formed. However, they are made of common chemical phases such as Calcium Oxalate, Calcium Phosphate, and Urate. There are 5 different types of Drug-Related kidney stones.
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Kidney Stone Symptoms

A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, you may experience these signs and symptoms:

  • - Severe pain in the side and back, below the ribs
  • - Pain that radiates to the lower abdomen and groin
  • - Pain that comes in waves and fluctuates in intensity
  • - Pain on urination
  • - Pink, red, or brown urine
  • - Cloudy or foul-smelling urine
  • - Nausea and vomiting
  • - Persistent need to urinate
  • - Urinating more often than usual
  • - Fever and chills if an infection is present
  • - Urinating small amounts

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

DETECTION OF HEREDITARY STONE DISEASE

One primary interest of the research community is the rapid detection of severe hereditary diseases that, if treated late or improperly, may lead to progressive impairment of renal function and end-stage renal failure. Such a dramatic evolution is usually due to late or erroneous diagnosis. It is all the more unfortunate since it might be prevented or substantially delated y an appropriate treatment, and since a stone episode most often reveals these diseases. This aspect is to be especially emphasized with regards to two hereditary diseases of particularly high detrimental consequences:

PRIMARY HYPEROXALURIA TYPE 1

This inherited disease is the most severe of all stone diseases due to the permanent endogenous (from within the body) overproduction of oxalate which leads to massive hyperoxaluria, recurrent COM kidney stones and nephrocalcinosis (deposits of calcium salts within the renal tubules, the tubular epithelium, and/or the interstitium) with a parenchymal deposit of COM crystals (deposits that negatively impact kidney function), decline in GFR (Glomerular filtration rate= how well the kidneys are functioning), hyperoxalemia with systemic oxalosis (a potentially life-threatening condition that results from the progression of primary or enteric hyperoxaluria. Excess oxalate that cannot be eliminated by the kidneys begins to accumulate in tissue throughout the body, including the blood, bones, joints, skin, eyes, heart, and kidneys), and ultimately end-stage renal disease requiring a combined liver-kidney transplant.

Discovery of Type Ic kidney stones made of pure COM with an unexpected clear color instead of the usual dark color or common COM stones should immediately alert to the probability of Primary Hyperoxaluria Type 1 (PH1). Laboratory evaluation to achieve a definitive diagnosis [4,86] and early institution of conservative medical treatments is suggested. It starts by testing the effect of pharmacological doses of pyridoxine, which diverts glyoxylate metabolism and may substantially reduce endogenous oxalate production. 

DIHYDROXYADENINURIA

This condition is due to mutations of the enzyme adenine phosphoribosyltransferase (APRT). It results in both the formation of stones made of 2,8-DHA and infiltration of the renal parenchyma (the functional tissue of an organ as distinguished from the connective and supporting tissue) by 2,8-DHA crystals leading to extensive interstitial fibrosis and ultimately to end-stage renal disease, requiring chronic dialysis and kidney transplant.

DHA-based stones are typically embossed and rough on the surface and beige to rust-brown in color. They are often confused with uric acid stones. Unfortunately, alkalization is ineffective in treating DHA stone as you can with uric acid stones, which is why proper analysis is so critical.

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