Some conditions present in summer months lead to greater prevalence of kidney stones. Hydration is especially important to prevent these mineral accumulations.
Dr. Charles Marguet, urologist, explains how kidney stones develop, symptoms to watch for, and how kidney stones are treated.
Selected Podcast
Stone Season
Featured Speaker:
Charles Marguet, MD, FACS
Charles Marguet, MD earned his medical degree from the Indiana University School of Medicine and completed residencies in both General Surgery and Urologic Surgery at Duke University Medical Center. Dr. Marguet focuses on minimally invasive surgery and treatment for bladder, kidney and prostate cancers.Transcription:
Bill Klaproth (Host): In the south, the summer months are known as stone season as certain factors can lead to the development of kidney stones. Here to talk with us about stone season is Dr. Charles Marguet, a urologist with Greenville Health System. Dr. Marguet, thank you for your time. So, what is a kidney stone?
Charles Marguet, MD, FACS (Guest): Well thank you for having me. Urinary stones can occur anywhere in the urinary tract. They are crystalized mineral salts that accumulate and when these substances crystalize and lump together; kidney stones begin to form.
Bill: Are there people that are at a higher risk for kidney stones then?
Dr. Marguet: Yes, some people have a family history or genetic predisposition or certain metabolic factors that make them more likely to form stones.
Bill: So why do people form more stones in the summertime?
Dr. Marguet: Well the primary cause of stone formation in most people is dehydration. When the temperatures increase, and the humidity gets high in the summertime; this causes us to lose total body water which can increase the concentration of salts and other chemicals in our urine. Unless that water is replaced, the salts can crystalize out of the urine and form stones.
Bill: So, what are the symptoms? How would someone know this is happening?
Dr. Marguet: Well some people are asymptomatic, in other words, they don’t have any signs or symptoms. But usually if the stones grow large enough and block the flow of urine from the kidney to the bladder; they can cause severe pain in the back or side or lower abdomen as well as nausea which could be accompanied by fevers, chills, or flu-like symptoms. Sometimes urination is painful or more frequent than usual. The urine may also appear cloudy or bloody.
Bill: I heard these are really, really painful. Is that right?
Dr. Marguet: Yeah, a lot of people say that they are almost as bad as having pregnancy or labor. They can be really, really painful.
Bill: Oh, my goodness. So, how do you diagnose this because you said pain in the back, pain other areas. How do you diagnose it to know that it is a kidney stone and not something else?
Dr. Marguet: Well, we certainly look at the patient. We do a urinalysis to see if there is blood in the urine which is very common with kidney stones. But the most useful diagnostic test is really an imaging study in the form of either a renal ultrasound or a CT scan. That gives us great information about the size of the stone and its location.
Bill: So, can this happen to anybody at any age?
Dr. Marguet: Stones are more common as we get older particularly in men as we get older, but yes, stones can happen in children, even very, very young children and can happen in the very elderly as well.
Bill: So, if someone is diagnosed with a kidney stone, what is the treatment protocol then?
Dr. Marguet: Well, a lot depends upon again, how large the stone is and where it’s located in the urinary tract. Most stones will – if given enough time and if the patient can tolerate it, will pass on their own without intervention. However, sometimes patients need treatment from a urologist in the form of shockwave lithotripsy which means breaking up the stone with sound waves or endoscopy of the urinary tract with fragmentation of the stone with the laser. Very occasionally, when the stones get very large, do we have to go in directly to the kidney from the back or do open stone surgery and make an incision and get the stones out.
Bill: So, Dr. Marguet, this can happen to men and women?
Dr. Marguet: Yes, traditionally it has been much more common with men, but over the last 20 years or so, the incidence of kidney stones in women has risen as well and so it’s almost equal now.
Bill: So, once you have a kidney stone, are you more likely to develop another one in the future?
Dr. Marguet: Yes, there’s about a 50% chance of forming a second stone after you form your first. You can modify those risk factors in a lot of ways by increasing the amount of fluid that you take or avoiding certain dietary stone risks as well. But yes, the risk is much higher of forming a second stone after you have formed your first.
Bill: And are these hereditary at all? So, if my father had one, do I have to worry about that in the future?
Dr. Marguet: Thankfully, only a small minority of stones are directly related to genetics or inherited. But yes, some of them are.
Bill: So, you had mentioned before, drinking water to make sure things are you say hydrated and you keep things flowing; are there other things we can do to prevent kidney stones from forming?
Dr. Marguet: Well, avoidance of high concentration of dietary salt will oftentimes prevent kidney stones from forming. And many times, we are able to individualize a dietary plan for patients who form kidney stones. We do that by analyzing their urine over a 24-hour period and we can come up with an individualized plan, so they can keep from forming stones.
Bill: So, these stones or as you called them before, they are mineralized crystals; they come in different sizes, then right? Someone can have a smaller one that’s not as painful and someone else could develop a big one that’s really problematic?
Dr. Marguet: Well, they certainly come in different sizes, but you can’t be fooled by that. Oftentimes, a very small stone say two to three millimeters can be more painful than a stone that’s much larger. It just depends on whether the stone is blocking the flow of urine. That blockage can cause the urinary tract to stretch which is really the source of the pain. So, the size of the stone doesn’t really matter necessarily, it’s the blockage of urine flow.
Bill: And left untreated, I mean it’s going to kind of work itself out eventually, but left untreated, can it lead to other problems down the road or more immediately for that person?
Dr. Marguet: That’s a great question and so, yes, they absolutely can. If you leave a kidney blocked for a long period of time, that kidney will cease to function. So, if the stone is blocking the urinary tract; it absolutely should be seen and treated by a urologist. Stones that are blocking the urinary tract can also lead to chronic infections of the urine which can be problematic as well. So, if someone has kidney stones, they should at the very least be evaluated by a urologist at some point.
Bill: So, Dr Marguet, at what point should someone go see the doctor if they feel any sort of back pain or fever or chills etc.? When do they go see the doctor? When is it serious enough to do that?
Dr. Marguet: Well if the pain persists longer than you would expect for just a tweaked muscle or general backache, obviously, you should seek medical attention. Also, if you have pain in you back associated with fever or chills, that could be a sign of serious infection and if the pain becomes intolerable or you have associated nausea and you are unable to keep food down, then that would also prompt a visit to the doctor.
Bill: So, Dr. Marguet, does this pain come on quickly?
Dr. Marguet: Yes, usually it’s an abrupt, out of the blue kind of pain, but it can wax and wane because the urinary tract peristalsis, in other words, it squeezes to propel urine down from the kidney to the bladder. So, as that urinary tract squeezes, sometimes the pain can become more intense and we call that renal colic.
Bill: Alright and if you could wrap it up for us Dr. Marguet. What else do we need to know about stone season and kidney stones?
Dr. Marguet: Well, drinking water is the best way to prevent dehydration and the formation of kidney stones. Although the absolute perfect amount of water required to keep stones away varies. A real good rule of thumb is to drink enough water to keep your urine clear. If there is any color to the urine; you are probably not drinking enough. Also, drinking lots of sweet tea, punch, sodas and other sugar sweetened beverages during hot, humid weather may increase the chance of developing kidney stones as it interferes with absorption of certain chemicals. Remember, water is the best way to hydrate yourself during these hot times. Also, remember that some people have metabolic problems which put them at risk for stone formation and anyone that forms multiple stones really should be evaluated by a urologist for ways to prevent them from making more stones in the future.
Bill: So, remember to drink your water, the best way to fight stone season. Dr. Marguet, thank you for your time. For more information or to find a urologist please visit www.ghs.org, that’s www.ghs.org. You’re listening to Inside Health with Greenville Health System. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): In the south, the summer months are known as stone season as certain factors can lead to the development of kidney stones. Here to talk with us about stone season is Dr. Charles Marguet, a urologist with Greenville Health System. Dr. Marguet, thank you for your time. So, what is a kidney stone?
Charles Marguet, MD, FACS (Guest): Well thank you for having me. Urinary stones can occur anywhere in the urinary tract. They are crystalized mineral salts that accumulate and when these substances crystalize and lump together; kidney stones begin to form.
Bill: Are there people that are at a higher risk for kidney stones then?
Dr. Marguet: Yes, some people have a family history or genetic predisposition or certain metabolic factors that make them more likely to form stones.
Bill: So why do people form more stones in the summertime?
Dr. Marguet: Well the primary cause of stone formation in most people is dehydration. When the temperatures increase, and the humidity gets high in the summertime; this causes us to lose total body water which can increase the concentration of salts and other chemicals in our urine. Unless that water is replaced, the salts can crystalize out of the urine and form stones.
Bill: So, what are the symptoms? How would someone know this is happening?
Dr. Marguet: Well some people are asymptomatic, in other words, they don’t have any signs or symptoms. But usually if the stones grow large enough and block the flow of urine from the kidney to the bladder; they can cause severe pain in the back or side or lower abdomen as well as nausea which could be accompanied by fevers, chills, or flu-like symptoms. Sometimes urination is painful or more frequent than usual. The urine may also appear cloudy or bloody.
Bill: I heard these are really, really painful. Is that right?
Dr. Marguet: Yeah, a lot of people say that they are almost as bad as having pregnancy or labor. They can be really, really painful.
Bill: Oh, my goodness. So, how do you diagnose this because you said pain in the back, pain other areas. How do you diagnose it to know that it is a kidney stone and not something else?
Dr. Marguet: Well, we certainly look at the patient. We do a urinalysis to see if there is blood in the urine which is very common with kidney stones. But the most useful diagnostic test is really an imaging study in the form of either a renal ultrasound or a CT scan. That gives us great information about the size of the stone and its location.
Bill: So, can this happen to anybody at any age?
Dr. Marguet: Stones are more common as we get older particularly in men as we get older, but yes, stones can happen in children, even very, very young children and can happen in the very elderly as well.
Bill: So, if someone is diagnosed with a kidney stone, what is the treatment protocol then?
Dr. Marguet: Well, a lot depends upon again, how large the stone is and where it’s located in the urinary tract. Most stones will – if given enough time and if the patient can tolerate it, will pass on their own without intervention. However, sometimes patients need treatment from a urologist in the form of shockwave lithotripsy which means breaking up the stone with sound waves or endoscopy of the urinary tract with fragmentation of the stone with the laser. Very occasionally, when the stones get very large, do we have to go in directly to the kidney from the back or do open stone surgery and make an incision and get the stones out.
Bill: So, Dr. Marguet, this can happen to men and women?
Dr. Marguet: Yes, traditionally it has been much more common with men, but over the last 20 years or so, the incidence of kidney stones in women has risen as well and so it’s almost equal now.
Bill: So, once you have a kidney stone, are you more likely to develop another one in the future?
Dr. Marguet: Yes, there’s about a 50% chance of forming a second stone after you form your first. You can modify those risk factors in a lot of ways by increasing the amount of fluid that you take or avoiding certain dietary stone risks as well. But yes, the risk is much higher of forming a second stone after you have formed your first.
Bill: And are these hereditary at all? So, if my father had one, do I have to worry about that in the future?
Dr. Marguet: Thankfully, only a small minority of stones are directly related to genetics or inherited. But yes, some of them are.
Bill: So, you had mentioned before, drinking water to make sure things are you say hydrated and you keep things flowing; are there other things we can do to prevent kidney stones from forming?
Dr. Marguet: Well, avoidance of high concentration of dietary salt will oftentimes prevent kidney stones from forming. And many times, we are able to individualize a dietary plan for patients who form kidney stones. We do that by analyzing their urine over a 24-hour period and we can come up with an individualized plan, so they can keep from forming stones.
Bill: So, these stones or as you called them before, they are mineralized crystals; they come in different sizes, then right? Someone can have a smaller one that’s not as painful and someone else could develop a big one that’s really problematic?
Dr. Marguet: Well, they certainly come in different sizes, but you can’t be fooled by that. Oftentimes, a very small stone say two to three millimeters can be more painful than a stone that’s much larger. It just depends on whether the stone is blocking the flow of urine. That blockage can cause the urinary tract to stretch which is really the source of the pain. So, the size of the stone doesn’t really matter necessarily, it’s the blockage of urine flow.
Bill: And left untreated, I mean it’s going to kind of work itself out eventually, but left untreated, can it lead to other problems down the road or more immediately for that person?
Dr. Marguet: That’s a great question and so, yes, they absolutely can. If you leave a kidney blocked for a long period of time, that kidney will cease to function. So, if the stone is blocking the urinary tract; it absolutely should be seen and treated by a urologist. Stones that are blocking the urinary tract can also lead to chronic infections of the urine which can be problematic as well. So, if someone has kidney stones, they should at the very least be evaluated by a urologist at some point.
Bill: So, Dr Marguet, at what point should someone go see the doctor if they feel any sort of back pain or fever or chills etc.? When do they go see the doctor? When is it serious enough to do that?
Dr. Marguet: Well if the pain persists longer than you would expect for just a tweaked muscle or general backache, obviously, you should seek medical attention. Also, if you have pain in you back associated with fever or chills, that could be a sign of serious infection and if the pain becomes intolerable or you have associated nausea and you are unable to keep food down, then that would also prompt a visit to the doctor.
Bill: So, Dr. Marguet, does this pain come on quickly?
Dr. Marguet: Yes, usually it’s an abrupt, out of the blue kind of pain, but it can wax and wane because the urinary tract peristalsis, in other words, it squeezes to propel urine down from the kidney to the bladder. So, as that urinary tract squeezes, sometimes the pain can become more intense and we call that renal colic.
Bill: Alright and if you could wrap it up for us Dr. Marguet. What else do we need to know about stone season and kidney stones?
Dr. Marguet: Well, drinking water is the best way to prevent dehydration and the formation of kidney stones. Although the absolute perfect amount of water required to keep stones away varies. A real good rule of thumb is to drink enough water to keep your urine clear. If there is any color to the urine; you are probably not drinking enough. Also, drinking lots of sweet tea, punch, sodas and other sugar sweetened beverages during hot, humid weather may increase the chance of developing kidney stones as it interferes with absorption of certain chemicals. Remember, water is the best way to hydrate yourself during these hot times. Also, remember that some people have metabolic problems which put them at risk for stone formation and anyone that forms multiple stones really should be evaluated by a urologist for ways to prevent them from making more stones in the future.
Bill: So, remember to drink your water, the best way to fight stone season. Dr. Marguet, thank you for your time. For more information or to find a urologist please visit www.ghs.org, that’s www.ghs.org. You’re listening to Inside Health with Greenville Health System. I’m Bill Klaproth. Thanks for listening.
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