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Johns Hopkins Health - Skipping Stones

Winter 2011
Issue No. 11

Skipping Stones

Date: January 20, 2011

two boys skipping stones at a lake

End your kidney stone misery with these hard facts from Brian Matlaga, M.D., director of stone disease at the Johns Hopkins Brady Urological Institute

Do kidney stones that don’t pass on their own require surgery?
In the past, major surgery was the only answer. But now people with small kidney stones that can be easily seen by X-ray can be treated with a procedure called extracorporeal shock wave lithotripsy—or ESWL—without an incision. During ESWL, a machine generates shock waves, which are focused by X-ray onto the kidney stone. The shock waves travel into the body, through skin and tissue, and reach the stone, breaking it into smaller and smaller pieces until it becomes like grains of sand and washes out of the kidney. Most ESWL treatments last about one hour and are performed on an outpatient basis.

Does diet play a role in kidney stones?
Yes. The most simple and important dietary change to prevent stones is to drink plenty of fluids. Water is best. One guideline is to drink enough liquids throughout the day to produce at least 2 liters of urine every day. That’s roughly six to eight glasses of water, depending on your activity level and the outdoor temperature.

Now that I have a kidney stone, I know why the pain of passing one has been compared to childbirth. Should I expect a normal delivery?
Fortunately, most stones pass through the urinary system after the patient drinks plenty of water and takes pain medication as needed. But some stones require special care if they cause constant pain and don’t pass after a reasonable time.

Do only adults get kidney stones? Or should I be concerned about my children?
A recent study performed at Johns Hopkins showed a dramatic increase in kidney stones among children. We looked at a nationwide database to see how many children were hospitalized with kidney stones between 1997 and 2003 and discovered a dramatic rise—a 365 percent increase among girls and 274 percent increase among boys. We also found that children up to age 5 with a kidney stone are more likely than their peers to have high blood pressure and diabetes. So we now know that kidney stones have ties to other very serious disease processes in young children.

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