Dr. Jodi Antonelli on Kidney Stones

Q:

What are the key risk factors in the formation of kidney stones?

A:

We believe that one of the most common reasons people form kidney stones is dehydration. Educating people on the importance of adequate fluid intake can dramatically reduce their risk of stones.

Other risk factors we look for in the urine are the levels of calcium, sodium, uric acid, citrate, and oxalate. All of these can typically be modified to some degree by dietary changes, but some people require medication in addition to dietary modifications to alter those levels.

Q:

How do you evaluate and treat kidney stones?

A:

Kidney stones can sometimes be treated conservatively with observation and medication. However, we often advise surgical removal due to the size and location of stones.

For patients who are recurrent stone formers or who have a positive family history for stone disease, we typically recommend a metabolic evaluation to determine their risk factors. This includes a panel of blood work as well as urine samples collected over 24 hours.

Depending on what we find, we usually recommend dietary modifications or a combination of dietary modifications and medication. We test patients again in several months to make sure that our recommendations have normalized their lab values.

Q:

What is percutaneous nephrolithotomy?

A:

Percutaneous nephrolithotomy is a procedure in which we go through a one-inch incision in the patient’s back to remove large stones from the kidney.

In the operating room, X-ray guidance enables us to place a small tube from the back directly into the kidney. We then pass a scope through this tube into the kidney, visualize the stone, break it into small fragments, and remove the pieces.

This procedure enables us to remove very large stones in a minimally invasive manner, allowing patients to recover quickly so they can return to their lives.