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How to prevent and treat kidney stones

November 06, 2018 | UCI Health
dr ralph clayman speaks with patient

UCI Health urologist Dr. Ralph Clayman is world-renowned for his expertise in minimally invasive surgery for kidney stones, kidney cancer and ureter strictures.


Kidney stones are a painful yet highly treatable condition suffered by more than 10 percent of men and about 8 percent of women in the United States.

UCI Health has a highly skilled team of specially trained urologists who use the latest technology to break up kidney stones without surgery, using a sophisticated imaging and stone-fragmenting system called a Gemini unit, one of only three in the nation.

UCI Health urologist Dr. Ralph Clayman is world-renowned for his expertise in minimally invasive surgery for kidney stones, kidney cancer and ureter strictures.

He describes the causes, treatments and prevention of kidney stones.

What are kidney stones, and where are they found within the kidneys?

Kidney stones are hard deposits made of minerals and salts.

They can be found anywhere in the kidneys — in the areas responsible for forming or draining urine — or in the ureter or bladder.

Who is most likely to get kidney stones?

They are more common in:

  • Males
  • In adults generally in their 40s to 60s
  • People who live in warm climates

Added risk factors are:

What treatments are available for kidney stones?

Most small stones can be passed through the urinary tract by drinking lots of water and the help of pain relievers and medication to relax the ureters, which carry the urine from the kidneys to the bladder.

We have an array of techniques to deal with larger, more problematic stones:

  • We offer completely noninvasive shock wave lithotripsy, using electromagnetic waves to break up small stones.
  • We can also use an ureteroscope, a thin, lighted tube that is inserted through the urethra and bladder into the ureter and even up to the kidney. Through it, we pass a laser fiber smaller than a human hair to break a stone into tiny fragments.
  • Another technique, percutaneous nephrolithotomy, involves a one-inch incision in the back. This lets us remove stones up to several inches in size.

Is open surgery sometimes required to remove kidney stones?

With the Gemini technology, ureteroscopy and percutaneous stone removal, we have eliminated open surgery in 99 percent of cases. If someone recommends open surgery to remove a kidney stone, it is a good idea to get a second opinion.

What can be done to prevent kidney stones?

  • Nothing is more important than drinking three quarts of fluid a day. All fluid is good except for dark colas. People who are prone to forming kidney stones should drink 16 ounces of water when they arise in the morning, 16 ounces before going to bed and another two quarts throughout the day.
  • I also recommend a low-salt, Mediterranean-type diet.

If you follow these guidelines, chances are extremely low that you’ll develop a kidney stone — and if you’ve had one, this regimen may prevent a recurrence.

Once a person has a kidney stone, are they likely to develop more?

Yes, half the patients who have a kidney stone generally develop another one in five to seven years if they don’t change their fluid intake and diet.

How can I prevent stones from coming back?

People need to know that this is a preventable disease. Simply increasing fluid intake eliminates stone development in 50 percent of patients. Dietary changes also are helpful. In general, vegetables are better than fish, fish is better than chicken and chicken is better than red meat.

It is important to have a full metabolic evaluation by a urologist or nephrologist who specializes in kidney stones if you: 

  • Have had more than one kidney stone in less than five years
  • Have multiple kidney stones when you are first diagnosed
  • Have a strong family history of kidney stones

This involves collecting your urine over two 24-hour periods and assessing the amount of specific salts and minerals. This lets us discern the cause of your kidney stone and enables us to develop a personalized dietary and medical regimen to prevent a recurrence.

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