The southeastern United States is often called the “kidney stone belt” because of the high number of people who develop stones. Why do these stones form and can you do anything to stop it? Jeffrey Mullins, M.D., urologist with CHI Memorial Chattanooga Urology Associates, explains how metabolic screening can help determine a person’s risk of developing stones.
“About 10 percent of people will have a kidney stone at some point in their life. And once you’ve had one stone, you have a 50 percent chance of developing more stones within five years”, says Dr.
Mullins. “With the metabolic screening, we try to limit trips to the emergency room and the operating room, by identifying individualized risk factors and try to intervene and prevent a person from forming further stones.”
The metabolic screening involves blood work and a 24-hour urine study. A company analyzes the urine and sends the results to your doctor. “Based on those results, we can really understand what’s going on as far as the cells in your kidney and why you form kidney stones”, explains Dr. Mullins. “We’ll go over your blood results, your urine results and the composition of your stones, then base a plan which could be pills or dietary modifications.” It takes about two weeks to complete the screening process.
Kidney stones form for a variety of reasons. Dr. Mullins says stones can be caused by an abnormality in how the kidney handles minerals such as calcium and sodium or how acidic or basic the urine is. “If we can identify people who have a known risk factor and put them on a pill or two a day, that can keep them out of the operating room which will help their overall health, help their kidney function, and help save them and the health care system money.”
Dehydration is also a major risk factor for forming stones. When a person is dehydrated, the urine has a higher concentration of minerals and that can lead to crystallization and forming stones. “General recommendations for preventing stones include good hydration. You should drink enough to make two liters of urine per day. The amount of fluid this will take depends on the patient, their activity level, and even the weather. Eat a normal calcium diet, relatively low protein, and limit the amount of salt and salt-related foods in your diet as well”, says Dr. Mullins. (Check with your doctor before changing your diet, especially if you have restrictions on fluid intake.)
Candidates for the metabolic screening include people who formed stones at early ages, in their 20s or 30s; people who have had two to three stones in the past; or had large volume stones requiring more invasive procedures. Dr. Mullins says, “We try to limit invasive procedures to one per person if we can, so people who have a long-standing history or a family history of kidney stones should really be screened early.”
For more information about metabolic screening for kidney stones or to make an appointment with Dr. Jeffrey Mullins, contact CHI Memorial Chattanooga Urology Associates at (423) 697-0072. The practice has two locations at CHI Memorial Chattanooga, 725 Glenwood Drive, Suite 780, Chattanooga, TN 37404 and at CHI Memorial Hixson, 2051 Hamill Road, Suite 108, Hixson, TN 37343.