Kidney Stones: Avoiding the Pain

Prevention plays a leading role in management of kidney stones

Each year, almost a million Americans are treated for kidney stones. For many of these unlucky people, this is not their first experience with passing a stone. The problem comes when crystallized chemicals from the urine form a mass in the kidney, then try to follow the path of urine through the system.

The experience is painful—excruciatingly painful—to the point that most people want to do all that is necessary to avoid repeat stones. Lisa Rodriquez knows first hand. "I've passed four stones in seven years, including one while I was pregnant," she said.

A kidney stone can be as tiny as a grain of salt or as big as a golf ball.

Pain is usually the first symptom, although diagnosis usually involves urine and blood tests, X-rays and sound waves. Once the stones are found, the majority of them will pass naturally within three to six weeks. Some stones, however, require surgery or extracorporeal shockwave lithotripsy. Both treatments work to break up the stone or to facilitate passage. Medical follow-up is important to prevent reoccurence.

According to Dr. Glenn D. Preminger, professor of urologic surgery at the Duke University Medical Center and director of the Duke Comprehensive Kidney Stone Center in Durham, NC, a large stone can block the flow of urine, causing pressure to build throughout the system, including in the kidneys. "Increased pressure results in stretching and irritation, which causes the pain," he said.

Beyond the acute pain in the abdomen that often shifts to the groin, other symptoms can include blood in the urine, fever, weakness, nausea and vominting. Although kidney stones do not usually cause permanent damage, a blockage could lead to infection.

Patients frequently suffer multiple stone episodes that could be prevented with combination therapy.

Diet is part of the treatment. Not enough fluids and too much protein, salt and oxalate (found in spinach, nuts, and strawberries) can lead to the formation of additional stones. Despite changing their diets, many people who pass stones still form new ones.

"To prevent recurrence, studies have found that a potassium citrate treatment, such as Urocit^®-K, administered following a kidney stone experience is highly effective," said Dr. Preminger. "Potassium citrate picks up where shock wave therapy leaves off, by restoring the natural chemicals that block the formation of stones. It reduces the tendency of uric acid to form stones and minimizes the chance of recurrence by more than 85 percent."

Lisa Rodriguez wishes she was treated for recurrence. "I'm still paying for the shock wave therapy I had years ago," she said, "but I'm still suffering from this condition, despite changing my diet."

Dr. Preminger suggests patients like Lisa ask their doctor for more information about diagnostic tests and treatments to prevent the pain from returning.

"Once you've lived through it, you don't want to live through it again," Lisa said.

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Urocit®-K is a prescription form of potassium citrate. It helps restore the chemicals in urine that stop crystals from forming, and reduces the formation of the two most common types of kidney stones: calcium oxalate and uric acid stones.

Important Safety Information

Urocit®-K is not for everyone. It has not been tested on children, pregnant women, or women who are breastfeeding, and it is unknown whether Urocit®-K can affect reproductive capacity, unborn children, or breast milk content. You should not take Urocit®-K if you are pregnant, may become pregnant, or are currently breastfeeding, unless your doctor has discussed the risks with you and determined that it is necessary.

Certain drugs can interact with Urocit®-K and lead to increased gastrointestinal (GI) irritation. Drug interactions can also lead to hyperkalemia, an excess of potassium in your blood that could lead to cardiac arrest or death. These serious and possibly fatal conditions can develop rapidly with no noticeable symptoms. Always talk to your doctor about any medications you are taking before starting a prescription of Urocit®-K.

If you have hyperkalemia, or any condition that puts you at risk for the condition or prevents your body from processing potassium normally, do not take Urocit®-K because it could lead to cardiac arrest. Conditions that may put you at risk include kidney failure, uncontrolled diabetes, severe dehydration, strenuous physical exercise if you're unconditioned, extensive tissue breakdown, or adrenal insufficiency (when your adrenal glands do not produce the correct amount of chemicals needed to regulate the function of your organs).

Do not take Urocit®-K if you have an active urinary tract infection, peptic ulcer disease, or conditions that slow or prevent the tablet from passing through your GI tract, such as compression of the esophagus, delayed gastric emptying, or narrowing or blockage of your intestines.

Take Urocit®-K only as directed. Do not crush, chew, or suck on the tablets, and check with your doctor if you experience any trouble swallowing tablets or if they seem to get stuck in your throat.

To ensure your safety during your prescription, your doctor may perform regular blood tests and EKGs (which analyze the electrical activity in your heart).

Some patients taking Urocit®-K may develop minor GI side effects such as abdominal discomfort, vomiting, diarrhea, loose bowel movements or nausea. To reduce these effects, take each dose of Urocit®-K with meals or snacks, or talk to your doctor about reducing the amount of your dosage.

If you experience severe vomiting, abdominal pain, tarry stools, or other signs of intestinal bleeding, stop taking Urocit®-K and see your doctor right away. These could be signs of a serious condition such as a perforated or blocked bowel.

To report negative side effects, contact Mission Pharmacal Company at 1-800-298-1087 or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.