Kidney Stones

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Kidney stones can increase your risk of chronic kidney disease, which is why fast detection and treatment is important when painful symptoms occur. Duke urologists use advanced technology to determine your type of kidney stone, its cause, and any conditions that require treatment to prevent a recurrence. Our goal is to quickly return you to a pain-free life and minimize your risk for kidney-related problems in the future.

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Testing for Kidney Stones

Kidney stones can run in families. Along with an initial physical exam, your health history can help us with a diagnosis. Additional testing may be needed.

Urine Collection and Analysis

After your initial appointment, you will receive a urine collection kit so you can capture your urine over a 24-hour period. The kit can be returned to the lab using pre-paid postage. Results help your urologist determine the cause of your kidney stones and recommend appropriate treatments as well as dietary changes and medications to help prevent future occurrences.

3-D Kidney X-Ray

This special technology, known as digital tomosynthesis, uses a series of two-dimensional X-rays taken in a single scan to build a three-dimensional image. The enhanced detail allows your urologist to more clearly see kidney stones as small as five millimeters in size. It’s particularly useful if you have recurrent kidney stones because of its low dose of radiation. Low-dose CT scans may also be used to help diagnose kidney stones.

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Treatment for Kidney Stones

Kidney stones don’t always require surgery. We’ll work closely with you to minimize their impact and educate you about preventative options. Small, pain-free kidney stones may be passed naturally with help from diet changes, medication, and guidance from your urologist. Larger kidney stones may require more intervention.

Medication

If you have recurring kidney stones despite dietary changes, your urologist may recommend medication. Common medicines include potassium citrate, which can alter the acidity of your urine to prevent stones from forming, and thiazide diuretics, which reduce the amount of calcium your kidneys release into the urine. Lifelong use of medications may be recommended to reduce kidney stone formation.

Shock Wave Lithotripsy

This outpatient procedure can treat kidney stones, depending on their size and location. A water-filled cushion is placed on your back, behind the location of your kidney stone. Shock waves pass through the skin to break the stone into smaller, dust-like pieces that pass out of the kidney in urine. You will be sedated for the length of the therapy, which can take up to 45 minutes.

Ureteroscopy

During this outpatient procedure, your urologist will insert a small scope with a camera on its tip into your ureter or kidney to look for stones. A laser breaks the stones into small pieces, which are captured and removed.

Minimally Invasive Surgery for Complicated Cases

When appropriate, kidney stones can be removed through several small incisions using robotic surgery or laparoscopically. These procedures are reserved for patients with complex kidney stones in locations that are difficult to reach with a scope. Our urologists helped develop these techniques, now considered the standard for surgical kidney stone removal.

Large Kidney Stone Removal

Larger kidney stones -- about the size of a marble, or larger -- may require a procedure called percutaneous nephrolithotomy. During this inpatient surgery, your surgeon inserts a tube with a camera at the end through a small incision in your back. Your surgeon uses the camera to view the kidney stone. A special instrument delivers pulses to break up the kidney stone into smaller pieces, which are then captured and removed. The procedure typically requires an overnight hospital stay.

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Why Choose Duke

A Proven Track Record
Our team of urologists perform about 400 ureteroscopic procedures every year. This gives our specialists a unique level of experience that reduces the likelihood of complications and the skill to help you recover quickly.

Leaders in Kidney Stone Research and Treatment
We were one of the first centers to adopt the use of laser technology to break down kidney stones, and continued research keeps us at the forefront of designing more effective ways of removal. This means you get access to the latest treatments before they become available elsewhere, and we often treat people turned away by other centers that aren’t equipped for unique cases.

Best Hospital for Urology in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our urology program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2020–2021.

Reviewed: 07/20/2020