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 and nephrologists use advanced technology to determine your type of kidney stone, its cause, and any conditions that require treatment to prevent a recurrence. Small kidney stones can typically be treated with lifestyle changes or medication.
Our urologic surgeons are also experts in using minimally invasive treatments to remove complicated stones, such as large, recurrent stones, and to manage your care when other kidney diseases are present. Duke is among a small number of hospitals in the country that specialize in removing large and complex stones. Regardless of your diagnosis, our goal is to quickly return you to a pain-free life and minimize your risk for kidney-related problems in the future.
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 an initial appointment, you will use a urine collection kit to capture your urine over a 24-hour period. The kit can be returned to a lab using pre-paid postage. Results help your urologist determine the cause of your kidney stones. The most common treatment recommendation is often dietary changes. Your provider may also recommend medications or procedures to help prevent future occurrences.
Blood may be drawn to check for certain levels of calcium or hormones that could cause the formation of kidney stones.
3D 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 requires only low doses of radiation and allows your urologist to more clearly see kidney stones that are as small as five millimeters in size. This is particularly useful if you have recurrent kidney stones. Low-dose CT scans may also be used to help diagnose kidney stones.
Duke Health urologist Chad Gridley explains how your diet can be a big factor in preventing kidney stones. He shares tips on what to eat, drink, and make easy adjustments to keep your body healthy and avoid the pain of passing a kidney stone.
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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 dietary changes, medication, and guidance from your urologist. Larger, complex kidney stones may require more advanced intervention and an overnight hospital stay.
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.
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.
Kidney Stone Treatment Videos
While kidney stones are common, there are ways to prevent them and several options to treat them if they form.
About half of the stone removals Duke urologists perform each year are considered complex because of the size of the stone, its location, and/or an inability to pass on their own. In these cases, kidney stones can be removed through several small incisions using robotic surgery or laparoscopically. We are one of the highest-volume health systems in the country for removing large kidney stones that are about the size of a marble, or bigger.
Percutaneous Nephrolithotomy (PCNL)
This inpatient surgery is performed under general anesthesia, so you won't be awake or experience pain. During the PCNL procedure, your surgeon inserts a tube with a camera at the end through a small incision in your back. With X-ray guidance, your surgeon moves the tube to the location of the kidney stone and uses the camera to view it. A special instrument delivers pulses to break up the kidney stone into smaller pieces, which are then captured and removed. The procedure requires an overnight hospital stay. Because there is a chance for small amounts of bleeding if you exert yourself after the surgery, it's recommended that you do not lift anything over 10 pounds for two weeks. After that, you can return to normal activities.
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.
A Team Approach
Our team has years of surgical experience treating and removing complex kidney stones. Along with urologic surgeons, our anesthesiologists, physician assistants, and nurse practitioners have completed specific training in treating kidney stones. This breadth of understanding and support makes Duke a unique option for kidney stone care.
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 ongoing research keeps us designing more effective ways to remove them. This means you get access to the latest treatments before they become available elsewhere. Because our helped develop many of today’s standard techniques for surgical kidney stone removal, we have an advanced understanding of how to best treat you. 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 2022–2023.