Treatment and Prevention of Kidney Stones
Treatment of Pain from Kidney and Ureteral Stones
Antispasmodic medications and pain medications are used in the acute management of kidney stones.
Alpha blockers such as Flomax are used to improve and accelerate stone passage as part of medical expulsive therapy (MET) for kidney stones.
Further treatment is based on the type of stone:
- Calcium Oxalate Stones: Thiazide diuretics are commonly used medical treatments for lowering calcium excretion in recurrent calcium stone formers
- Uric Acid Stones: The treatment strategy involves increasing the solubility of uric acid in urine and reduce its concentration (alkalinization). Potassium citrate is used either alone or in combination with thiazide treatment. Allopurinol also reduces urinary uric acid excretion as well as stone recurrence.
- Calcium Phosphate and Struvite Stones: Since these stones are formed in alkaline urine due to infection with urease-splitting micro-organisms, treatment is with antibiotics and the urease inhibitor acetohydroxamic acid.
- Cystine Stones: Treatment is aimed at reducing the concentration of free cystine and increasing its solubility. A high fluid intake and alkalinization of urine with citrate or bicarbonate is recommended.