May 26, 2009 10:48 pm US/Central
St. Paul Researcher Works To Prevent Kidney Stones
ST. PAUL (WCCO) ―
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More than 10 percent of Americans get kidney stones. Fifty percent people who get a first stone are expected to get another one within 7 to 10 years.
CBS
A urinary blockage caused by a kidney stone can be one of the most painful experiences you'll ever have and about one in 10 people will go through it. A Twin Cities doctor is trying to boost the odds you will only have to endure it once.
Dr. Andrew Portis is the Director of the HealthEast Kidney Stone Institute in St. Paul. Millions of people have a stake in Portis' findings. More than 10 percent of Americans get kidney stones. Fifty percent people who get a first stone are expected to get another one within 7 to 10 years.
One of Dr. Portis' patients is 20-year-old Melissa Ramey who got her first kidney stone in the fifth grade.
"I would say it's like a sharp pain in the back. Then you get really dehydrated," said Melissa. "It's just something that no one wants to go through."
Her stone was 3 centimeters long and large enough to require surgery.
Melissa is not the only one in her family suffering from kidney stones. Her mother Diane said there is a genetic predisposition in the family.
"I have five children, two boys and three girls, and three out of five have had kidney stones," said Diane.
While the Ramey family portrait shows smiling, handsome faces, the family photo Portis keeps on his computer is a series of side-by-side, black and white scans for the three children with kidney stones.
Portis has been monitoring the Ramey children with regular CT scans because kidney stones like to come back.
"I was getting them every single year," said 15-year-old Allison, who has had three surgeries. Melissa has had five surgeries.
The stones can form from a variety of body chemicals that crystallize in the channels of the kidneys, but surgically removing any kind has its challenges. Portis said the outcome for removing kidney stones through surgery has been so poor for so long that both doctors and patients often go into it expecting to fail. He said that's not good enough, especially if you don't want the stones to come back.
In his research, Portis has concluded one of the key factors in determining "whether or not somebody is going to require future treatment is whether the first treatment actually accomplished the goal which is to get all the stone out."
To try to achieve that "what we are doing is going in through the back, making a small hole, breaking up a large stone, making sure we have got all the pieces," according to Portis.
Just in case any troublesome fragments remained inside, Melissa's earlier surgeries meant going home with a kidney access tube protruding from her back.
Tubeless percutaneous nephrolithotomy, or PCNL, a less invasive technique, has now been proven to be an option for 90 percent of patients. Portis, who lead the research, says PCNL patients are able to reduce their stays in hospital from about four days to just one, and they go home without the tube.
The key, again, is vacuuming up all the crumbs.
"We have very good regular X-ray that is live [and other imaging technology.] We can look from all sorts of different angles and we are looking through a telescope inside," said Portis.
Shorter stays, less pain and longer lasting effects are the proven benefits. After seven years of follow up study, instead of a 50 percent recurrence rate, only 17 percent of patients have required retreatment.
Depending on the composition of the initial kidney stones, Portis said many future problems can be prevented with a change of diet, lots of water and, in some cases, medication.
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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