• Kidney stones most frequently
occur in people between the ages of 20 and 60; men have kidney
stones three times more often than women.
• The four major types
of kidney stones are defined by their make-up. The most common
type is a calcium stone (75%).
• Stones that are larger,
irregularly shaped, higher in the kidney, or causing a blockage
may need to be broken up or taken out.
• Approximately 20% to
30% of people with kidney stones require some treatment.
past 15 years have seen great strides in the treatment of nephrolithiasis,
or renal stone disease. However, there is still much to discover
about how these stones develop, and how to prevent the formation
of the hardened mineral deposits that separate from urine and build
up on the inner surfaces of the kidney over time.
In the 1930s, Dr. Hugh Hampton
Young, the first director of the Johns Hopkins Brady Urological
Institute, mentored Dr. Alexander Randall, who had a great interest
in the way that kidney stones formed. Dr. Randall went on to describe
little plaques-pre-calculus lesions of the renal papilla now called
Randall's plaques-in the kidney, noting that stones generally formed
here. Substantiated by others during the next decade, his work was
nevertheless largely ignored until recently. Research into stone
disease is coming full circle, thanks to the investigating work
of Brian Matlaga, M.D., the new director of an active and comprehensive
kidney stone program at Johns Hopkins emphasizing prevention of
stone recurrence and preservation of renal function.
A full range of minimally invasive
therapies are available to remove stones, including an extracorporeal
shock wave lithotripter that is used to fragment and break up stones.
Percutaneous, laser, and endourologic technology also allows for
stone removal without the need for an incision, or, in selected
cases, only through a small "keyhole" incision.
Dr. Matlaga is actively engaged
in clinical and basic science research involving the formation and
prevention of stone disease, and his research picks up where
Dr. Randall's left off. Important
questions to be answered include:
- Who is developing stones?
- Why are other disease processes-hypertension,
other kidney diseases, and possibly diabetes-often associated
with stone formation?
- How well are we treating patients?
- What are the long-term consequences for kidney
and pancreas function following shock wave and percutaneous therapy?
By building on Dr. Randall's work and abnormalities
in the kidney on a cellular level, Dr. Matlaga hopes to develop
therapies to prevent or modulate stone disease.