Treasury Secretary Geithner hospitalized for kidney stone surgery

Treasury Secretary Timothy Geithner was hospitalized today at George Washington University Hospital in Washington, DC. The 49 year old complained of severe abdominal pain last night and was diagnosed today with a kidney stone. He will undergo “a minor surgical procedure” today to remove the stone. Treasury spokesman Steve Adamske said, that although Geithner will need to cancel his appearances on the Sunday talk shows, he should be back in the office on Monday. Geithner has been very busy, serving a key role in negotiations over the tax cut bills before congress during the lame duck session.

Kidney stones, one of the most painful of the urological disorders, have beset humans for centuries. Scientists have found evidence of kidney stones in a 7,000-year-old Egyptian mummy. Unfortunately, kidney stones are one of the most common disorders of the urinary tract. Each year, people make almost 3 million visits to health care providers and more than half a million people go to emergency rooms for kidney stone problems.

What is a kidney stone? (Source: NIDDK)

A kidney stone is a hard mass developed from crystals that separate from the urine within the urinary tract. Normally, urine contains chemicals that prevent or inhibit the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones. If the crystals remain tiny enough, they will travel through the urinary tract and pass out of the body in the urine without being noticed.

Kidney stones may contain various combinations of chemicals. The most common type of stone contains calcium in combination with either oxalate or phosphate. These chemicals are part of a person’s normal diet and make up important parts of the body, such as bones and muscles.

A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. Another type of stone, uric acid stones, are a bit less common, and cystine stones are rare.

Who gets kidney stones?

For unknown reasons, the number of people in the United States with kidney stones has been increasing over the past 30 years. In the late 1970s, less than 4 percent of the population had stone-forming disease. By the early 1990s, the portion of the population with the disease had increased to more than 5 percent. Caucasians are more prone to develop kidney stones than African Americans. Stones occur more frequently in men. The prevalence of kidney stones rises dramatically as men enter their 40s and continues to rise into their 70s. For women, the prevalence of kidney stones peaks in their 50s. Once a person gets more than one stone, other stones are likely to develop.

What causes kidney stones?

Doctors do not always know what causes a stone to form. While certain foods may promote stone formation in people who are susceptible, scientists do not believe that eating any specific food causes stones to form in people who are not susceptible.

A person with a family history of kidney stones may be more likely to develop stones. Urinary tract infections, kidney disorders such as cystic kidney diseases, and certain metabolic disorders such as hyperparathyroidism are also linked to stone formation.

There are four major types of kidney stones:

• The most common type of stone contains calcium. Calcium is a normal part of a healthy diet. Calcium that is not used by the bones and muscles goes to the kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine. People who have calcium stones keep the calcium in their kidneys. The calcium that stays behind joins with other waste products to form a stone. The most common combination is called calcium oxalate.
• A struvite stone may form after an infection in the urinary system. These stones contain the mineral magnesium and the waste product ammonia.
• A uric acid stone may form when the urine contains too much acid. If you tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
• Cystine stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a stone. The disease that causes cystine stones runs in families.

What are the symptoms of a kidney stone?

You should call a doctor if you have any of the following signs:

• extreme pain in your back or side that will not go away
• blood in your urine
• fever and chills
• vomiting
• urine that smells bad or looks cloudy
• a burning feeling when you urinate

What can my doctor do about a problem stone?

Most kidney stones pass out of the body without any intervention by a physician. Drinking plenty of water—2 to 3 quarts a day—can help move the stone along. Stones that cause lasting symptoms or other complications may be treated by various techniques, most of which do not involve major surgery. Also, research advances have led to a better understanding of the many factors that promote stone formation and thus better treatments for preventing stones.

Extracorporeal shock wave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into small particles and are easily passed through the urinary tract in the urine.

Sometimes a stone is removed through “tunnel surgery.” The surgeon makes a small cut in the back and creates a narrow tunnel into the kidney. The surgeon then locates and removes the stone using a special instrument.

If the stone is in the ureter—the tube that carries urine from the kidney to the bladder—the doctor may use a ureteroscope. This slender instrument is inserted into the urethra—the short tube that carries urine out of the bladder when you urinate—through the bladder, then into the ureter. The doctor will catch the stone with a small cage in the uteroscope and pull it out. Or the doctor may shatter the stone with a device inserted through the ureteroscope.

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