Gyan Pareek, MD, director of the Kidney Stone Center, discusses how kidney stones are treated and ways to prevent them.
Learn about the causes and symptoms of kidney stones.
The new Kidney Stone Center has officially opened its doors at The Miriam Hospital, bringing together a team of nephrologists, urologists and dietitians under one roof in a
collaborative effort to evaluate, diagnose and treat patients suffering from kidney stones. It is the only center of its kind in Rhode Island.
This multidisciplinary treatment team works together to provide complete medical and dietary management of kidney stones using the latest technology and
preventive techniques. Diagnostic services, including sonography, are also available on-site.
According to urologist Gyan Pareek, M.D., FACS, director of the Kidney Stone Center at The Miriam Hospital, kidney stones are one of the most common – and
painful – disorders of the urinary tract, affecting approximately 12 to 14 percent of Americans each year. They are also persistent: about half of all
patients who have had a kidney stone removed will experience recurrent stone disease within five to ten years.
“Our team-based approach to kidney stone treatment will streamline and ease treatment for patients, who will now be evaluated by a urologist, nephrologist
and dietitian in a single visit,” he said. “Our goal is to not only treat existing kidney stones, but to also prevent new stones from forming. Because most
kidney stones are diet-related, tailored nutrition and dietary management are critical to providing the best treatment and follow-up care. We hope that our
patient’s first kidney stone removal is also their last.”
Pareek is joined at the Kidney Stone Center by assistant director John O’Bell, M.D., a nephrologist at The Miriam Hospital, and Mary Flynn, Ph.D., R.D.,
LDN, the hospital’s chief research dietitian.
Kidney stones are small, hard deposits of mineral and acid salts that form inside the kidney or ureter. The stone – which may be as small as a grain of
sand or as large as a pearl – may remain in the kidney or break loose and travel down the urinary tract. Although a small stone may pass through the body,
a larger stone can get stuck in a ureter, the bladder or the urethra, which may block the flow of urine and cause significant pain.
In most cases, patients are treated with medical explusive therapy, such as alpha blocker medicines, which can increase the spontaneous passage of the
stone while decreasing the time it takes to pass. However, depending on the size and location of the stone, as well as the overall health of the patient,
minimally invasive surgery may be recommended in some cases.
These surgical options include shockwave lithotripsy, a non-invasive technique that uses sound waves delivered outside
the body to dissolve the kidney stone to a passable size, and ureteroscopy, in which a small scope is inserted into the urethra and through the urinary
system while the patient is under general anesthesia, while a laser breaks up the stone and extracts the pieces. Both are performed on an outpatient basis
at The Miriam Hospital. However, if the stone is too large to treat with these procedures, more complex surgical techniques may be required.
When it comes to preventing future kidney stones, the Kidney Stone Center team takes a comprehensive approach by considering such factors as genetics, age,
test results, other health issues and diet to determine potential causes of stones. If available, they will also analyze kidney stones removed or passed by
patients to look for clues about how they formed. Since nutrition is integral to the treatment and prevention of stones, Flynn also tailors a plan for each
patient with the goal of reducing the risk of new stones.
For more information about the Kidney Stone Center at The Miriam Hospital, please visit
or call 401-793-3158.