I agree, you should ask the urologist or nephrologist if the stone can be removed.
Stones can get too big at times , they can block the the ureters and damaging the kidney.
here's some info I found:
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
See also: Cystinuria
The main symptom is severe pain that starts suddenly and may go away suddenly:
Pain may be felt in the belly area or side of the back
Pain may move to groin area (groin pain) or testicles (testicle pain)
Other symptoms can include:
Abnormal urine color
Blood in the urine
The goal of treatment is to relieve symptoms and prevent further symptoms. (Kidney stones that are small enough usually pass on their own.) Treatment varies depending on the type of stone and how severe the symptoms are. People with severe symptoms might need to be hospitalized.
When the stone passes, the urine should be strained and the stone saved and tested to determine the type.
Drink at least 6 - 8 glasses of water per day to produce a large amount of urine. Some people might need to get fluids through a vein (intravenous).
Pain relievers can help control the pain of passing the stones (renal colic). For severe pain, you may need to take narcotic pain killers or nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen.
Depending on the type of stone, your doctor may prescribe medicine to decrease stone formation or help break down and remove the material that is causing the stone. Medications can include:
Allopurinol (for uric acid stones)
Antibiotics (for struvite stones)
Sodium bicarbonate or sodium citrate (which make the urine more alkaline)
Surgery is usually needed if:
The stone is too large to pass on its own
The stone is growing
The stone is blocking urine flow and cuasing an infection or kidney damage
Today, most treatments are much less invasive than in the past.
Extracorporeal shock-wave lithotripsy is used to remove stones slightly smaller than a half an inch that are located near the kidney. This method uses ultrasonic waves or shock waves to break up stones. Then, the stones leave the body in the urine.
Percutaneous nephrolithotomy is used for large stones in or near the kidney, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with an endoscope that is inserted into the kidney through a small opening.
Ureteroscopy may be used for stones in the lower urinary tract.
Standard open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible.
Kidney stones can form when urine contains too much of certain substances. These substances can create small crystals that become stones.
The biggest risk factor for kidney stones is dehydration.
Kidney stones may not produce symptoms until they begin to move down the tubes (ureters) through which urine empties into the bladder. When this happens, the stones can block the flow of urine out of the kidneys. This causes swelling of the kidney or kidneys, causing pain. The pain is usually severe.
Kidney stones are common. A person who has had kidney stones often gets them again in the future. Kidney stones often occur in premature infants.
Some types of stones tend to run in families. Certain kinds of stones can occur with bowel disease, ileal bypass for obesity, or renal tubule defects.
There are different types of kidney stones. The exact cause depends on the type of stone.
Calcium stones are most common. They occur more often in men than in women, and usually appear between ages 20 - 30. They are likely to come back. Calcium can combine with other substances, such as oxalate (the most common substance), phosphate, or carbonate to form the stone. Oxalate is present in certain foods. Diseases of the small intestine increase the risk of forming calcium oxalate stones.
Cystine stones can form in people who have cystinuria. This disorder runs in families and affects both men and women.
Struvite stones are mostly found in women who have a urinary tract infection. These stones can grow very large and can block the kidney, ureter, or bladder.
Uric acid stones are more common in men than in women. They can occur with gout or chemotherapy.
Other substances also can form stones.
Tests & diagnosis
Pain can be severe enough to need narcotic pain relievers. The belly area (abdomen) or back might feel tender to the touch.
Tests for kidney stones include:
Analysis of the stone to show what type of stone it is
Uric acid level
Urinalysis to see crystals and red blood cells in urine
Stones or a blockage of the ureter can be seen on:
Abdominal CT scan
Intravenous pyelogram (IVP)
Tests may show high levels of calcium, oxylate, or uric acid in the urine or blood.
Kidney stones are painful but usually can be removed from the body without causing permanent damage. They tend to return, especially if the cause is not found and treated.
If you have a history of stones, drink plenty of fluids (6 - 8 glasses of water per day) to produce enough urine. Depending on the type of stone, you might need to take medications or other measures to prevent the stones from returning.
You may need to change your diet to prevent some types of stones from coming back.
Decrease or loss of function in the affected kidney
Kidney damage, scarring
Obstruction of the ureter (acute unilateral obstructive uropathy)
Recurrence of stones
Urinary tract infection
Welcome my Texas Brother!
First off, I'm not doctor, but I do have extensive personal experience in the kidney-stone arena.
As far as I'm aware, kidney-stones and creatinine levels are, for the most part, mutually exclusive. Again, I'm not a doctor, so it's best to ask your Nephrologist when you see him/her.
As for your 4mm stone, tell your Urologist that you're nervous about its implications, and that you'd like it removed. As ESWL will beat the heck out of your kidney, and you want to try and protect it as much as possible being that it's your only remaining, ask him/her about the possibility of a laser-cystoscopy. It all depends on where the kidney-stone is, and if it's accessible via cystoscopy, but if it's located in one of the lower poles, it should be a pretty simple procedure.
I have stones removed via cystoscope on a regular basis, and I'm in and out of the hospital within 24 hours, in most cases (sometimes even less than that).
Post back after you've talked to your Nephrologist. I'm curious about what he'll/she'll say about the kidney-stone/creatinine correlation, and if one exists.
Good luck to you.
Thanks so much for the responses.. Seeing my nephrologist today and will advise as to the course we proceed with.
Nephrologist is having me do a 24 hour urinalysis, to determine more about the stone. I am thinking about a second opinion because I want to make sure this is the correct approach. If the stone moves the doctor says I would be a serious medical emergency and would have to get to the ER asap... I am thinking I would not like to take the risk of having the stone move and go through all that at my local hospital. I have become spoiled to MD Anderson in Houston and the very high level of care that is provided there.
A 24-hour urinalysis? What on earth for??? You really should seek the advice/opinion of a Urologist. All the Nephrologist is going to want to do is try and figure out the 'why', not treat the stone you currently have.
I would agree that you probably want to have the urinalysis performed so you can prevent the formation of future stones, but for your immediate needs, I'd say a Urology consult (2nd opinion) is in order.
Side-Note: I'm not sure what I'd do if I moved out of Houston. I too have become spoiled with the level of care afforded me at Methodist Hospital, in the medical center, and the amazing & personal level of care that my current Urologist provides me. I have his personal cell-phone number, his email address, as well as the cell numbers and email addresses of all his nurses & fellows (understudies).
Most people don't get that personal level of care from their doctors, of that I'm certain.
Nope... in Houston I'm staying, for the foreseeable future!
Go see a Urologist, Brother, and get that 2nd-opinion. I'd really like to know how this turns out and what they say (what course of action they're going to take). I'm VERY curious about this, understand, as I'm more than likely going to lose my left kidney sooner rather than later, and my doctors suspect that my stone problem is going to present in my sole remaining kidney (which will put me in your boat).
Talk soon Brother.