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KIDNEY STONES

Kidneys are the vital organs responsible for clearing the body’s toxic products, salts and other waste material from the body in the form of urine. They help in maintaining the electrolyte balance in the body, produce hormones responsible for making red blood cells (RBC) and regulate the blood pressure.

Nephrolithiasis is the other name for kidney stones. Kidney stones are formed due to the deposition of minerals and salts in the inner lining of the kidneys.  Most of these stones pass on their own through the ureters into the urinary bladder and move out of the body through urine. Some of the stones are too large to pass through and cause an obstruction in urine passage.

Symptoms

The symptoms associated with kidney stones are:

  • Hematuria
  • Foul-smell urine
  • Nausea
  • Fever
  • Chills
  • Urinating fewer amounts of urine
  • Urinary frequency increases
  • Painful urination
  • Pain that radiates to lower abdomen and groin
  • Pain in the scrotum and testicles for males
  • Severe pain in the side, and back, below the ribs

The symptoms might be an indication of other underlying health conditions which is determined only through diagnosis.

Causes

Kidney stones are formed as a result of the deposition of salts, hard minerals, and chemicals that are too big to be passed through the urine. They’re usually very small in the initial stages, but they grow to an extent that can be removed only through surgical procedures.

The factors that are responsible for forming kidney stones are:

  • Change in factors like the normal balance of water, salts and minerals and other things found in the urine.
  • Inadequate intake of water
  • Medical conditions such as gout
  • Hereditary

Types of kidney stones

The various types of kidney stones formed are:

Calcium stones: Majority of the stones formed in the kidneys are calcium stones. About 80% of the kidney stones are calcium stones.

Uric acid stones: Uric acid stones are formed in people who don’t drink adequate quantities of fluids, lose too much of fluid, consume high protein diet and have gout problems.  About 5% to 10% of kidney stones formed are uric acid stones.

Struvite stones: These types of kidney stones are formed in response to infections like urinary tract infections.  About 10% of kidney stones formed are struvite stones.

Cystine stones: These types of kidney stones are found in people who have a hereditary problem of excreting more amounts of certain amino acids and it’s a rare one. Hardly less than 1% of the kidney stones formed are cystine stones. 

Risk factors for developing kidney stones

The following are the factors that increase the risk of developing kidney stones. These factors are:

  • Dehydration
  • Hereditary
  • Personal history
  • Obesity
  • Digestive diseases
  • Digestive surgeries
  • Diets rich in protein, sugar or salt
  • Urinary tract infections, hyperparathyroidism, cystinuria

Diagnosis

There are various tests done to confirm the presence of kidney stones. Some kidney stones do not cause any pain and they can be confirmed only through diagnosis. The various diagnostic tests performed are:

  • CT scan of the kidneys, ureters, urinary bladder, and urethra.
  • Urography with CT scan, MRI scan, X-ray (intravenous pyelogram). These tests are painless.
  • A uric acid blood test is performed to diagnose the presence of uric acid in the blood, recurrent kidney stones, and gout.
  • Ultrasound tests are performed in pregnant women to identify kidney stones.
  • Urine analysis for a period of 24 hours helps to identify the passing of any stones in the urine.
  • Kidney functioning tests, such as serum creatinine test, albumin urine test, glomerular filtration test etc help to identify the functioning capacity of the kidneys.

Treatment

Kidney stones usually pass out through the urine, if they’re small.  The following are some of the treatments provided, which depend on the size and cause of the kidney stone.

Removal of large stones

Some of the kidney stones formed are too large to pass through the urine and they cause severe pain, urinary tract infections, bleeding and other problems. There are special procedures used to remove these stones. This includes:

  • Sound waves: Extracorporeal shock wave lithotripsy (ESWL) is a procedure that uses sound waves to break large kidney stones into tiny stones present in the kidneys, ureters, and urinary bladder. These tiny kidney stones are then passed through the urine.
  • Ureteroscopy: A thin flexible telescope is inserted through the urethra to remove smaller stones closer to the urinary bladder. Fragmentation of the stones is done by using helium laser device. This procedure is used for people who are obese, pregnant, suffering from blood clotting disorders. 
  • Percutaneous nephrolithotripsy and nephrolithotomy:  These procedures are used to remove stones that are irregularly shaped, larger in size (greater than 2 cm), and recurring. These surgical procedures are performed in patients who did not get benefit from ESWL.

Removal of smaller stones   

Kidney stones which are smaller in size do not require any surgical procedures and they’re easily eliminated from the body. The stones are removed by:

  • Consuming plenty of water to produce more and clear urine
  • Passing stones through urine is painful; painkillers are used to get relief from the pain
  • Medications such as alpha blockers are used to relax ureter muscles  and allow the free passage of stones through the urine

Medications

Depending on the stones formed the mediations can be as follows:

  • Diuretics are used to treat calcium stones
  • Alkalizing agents are used for treating uric acid stones
  • Antibiotics are used to treat struvite stones

Prevention

The following lifestyle changes help to prevent kidney stones. These are:

  • Consuming plenty of water throughout the day
  • Avoiding or eating very less oxalate-rich foods such as soy products, sweet potatoes etc
  • Consuming calcium-rich foods and avoiding calcium supplements
  • Eating diet less in salt and animal protein
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