Kidney stones (renal calculi, nephrolithiasis) are diseases of the kidneys and ureters, in which small or large stones form inside the kidney. There may be one or more stones in the kidney at a time. Usually, these stones, if small, are removed from the body through the urethra without any difficulty, but if they become sufficiently large (2-3 mm in size) they can cause obstruction of the ureter.
This condition is most commonly found in people between the ages of 30 and 60 and is four times more common in men than in women.
In children and the elderly, more urinary stones are formed, while in adults, most of the stones are formed in the kidneys and urinary tract.
Today ten out of every hundred families in India are suffering from this painful condition, but the saddest thing is that only a few percent of these patients get it treated and people go through this unbearable pain.
Patients who have diabetes are more likely to develop kidney disease. If a patient has a blood pressure disease, he should focus on controlling blood pressure with regular medication because even if the blood pressure rises, the kidneys can get damaged.
What is a kidney stone?
A kidney stone is also called nephrolith or renal calculus, in the Hindi language, it is called a kidney stone. It is a hard substance like a stone. If you have too many certain minerals in your body, it can happen in one or both kidneys.
Types of Kidney Stone
There are five types of kidney stones according to their chemical composition:
Calcium Stone
This is the most common type of kidney stone and includes calcium oxalate and calcium phosphate. They are formed when excess calcium remains in the body after being used by the bones and muscles and is not removed from the body.
Cystic Stone
This leads to a condition called cystinuria, a genetic condition in which amino acids and cysteine are leaked out of the urine.
Uric Acid Stone
These stones are formed when the level of uric acid in urine becomes high. People who eat a lot of fish, shellfish, and meats are at a higher risk of getting uric acid stones.
Struvite Stone
These stones are formed after UTI (Urinary Tract Infection). They form on their own and grow rapidly.
What is kidney stone analysis?
Apart from the types, kidney stones can occur again and again, so if you have had a stone once, it is important to know what type of stone was, so that you can adopt some preventive measures to prevent it from developing again in the future.
That is why kidney stones are checked on the basis of the chemicals present in them. This test is done if the stone has passed into the urine (for small stones) or has been surgically removed (for large stones).
Cases of kidney stones are found more in men than in women. There are some factors that specifically increase the risk of getting kidney stones:
- If you have ever had stones before
- chronic inflammatory bowel disease
- urinary tract blockage
- not drinking enough water
- obesity
- frequent urinary tract infections
- Kidney disorders such as cystic kidney disease and renal tubular acidosis
- Gout (severe joint pain and swelling)
- Hypercalciuria (high amounts of calcium in the urine)
Kidney Stone Symptoms
Symptoms occur when Kidney Stone moves inside the kidney or moves into the ureter. The ureter is a tube that connects the kidney and bladder.
If stones get stuck in the ureter, they can block the flow of urine, causing the kidneys to swell and spasm in the ureter, which is very painful.
Once the condition reaches this stage, the symptoms may include:
- Burning or pain when urinating
- Pain that spreads to the lower abdomen and genitals
- Pain that is intermittent and sometimes mild sometimes severe
Other signs and symptoms
Except above, some other signs may appear in kidney stones.
- Pink, red, or brown urine
- Smelly urine
- Frequent need to urinate, urinating more often than usual or less urine at once
- Nausea and vomiting
As the stone moves up the urinary tract, the pain of the stone may change along with it – for example, it may be in a different location or be more severe.
Causes
Following are some of the causes of kidney stones –
Heredity
Some people are more likely to get kidney stones due to heredity. Some rare genetic diseases can also cause kidney stones such as tubular acidosis or problems with the body’s digestion of certain chemicals such as cysteine (an amino acid), oxalate (salt of an organic acid), and uric acid, and other chemicals.
Geographic location
Where you live can also be responsible for getting kidney stones. Living in an area of a hot climate and having insufficient fluid intake can be the cause of stone formation.
Diet
If a person is susceptible to stone formation, he or she may be at high risk from animal protein and salt. However, if a person is not susceptible to stone formation, the diet probably poses no risk to them.
Medicines
People taking diuretics and high-calcium antacids can have high levels of calcium in their urine, which can also lead to stone formation. Indinavir medicine for the treatment of HIV can lead to indinavir stone formation.
Risk factors of kidney stones
- Men between the ages of 30 and 50 are more likely to develop kidney stones.
- Women with low estrogen levels and women who have had their ovaries removed are more likely to develop kidney stones.
- Dehydration.
- Obesity.
- Eating a diet high in protein, salt, or glucose.
- Having a condition called hyperparathyroidism (too much of parathyroid hormone in the bloodstream).
- Gastric bypass surgery.
- Inflammatory bowel disease that increases calcium absorption.
- Taking diuretics, anti-seizure drugs, and calcium-based antacids.
Prevention
The following are the methods to avoid kidney stones –
Drink more water
Drink enough water per day to give you 2 liters of urine. Drinking some citrus drinks like lemonade and orange juice may also help.
Take calcium
Taking too little calcium can increase oxalate levels which can lead to kidney stones. Try to get calcium from foods as taking calcium supplements can also lead to stones.
Take less sodium
Excess sodium in the diet can lead to stone formation as it increases the amount of calcium in the urine. Current guidelines recommend no more than 2,300 milligrams of sodium a day.
If you’ve had kidney stones from sodium in the past, try reducing your daily sodium intake to 1,500 milligrams.
Limit animal protein
Eating foods such as red meat, poultry, eggs, and seafood can increase uric acid levels which can lead to kidney stones.
Don’t eat stone-forming foods
Most nuts including beetroot, chocolate, spinach, tea, and coals contain oxalate, and phosphate, these substances form stones. If you suffer from kidney problems, your doctor may advise you to avoid these foods or have them in moderation.
Diagnosis
Kidney stones are diagnosed in the following methods –
Blood test
The blood test checks for excess calcium or uric acid in your blood. Blood test results are helpful for checking your kidney health and other medical conditions.
Urine test
A 24-hour urine collection test can show whether you have too many stone-forming minerals in your urine or too few substances that prevent stone formation. For this test, your doctor may ask you to do two urine collections for two consecutive days.
Imaging test
Imaging tests include an abdominal X-ray, CT scan, ultrasound, a non-invasive test, and intravenous urography (in which a dye is injected into a vein in an arm and an X-ray or CT scan takes images of your kidneys. Stones are detected from the bladder.
Analysis of passed stones
You may be asked to urinate through a strainer to obtain the stone. Lab analysis can pinpoint the cause of your kidney stone formation and your doctor can use this information and make a plan to prevent kidney stone formation.
Kidney Stone Treatment
Following are the ways to treat kidney stones –
Medicines
Pain relief may require narcotic medications. The presence of infection can be treated with antibiotics. Other medicines are –
- Allopurinol (for uric-acid stones)
- Diuretic drugs
- Sodium bicarbonate (for sodium citrate)
- Phosphorus solution
lithotripsy
Extracorporeal shock wave lithotripsy uses sound waves to break up large stones so that they can pass through your ureters into your bladder. This can lead to bruises in the lower abdomen and back, and bleeding around the kidneys and organs.
Percutaneous Nephrolithotomy
In this, the stone is removed through a small incision in your back and may be necessary when –
- The stones block and infect or damage the kidneys.
- The stone has become so big that it cannot be passed.
- The pain cannot be controlled.
Ureteroscopy
When a stone becomes stuck in your ureter or bladder, your doctor may use an instrument called a ureteroscope. A small wire with a camera attached to it is inserted into the urethra, which leads to the bladder. A small cage is used to remove the stone and sent to the stone laboratory for analysis.
Kidney Stone Complications
Stones do not always stay in the kidney, sometimes they move from the kidney into the ureter. The ureters are small and fragile, making it difficult for stones to pass. The passage of stones into the ureters can cause cramping and blood in the urine.
