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Kidney Stones

What are kidney stones?

Kidney stones are also called renal calculi, which are the solid mass made up of calcium, minerals, and salts that form inside your kidney, these kidney stones usually begin in your kidneys but they can develop anywhere in the along in the urinary system.

The urinary system consists of the following parts:

  • Kidney
  • Ureter
  • Urinary bladder
  • Urethra

Kidney stones or renal calculi are also called nephrolithiasis or urolithiasis. Kidney stones can be one of the most painful among all the medical conditions.

Kidney stones

Types of kidney stones

There are different types of kidney stones, these types help to determine the cause and it also helps to reduce your risk of getting more kidney stones. The types of kidney stones include:

Calcium stones

These are the most common among all the kidney stone types. These are made up of calcium oxalate. Oxalate is a substance that is made by the liver daily or absorbed from your diet. Eating oxalate-rich foods may increase the risk of developing calcium stones. The food that contains high-oxalate content are:

  • Peanuts
  • Potato chips
  • Beets
  • Chocolate
  • Spinach

These calcium stones may also occur in the form of calcium phosphate. These are more common in metabolic conditions like renal tubular acidosis. It can also be associated with certain medications used for treating seizures or migraines.

Struvite

The main cause of these types of kidney stones is the urinary tract infection (UTI). These are most common in women. These types of stones can cause urinary tract obstruction (blockage) because of their large size. These are a result of kidney infection. By treating an underlying infection may prevent the development of struvite stone.

Uric acid

This type of stone develops when the level of uric acid in your urine is too high. A purine-rich diet can increase the acidic level in your urine. Purine is a discolored substance found in animal proteins such as fish, meats, etc.

These types of kidney stones are more common in men than in women. People with gout or those who are going under chemotherapy can develop these types of kidney stones.

Cystine

These kidney stones are rare. They may develop in both men and women who are suffering from genetic disorder cystinuria. In this type of stone cystine (an acid that occurs in the body naturally) leaks from the kidney into the urine.

Risk factors for kidney stone

  • Dehydration
  • Obesity
  • Less than 1-liter production of urine by kidneys
  • A diet rich in proteins, salt or glucose
  • Gastric bypass surgery
  • Increased calcium absorption
  • Inflammatory bowel disease
  • Medications such as calcium-based antacids, anti-seizure drugs, and triamterene diuretics.

Symptoms of kidney stone

Kidney stones usually will not cause any symptoms until it moves in your kidney or passes into your ureters. This can be lodged in the ureters and it can block the urine flow, this will cause hydronephrosis (swelling to the kidney) and spasm to the ureter, this can cause you severe pain. This severe pain is called flank pain or renal colic. The pain can be felt on one side of your back or abdomen.

In males, this pain can be radiated to the groin area. The pain comes and goes, but it can be intense. People with flank pain tend to be restless.

In case the size of kidney stones is small, it will pass out of the body through the urinary tract and you may not feel any pain.

Other symptoms of a kidney stone include:

  • Hematuria (blood in the urine)
  • Vomiting
  • Nausea
  • Discolored or foul-odor urine
  • Fever and chills
  • Frequent urine
  • Urinating small amounts of urine

Diagnosis of kidney stones

Kidney stones are best diagnosed by a computed tomography (CT) scan, your doctor may order a Computed tomography of kidney, ureter, and bladder (KUB). In case you have multiple kidney stones or the stone is lodged into the ureter, a computer tomography (CT) scan is very useful to see the exact size and location of the stone.

CT KUB
CT KUB
CT KUB

Other diagnostic tests include

  • X-ray of the abdomen or KUB (kidney, ureter, and bladder)
  • Intravenous pyelogram (IVP)
  • Ultrasound of the kidneys, ureter, and bladder, KUB in short
  • MRI abdomen
  • Blood tests for calcium, phosphorus, uric acid and electrolytes
  • Blood urea nitrogen (BUN), kidney function test (KFT) and creatinine to access the function of the kidney
  • Examination of passed stones
  • Urinalysis

Treatment of kidney stone

Your treatment will be based on the type of stone you have.

The small-sized stone can be flushed out of the body through the urinary tract, this requires you to drink a lot of water and fluids (six to eight glass water per day). This may increase urine flow. For the persons who are dehydrated and have severe nausea and vomiting may require intravenous fluid.

Medications

Pain relief medication may prescribe by your urologist or healthcare provider.

Antibiotics may be prescribed to remove the infections.

Lithotripsy

In this method, the large-sized stones are broken by using extracorporeal shock waves and sound waves so that they can easily pass down from the ureter into your bladder. This procedure may cause you discomfort and also requires mild anesthesia. This may cause bruising on the abdomen and back and also bleeding around the kidney and its related organs.

Tunnel surgery (percutaneous nephrolithotomy)

This includes the removal of stones by making a small incision in your back. This procedure performed when:

  • The stone cause infection and obstruction
  • The stone is damaging the kidneys
  • Unmanaged pain
  • Stone is too large to pass

Ureteroscopy

This procedure is performed when a stone is stuck in the ureter or bladder. In this procedure, your doctor may need to use ureteroscope to remove the stone.

A small tube with a camera attached is inserted into the urethra and passed into the urinary bladder. Then the surgeon uses a small cage to snag the stone and remove it and send it to a laboratory for analysis.