What exactly are Kidney Stones (Causes, Symptoms, Diagnosis and
Treatment)
What are Kidney Stones
Kidney stone also called renal calculi, nephrolithiasis or urolithiasis is a solid, pebble like piece of material that can form in one or both of your kidneys when high levels of certain minerals are in your urine. They are hard deposits made of minerals and salts that form inside your kidneys.
Kidney stones form when certain chemicals become concentrated enough in the urine to form crystals. The crystals grow into larger masses (stones), which make their way through the urinary tract. If the stone gets stuck somewhere and blocks the flow of urine, it can be extremely painful. Kidney stones have many causes and can affect any part of your urinary tract from your kidneys to your bladder.
Types of Kidney Stones
Calcium stones form when the kidneys retain the excess calcium that the muscles and bones do not use, rather than flushing it out of the body. The calcium combines with other waste products to form crystals, such as calcium oxalate, which clump together to make a stone.
Uric acid stones result from a lack of water in the body. Urine contains uric acid. When there is not enough water to dilute the uric acid, the urine becomes more acidic.
Struvite stones can form after a UTI. They consist of magnesium, ammonium and phosphate.
Cystine stones develop when cystine, a substance present in the muscles, builds up in urine. These are rare
Symptoms of Kidney Stones
Many people with kidney stones have no symptoms. However, some people do get symptoms, which may include:
- a gripping pain in the back (also known as ‘renal colic’) usually just below the ribs on one side, radiating around to the front and sometimes towards the groin. The pain may be severe enough to cause nausea and vomiting
- pink, red, or brown blood in your urine, also called hematuria
- cloudy or bad smelling urine
- shivers, sweating and fever – if the urine becomes infected
- small stones, like gravel, passing out in the urine, often caused by uric acid stones
- an urgent feeling of needing to urinate, due to a stone at the bladder outlet.
- pain while urinating
- inability to urinate or can only urinate a small amount
What causes kidney stones?
- Kidney stones are caused by high levels of calcium, oxalate, and phosphorus in the urine. These minerals are normally found in urine and do not cause problems at low levels.
- Certain foods may increase the chances of having a kidney stone in people who are more likely to develop them.
- Low urine volume
- Medical conditions
Who is more likely to develop kidney stones?
- Men are more likely to develop kidney stones than women. If you have a family history of kidney stones, you are more likely to develop them. You are also more likely to develop kidney stones again if you’ve had them once.
- You may also be more likely to develop a kidney stone if you don’t drink enough liquids.
- People who take certain medications like diuretics.
- People with certain medical conditions(a blockage of the urinary tract, hyperoxaluria, cystic kidney diseases, inflammation of the bowel etc)
Diagnosis of Kidney Stones
Many kidney stones are discovered by chance during examinations for other conditions.
- Lab tests: Urine tests can show whether your urine contains high levels of minerals that form kidney stones. Urine and blood tests can also help a health care professional find out what type of kidney stones you have.
- Urinalysis involves a health care professional testing your urine sample. You will collect a urine sample at a doctor’s office or at a lab, and a health care professional will test the sample. Urinalysis can show whether your urine has blood in it and minerals that can form kidney stones. White blood cells and bacteria in the urine mean you may have a urinary tract infection.
- Blood tests. A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show if you have high levels of certain minerals in your blood that can lead to kidney stones.
- Imaging tests
Health care professionals use imaging tests to find kidney stones. The tests may also show problems that caused a kidney stone to form, such as a blockage in the urinary tract or a birth defect. You do not need anesthesia for these imaging tests.
- Abdominal x-ray
- Computed tomography (CT) scan
- An examination of any stones that you pass in your pee
Kidney Stone Complications
Kidney stones can cause permanent kidney damage. Stones also increase the risk of urinary and kidney infection, which can result in germs spreading into the bloodstream. A large stone may get stuck in the urinary system. This can block the flow of urine and may cause strong pain.
Renal scarring and damage to the kidneys, resulting in permanent renal failure.
Loss of function of a kidney resulting in the need for removal of the kidney (nephrectomy).
Bladder blockage can result when a large kidney stone has managed to pass into the bladder but gets stuck in the urethra resulting in painful urinary retention
Treatment
If your test results show that your kidney stone is small, your doctor may tell you to take pain medicine and drink plenty of fluids to help push the stone through your urinary tract. If your kidney stone is large, or if it is blocking your urinary tract, additional treatment may be necessary. A urologist can remove the kidney stone or break it into small pieces with the following treatments:
One treatment option is shock wave lithotripsy. This treatment uses shock waves to break up the kidney stones into small pieces. After the treatment, the small pieces of the kidney stone will pass through your urinary tract and out of your body with your urine. This treatment usually takes 45 minutes to one hour and may be done under general anesthesia, which means you will be asleep and unable to feel pain.
Cystoscopy: During cystoscopy, the doctor uses a camera to look inside the urethra and bladder to find a stone in your urethra or bladder. The stone can then be fragmented by a process called Lithotripsy using an energy source like laser.
Another treatment option is Ureteroscopy. This treatment is also done under general anesthesia. The doctor uses a long tool shaped like a tube to find and remove the stone or to find and break the stone into small pieces. If the stone is small, the doctor may be able to remove it. If it is large, it may need to be broken into pieces. In this case, a laser will be used to break the stone into pieces that are small enough to pass through your urinary tract.
In some cases, a surgery called percutaneous nephrolithotomy is needed to remove a kidney stone. During the surgery, a tube will be inserted directly into your kidney to remove the stone through the skin at the back.
Avoiding recurrence of kidney stones
If you have had one kidney stone, some tips that may help to prevent a second stone forming include:
Talk to your doctor about the cause of the previous stone.
Ask your doctor to check whether the medications you are on could be causing your stones. Do not stop your medications without talking to your doctor.
Get quick and proper treatment of urinary infections.
Avoid dehydration. Drink enough fluids to keep your urine volume at or above two litres a day. This can halve your risk of getting a second stone by lowering the concentration of stone-forming chemicals in your urine.
Avoid drinking too much tea or coffee. Juices may reduce the risk of some stones, particularly orange, grapefruit and cranberry. Ask your doctor for advice.
Reduce your salt intake to lower the risk of calcium-containing stones. Choose low- or no-salt processed foods.
Avoid drinking more than one litre per week of drinks that contain phosphoric acid, which is used to flavour carbonated drinks such as cola and beer.
Always talk to your doctor before making changes to your diet.
If you’re concerned about your risk of developing kidney stones, talk with your doctor. If you have questions or want to learn more about kidney stones, call 08174209999 or 08174209990 to schedule an appointment with one of our doctors.