By Dr Arun Kumar Donakonda
Consultant Nephrologist & Renal Transplant Physician

What is Kidney Stones?

Kidney stones (renal calculi, urolithiasis, or nephrolithiasis) are hard masses, deposits of minerals and salts that form inside the kidneys.

kidney-stones-overview

The size of kidney stones are usually like a chickpea, but they can also be as small as a sand grain or as large as a golf ball. However, small stones can pass through the urinary tract, but larger ones may require surgery.

Kidney stones can be caused by a variety of factors, including diet, excess body weight, certain medical conditions, and certain supplements and medications. The stones can affect any part of your urinary tract, including the kidneys and bladder.

If kidney stones are detected early, they may not cause permanent damage. To clear a kidney stone, you may only need to take pain medication and drink plenty of water, depending on your circumstances. Surgery may be required in some cases, such as when stones get lodged in the urinary tract, and are associated with a urinary infection, or cause complications.

Symptoms of Kidney Stones

A kidney stone normally does not cause symptoms until it moves around within the kidney or goes through the ureters, which connect the kidneys and bladder. It can block the flow of urine and cause the kidney to enlarge and the ureter to spasm, which can be quite painful. You may then experience the following signs and symptoms:

  • Pain in the side and back, below the ribcage, is severe and intense
  • Pain in the lower abdomen and groyne that radiates
  • Urinating causes pain or a burning sensation.

Other signs and symptoms may include:

  • Pink, brown or red urine
  • Cloudy or foul-smelling urine
  • Vomiting
  • Blood in the urine
  • Frequent urge to urinate
  • Urinating in small amounts
  • Nausea
  • Fever and chills

As a kidney stone passes through the urinary tract, the pain it causes may vary — for example, migrating to a new spot or rising in intensity.

Types of kidney stones

kidney-stones-types

Knowing the type of kidney stone can help to determine its cause and may provide guidance on how to lower your risk of future kidney stones. If possible, save the kidney stone and bring it to the doctor for analysis.

  • Calcium stones: The majority of kidney stones are calcium stones, most of which are calcium oxalate. Oxalate is a chemical that the liver produces or that people consume through their diet. Oxalate levels are high in several fruits and vegetables, as well as nuts and chocolate.
  • Struvite stones: These are developed as a result of a urinary tract infection. These stones can develop rapidly and become quite large, with minimal signs or warning.
  • Uric acid stones: People who consume high-protein diet, have diabetes or metabolic syndrome and also who lose too much fluid due to chronic diarrhoea or malabsorption, are at risk of developing uric acid stones. Certain genetic factors may also enhance your chances of developing uric acid stones.
  • Cystine stones: These stones are formed in people who have cystinuria, a hereditary condition in which the kidneys discharge an excessive amount of certain amino acids.

When To See A Doctor?

If a person has trouble passing urine or other symptoms such as blood in the urine or back or side pain, he or she should consult a doctor. If the symptoms are severe, the doctor may refer the patient to a specialist, such as a nephrologist or a well-experienced urologist.

Our Nephrologist at Medicover Hospitals will provide you with the finest kidney stone treatment possible.

Get the best treatment for Kidney Stones from our Nephrologists at Medicover Hospitals.

Causes and risks

Causes of Kidney Stone

There is no known cause for a kidney stone. However, certain conditions may increase the chances of developing this disorder. Kidney stones can form when the urine includes more crystal-forming components, including calcium, oxalate, and uric acid, than the fluid in the urine. Sometimes the urine lacks chemicals that help in preventing the crystals from adhering together and forming kidney stones

Risk factors

Factors that increase the risk of developing kidney stones include:

  • Family or personal history: If someone in the family has had kidney stones, he/she is more likely to develop them as well. If the individual has already had one or more kidney stones, he or she is at a higher risk of having another.
  • Dehydration: Not drinking enough water can raise the risk of kidney stones. People who live in hot, dry regions or who sweat a lot may be at a higher risk than others.
  • Certain diets: A diet high in sodium, protein, and sugar may increase the risk of certain types of kidney stones. Excessive salt in the diet can increase the amount of calcium, significantly raising the risk of kidney stones.
  • Obesity: A high BMI, a large waist circumference, and weight gain have all been associated to an increased risk of kidney stones.
  • Digestive diseases and surgery: Changes in the digestive process caused by inflammatory bowel disease or gastric bypass surgery might impair calcium and water absorption, increasing the amount of stone-forming chemicals in the urine
  • Other medical conditions: Renal tubular acidosis, hyperparathyroidism, cystinuria and repeated urinary tract infections can all increase the risk of developing kidney stones.

How is Kidney Stones diagnosed

Diagnosis

If the doctor diagnoses a kidney stone, the person may undergo the following diagnostic tests and procedures:

  • Blood testing:Blood tests may identify an excess of calcium or uric acid in your blood. Blood test results help your doctor monitor the health of your kidneys and may lead him or her to examine for other medical concerns.
  • Urine testing: In this test, the urine is tested, which is collected 24-hour. This could indicate that the individual is excreting either too many stone-forming minerals or not enough stone-preventing chemicals. The doctor may recommend collecting two urine samples on two consecutive days for this test
  • Imaging: Urine imaging tests may reveal kidney stones. Even microscopic stones can be detected using high-speed or dual-energy computerised tomography (CT). Simple abdominal X-rays are less commonly utilised. Another imaging technique for diagnosing kidney stones is ultrasound, which is a noninvasive, rapid and easy test.
  • Analysis of passed stones: He or she may be required to urinate through a strainer to catch stones that pass through. The type of kidney stone will be known through laboratory investigation and this will help to know the cause and to devise a plan to prevent future kidney stones.

Treatment

Kidney stone treatment varies depending on the type of the stone and the cause.

Small stones with minimal symptoms Most small kidney stones do not require invasive treatment. The small stone can be passed through:

  • Drinking water: Drinking 1.8 to 3.6 litres of water per day will dilute the urine and may prevent stones from developing. Unless otherwise directed by the doctor, drink enough water to create clear or almost clear urine.
  • Medical therapy:The doctor may prescribe medication to help patients pass a kidney stone. An alpha-blocker is a sort of medication that relaxes the muscles in the ureter, allowing people to pass the kidney stone more rapidly and with less pain. Tamsulosin (Flomax) and the medication combination dutasteride and tamsulosin are examples of alpha-blockers (Jalyn).

Large stones and those that cause symptoms Larger kidney stones that cause bleeding, kidney damage may require more thorough treatment. Procedures may include the following:

  • Using sound waves to break up stones: The doctor may recommend extracorporeal shock wave lithotripsy (ESWL) for certain kidney stones. Sound waves are used in ESWL to generate intense vibrations (shock waves) that break the stones into little pieces that can be passed in your urine. The operation takes about 45 to 60 minutes and can be painful, so patients may be medicated or given light anesthesia to make them more comfortable.
  • Surgery to remove very large stones in the kidney: Percutaneous nephrolithotomy is a surgical treatment that removes the kidney stone using a small telescope that is placed through a small incision in the back.During the procedure, patients will be anesthetized and hospitalised for one to two days to recover. If ESWL does not work, the doctor may recommend this surgery.
  • Using a scope to remove stones: To remove a small stone in the ureter or kidney, the doctor may insert a thin tube, known as a ureteroscope equipped with a camera through the urethra and bladder into the ureter.Once the stone has been identified, specific equipment can entrap it or break it up into pieces that will flow through the urine. The doctor may then insert a small tube (stent) into the ureter to reduce swelling and facilitate recovery. This operation may require a general or local anaesthetic.
  • Parathyroid gland surgery: Overactive parathyroid glands, which are located on the four corners of the thyroid gland, are the cause of certain calcium phosphate stones. When these glands create too much parathyroid hormone (hyperparathyroidism), the calcium levels rise and kidney stones form.Hyperparathyroidism can develop when a small, benign tumour grows in one of the parathyroid glands, or when patients have another condition that causes these glands to generate extra parathyroid hormone. The removal of the growth from the gland prevents the formation of kidney stones. Alternatively, the doctor may advise patients to treat the problem that is causing the parathyroid gland to overproduce the hormone.

Do’s and Don’ts of Kidney Stones

Kidney stone prevention may include a combination of lifestyle changes and drugs. You can lower the risk of kidney stones by following the do’s and don’ts:

Do’sDon’ts
Drink plenty of waterTake alcohol
Eat lots of watery fruits and vegetablesConsume stone-forming foods like beets, chocolate, spinach, tea, and most nuts
Have a diet low in animal protein and saltHave high amounts of salt in your diet
Eat fewer oxalate-rich foodsHave animal protein

Care at Medicover

At Medicover, we have the best team of Nephrologists and Urologists who work together to provide the best diagnosis and treatment for kidney stones with utmost precision. Our highly skilled team utilizes the latest medical equipment, diagnostic procedures, and technologies to treat various types of nephrology diseases and ailments. For kidney stones, we use laser lithotripsy and other advanced minimally invasive procedures which are safe and painless. We also adopt a multi-disciplinary approach to provide all-around care to the patients and attend to all of their medical needs at once for faster and sustained recovery.

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