What Are Kidney Stones?
Kidney stones, or renal calculi, are solid masses made of crystals. Kidney stones originate in your kidneys, but can be found at any point in your urinary tract. The urinary tract includes the kidneys, ureters, bladder, and urethra.
Kidney stones are known to be one of the most painful medical conditions. The causes of kidney stones vary according to the type of stone.
Types of Kidney Stones
The different types of kidney stones include:
Calcium
Calcium stones are the most common. They can be made of calcium oxalate (most common), phosphate, or maleate. Vitamin C and spinach contain oxalate. Calcium-based kidney stones are most commonly seen in young men between the ages of 20 and 30.
Uric Acid
This type of kidney stone is more common in men than in women. They can occur in people with gout or those going through chemotherapy.
Struvite
This type of stone is found mostly in women with urinary tract infection. These stones can be quite large and cause urinary obstruction.
Cystine
Cystine stones are rare. They occur in both men and women who have the genetic disorder cystinuria.
Recognizing the Symptoms and Signs of a Kidney Stone
Kidney stones are known to cause severe pain. Symptoms of kidney stones may not occur until the stone begins to move down the ureters. The severe pain is called renal colic. Pain may be located on one side of your back or abdomen. In men, pain may radiate to the groin area. The pain of renal colic comes and goes, but is quite intense. People with renal colic tend to be restless. Other symptoms that can be present are:
blood in the urine
vomiting
nausea
discolored or foul-smelling urine
chills
fever
Why Kidney Stones Can Be a Problem
Stones don’t always stay in the kidney. Sometimes, they pass from the kidney into the ureters. Ureters are small and delicate, and the stones may be too large to pass smoothly down the ureter to the bladder. Passage of stones down the ureter can cause spasms and irritation of the ureters as they pass, which causes blood to appear in the urine.
Sometimes stones block the flow of urine. This is called a urinary obstruction. Urinary obstructions can lead to kidney infection (pyelonephritis) and kidney damage.
Testing for and Diagnosing Kidney Stones
Most common confirmatory test are:
1. Ultrasound(KUB)
2. X Ray Spine AP & Lat
You can get these test even directly without any prescription and in report you will be informed number and size of stones. Appx cost of these tests in India on 1.5.2015 is 1250 Rs.
Diagnosis of kidney stones requires a complete health history assessment and a physical exam. Other tests include: blood tests for calcium, phosphorus, uric acid and electrolytes blood urea nitrogen (BUN) and creatinine to assess kidney functioning
urinalysis to check for crystals, bacteria, blood, and white cells
examination of passed stones to determine type
The following tests can rule out obstruction:
abdominal X-rays
intravenous pyelogram (IVP)
retrograde pyelogram
ultrasound of the kidney
MRI of the abdomen and kidneys
abdominal CT scan
How Kidney Stones Are Treated
Treatment is tailored according to the type of stone. Urine can be strained and stones can be collected for evaluation. Drinking six to eight glasses of water a day increases urine flow. People who are dehydrated or have severe nausea and vomiting may need intravenous fluids. Other treatment options include:
Medication
Pain relief may require narcotic medications. The presence of infection requires treatment with antibiotics. Other medications include:
allopurinol for uric acid stones
diuretics
sodium bicarbonate or sodium citrate
phosphorus solutions
Lithotripsy
Extracorporeal shock wave lithotripsy uses sound waves to break up large stones so they can more easily pass down the ureters into your bladder. This procedure can be uncomfortable and may require light anesthesia. It can cause bruising on the abdomen and back and bleeding around the kidney and nearby organs.
Tunnel Surgery (Percutaneous Nephrolithotomy)
Stones are removed through a small incision in your back and may be needed when:
the stone causes obstruction and infection or is damaging the kidneys
the stone has grown too large to pass
pain cannot be controlled
Ureteroscopy
When a stone is stuck in the ureter or bladder, your doctor may use an instrument called a ureteroscope to remove it. A small wire with a camera attached is inserted into the urethra and passed into the bladder. A small cage is used to snag the stone and remove it. The stone is then sent to the laboratory for analysis.
Part 7 of 7: Prevention
Hydration to Prevent Kidney Stones
Proper hydration is a key preventive measure. Johns Hopkins Medicine recommends drinking six to eight glasses of water daily . You can substitute some glasses with ginger ale, lemon-lime soda, and fruit juice.