Kidneys stones are the hard deposits of different minerals generally made up of calcium & uric acid. As the name implies, they generally form in the kidney (Nephrolithiasis) or bladder (Urolithiasis) or ureter (Ureterolithiasis) or anywhere in urinary tract.
The stones are formed when some minerals such as calcium oxalate start accumulating in the kidneys instead of excreting through the urine. The stones are dynamic in nature and keep on adding up their size.
If the stones are left unidentified or untreated, they will obstruct the flow of urine in the kidneys or urinary tract that can lead to kidney damage or kidney failure. That’s why it is very important to treat the stones before they get enlarged and a patient may require surgery eventually. So, if you have stones then you should immediately take steps for getting rid of them.
Family or personal history : If someone in your family has kidney stones, you’re more likely to develop stones, too. And if you’ve already had one or more kidney stones, you’re at increased risk of developing another.
Dehydration : Not drinking enough water each day can increase your risk of kidney stones.
Certain diets : Eating a diet that’s high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.
Obesity : High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.
Gastric Surgeries : Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.
Other medical conditions you may have? Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections.
There may be no symptoms until the stones block the flow of urine out of the kidneys. If the stone is too large to pass easily, pain continues as the muscles in the wall of the ureter try to squeeze the stone into the bladder.
As the stone moves and the body try to push it out, blood may appear in the urine, making the urine pink. As the stone moves down the ureter, closer to the bladder, a person may feel the need to urinate more often or feel a burning sensation during urination.
The main symptom is severe pain that starts suddenly and may go away suddenly if the stone passes through the ureter into the bladder.
- Pain may be felt in the abdomen or side of the back (Flank Region, Groin Region)
- Pain may move to groin area (groin pain) or testicles (testicle pain)
- Abnormal urine color
- Blood in the urine
If fever and chills accompany any of these symptoms, an infection may be present. In this case, a person should contact a doctor immediately.
Complete evaluation of stone analysis, serum calcium, serum uric acid, serum parathyroid hormone, serum bicarbonate & 24 hour urinary sodium, calcium, phosphorus, uric acid, magnesium, citrate, creatinine and urine pH can find out at least one abnormality in 97% of the stone-formers.
There are specific drugs to reduce calcium and uric acid excretion. Stone preventive salts like potassium, magnesium and citrate are available as supplements. Bacteria called Oxalobacter formigenes which degrade oxalate in food are available as capsules. When they colonize the gut, they reduce oxalate excretion.
In recurrent stone formers, regular ultrasound scanning of the urinary tract (KUB region) is a must to pick up and treat new stones early before they damage the kidney. This is a simple test without any harmful side effects like radiation unlike x-rays and CT scans.
Finally, whenever you undergo a stone removal procedure, make sure all the stones are removed completely. Residual stones or stone fragments are important causes for stone recurrences. Modern techniques like flexible ureterorenoscopy and laser (Retrograde Intra-Renal Surgery, RIRS) allow complete stone removal from every nook and corner of the kidneys.
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