All you need to know about kidney stones

Treatments – medicines, lithotripsy, ureteroscopy and more

What are kidney stones?

Kidney stones or renal calculi refer to the formation of a hard, crystalline mineral material within the kidney or urinary tract. Depending upon the location of the stones, the condition is further termed as:

  • Nephrolithiasis: stones are present in the kidney.
  • Urolithiasis: stones are present in thebladder or urinary tract.
  • Ureterolithiasis: stones are located in the ureters.

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    What are the types of kidney stones?

    Based on the chemical composition, these are the types of kidney stones:

    • Calcium oxalate stones
    • Calcium phosphate stones
    • Uric acid stones
    • Cystine stones

    Who is more prone to develop kidney stones?

    While kidney stones can develop in anyone, some groups of people are more prone to develop kidney stones. These include:

    • Men
    • Pregnant women
    • People aged between 20 and 50 years
    • People with previous history of kidney stones
    • People with family members having kidney stones
    • People with certain diseases and medical conditions like gout, hypercalciuria, hyperparathyroidism, diabetes, increase in uric acid levels, etc.
    • People taking certain medications like antacids, diuretics, etc.

    What causes kidney stones?

    Kidney stones are formed when stone forming substances (salts) are excreted in the urine. Change in composition of urine or reduction in the urine volume promotes formation of kidney stones. Some of the common factors causing such a situation include:

    • Dehydration caused due to less fluid intake or rigorous exercise
    • Any kind of obstruction in the outflow of urine
    • Infection in the urinary tract
    • Change in urine composition due to abnormalities of metabolism

    Certain dietary habits like high intake of proteins, excessive salt or sugar, prolonged intake of vitamin D supplements, and high intake of oxalate-containing foods like spinach

    What are the signs and symptoms of kidney stones?

    Some kidney stones are known as “silent” stones as they don’t cause any symptoms. Sometimes, people with kidney stones report colicky pain or renal colic, which is a sudden, unbearable pain in the low back or groin region, which may be accompanied by nausea and vomiting. The pain in such cases does not get relieved by changing the body posture. In both men and women, some additional symptoms may be present, which include:

    • Appearance of blood in the urine (haematuria)
    • Fever and chills due to infection in the urinary tract
    • Difficulty in passing urine or urgencyof urine
    • Back pain
    • Radiating pain towards lower abdomen and groin
    • Dark coloration of urine
    • Pain accompanied with nausea and vomiting
    • Pain in the penile or testicular area in men

    When to see a doctor?

    See a nephrologist, for bothering signs and symptoms – severe pain accompanied with fever and nausea; blood in urine; or difficulty passing urine.

    For relief from kidney stone, drink enough water, take over-the-counter painkillers, enjoy green tea or cranberry juice.

    How are kidney stones diagnosed?

    If you experience any sign or symptom of kidney stone, consult a nephrologist immediately. Your doctor/nephrologist would generally diagnose the condition on the basis of:

    1. Medical history
    2. Thorough examination
    3. Tests:

    • Blood tests
    • Imaging tests:
      •  Ultrasound with or without plain abdominal X-rays
      •  Non-contrast CT scan

    What is the treatment for kidney stones?

    Once a kidney stone is diagnosed, your nephrologist may advice a suitable treatment depending on the size of the stones, accompanying symptoms and underlying medical problems, if any. Sometimes, adequate intake of fluids helps the stones, if small (about 5mm or less), to pass through urinary tract on their own within a day or two. Your doctor may also give you medications to help relieve the pain and also aid to pass the stones through the urine.

    How are kidney stones removed?

    For larger stones that are not likely to pass on their own, the nephrologist may advice kidney stone removal procedures and surgeries.

    Extracorporeal shock wave lithotripsy (ESWL):Ultrasound shock waves are used to crush the larger stones which can then be easily eliminated through the urine.

    Alternative procedures include:

    • Ureteroscopy – Small kidney stones can be removed by doctor by inserting a tube along the ureter. For larger stones, doctor may also make use of laser within ureteroscope to dissolve or break them down.
    • Percutaneous nephrolithotomy (PCNL)
    • Open surgery

    Open surgery or operation is rarely used to remove kidney stones anymore. Doctor may advise open surgery only when stones are stuck, blocking urine flow, causing extreme pain and bleeding.

    How can kidney stones be prevented?

    One of the best ways to prevent formation of stones is keeping yourself adequately hydrated, especially during periods of rigorous exercise, cold weather, etc. This helps to keep the urine diluted and prevent buildup of calcifying agents.

    Uric acid stones in obese individuals can be controlled with weight loss.

    Diet for kidney stones:

    Based on the types of kidney stones, you may need to modify the food intake to reduce stone formation, reduce size of stones and prevent further kidney stones after remission. Talk to a dietitian who specializes in prevention of kidney stones.

    Some basic diet tips for kidney stones include:

    1. Reduce sodium intake. Keep a check on consuming processed food, pickles, fast-food. Limit the use of extra salt on table.
    2. Limit protein from animal source. Replace them with plant proteins such as legumes, soy food, nuts, sunflower seeds.
    3. A check on the consumption of foods rich in oxalate, such as spinach, beets, wheat germ, peanuts, etc., is also advisable for people who are prone to form calcium oxalate kidney stones.
    4. Take enough calcium. Both calcium oxalate and calcium phosphate stones can be minimized with enough calcium in your diet.

    If you have any queries about kidney stones, or want to inquire about the treatment option, request a call back and our kidney stone specialist will get back to you at the earliest.

    References

    Disclaimer: The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.

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