Kidney Stones – A Detailed Note on an Intolerable Issue !

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Kidney stones are solid piece of material, which forms inside the kidney. It can also be defined as the small and hard deposits of minerals and acid salts found in the kidney. It forms when the substances to be eliminated via urine are present in high concentrations. They might travel down the passage or remain in the kidney. Generally, a small stone passes down on its own causing little or no pain; but a larger stone might not pass down on its own, blocks the urine flow, and causes severe pain and bleeding. In simple words, stones in the kidney form under two conditions: (1) the urine volume is less than the normal and (2) the urine volume contains more substances capable of forming stones like calcium, oxalate, etc. Medically, nephrolithiasis is the term used for the kidney stones derived from the Greek ‘nephros-’ (kidney) and ‘lithos’ (stone) and urolithiasis is another term derived from the French word ‘urine’, which stems from the Latin ‘urina’ and the Greek ‘ouron’ ()urine — urine stones. Similarly, for the kidney stone present in the ureter, the condition is termed as ureterolithiasis (ureteral stone).

Kidney stones vary in both shape and size. They can vary in size from as small as a grain to a large one like a pearl. In some cases, the stones size might be larger than the pearl size. The stone might be jagged (generally yellowish color), smooth or golf-sized (brown color).

There are four major types of kidney stones that can form, which are described below.

  1. Calcium stones: these are the most common types of stones that occur in kidney. They are of two types mostly: calcium phosphate and calcium oxalate (most common); its rare common type is calcium maleate. Calcium phosphate stones occur as result of high pH urine, i.e. alkaline urine and high urine calcium. Calcium oxalate stones occur when the urine excreted is high in both calcium and oxalates. One should avoid consuming high-oxalate-rich foods like peanuts, potato chips, chocolates, spinach, and beets. Approximately 80% of kidney stones are of calcium type.
  2. Cystine stones: these are very rare and occur in both men and women, especially in those who have genetic disorder – cystinuria. Cystine is an acid that is occurs in the body. Cystine when spills over into the urine from kidneys and forms crystals, cystine stones occur.
  3. Uric acid stones: these are more common in men than women. People suffering with gout or undergoing chemotherapy are more likely to develop these types of stones. These stones are formed when the urine excreted is acidic persistently. If uric acid concentrates in urine, it settles and form stones. Foods like fish, meats, and shellfish increase the uric acid and ultimately the uric acid stones form.
  4. Struvite stones: women suffering from urinary tract infections are more prone to this type of kidney stones. Of all types, this stone is generally found to be the largest, which causes urinary obstruction. Struvite stones form as result of kidney infections. Removal of these infected stones from the urinary tract will help in staying infection free.
  5. Other stones: rarer types of kidney stones might occur. For example, xanthine stones which are extremely rare to occur. They are brick red in color and radiolucent. Other stones include homogentisic acid stones, proline stones, glycine stones, and hydroxyproline stones.

 

Structure of Kideny Stones

 

The major symptom of kidney stones is severe pain and blood in the urine (hematuria). The pain can be bearable or to severe to tolerate, depends upon the size of the stone and its position. Renal colic is the term used for this severe pain. The pain generally is observed in the backside of the abdomen. It is like the pain occurs when the stone movement occurs from its resting position; the pain comes and goes. Other symptoms include nausea or vomiting, foul-smelling urine, fever, discolored urine, blood in the urine, and frequent urination. If you are observing the above mentioned symptoms then it is advisable for you to consult a doctor get lab tests for kidney disease done before its too late.

Although some people are more likely than others to have the kidney stones, anyone can get a kidney stone. Nevertheless, people with frequent dehydration are at risk of developing or have kidney stones more likely than the others. Other major risk associated with kidney stone development is drinking too less of water, less than a liter in one day – due to this, premature infants suffer from kidney stones. In general, the people suffering from kidney stones range in age from 20 to 40. In case you have a history of kidney stone problem, you are more likely to suffer. African Americans are less likely to develop kidney stones than Caucasians. On a general comparison basis, women are affected less than men. Non-Hispanic White people have more stones than non-Hispanic Black people and Mexican Americans. According to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more men suffer with this problem than women – as sex plays a major role.

However, the major question still lingering around is what causes kidney stones? There is no cause of kidney stones but the actual cause is the people who are at high risk to develop them, as mentioned above that anyone can get these. The following are the cases to develop kidney stones in people with:

  1. cystinuria,
  2. urinary tract blockage,
  3. hyperparathyroidism,
  4. hypercalciuria,
  5. chronic inflammation in the bowel,
  6. hyperoxaluria,
  7. renal tubular acidosis,
  8. hyperuricosuria,
  9. gout,
  10. diet with high protein and salt,
  11. obese people,
  12. taking anti-seizure drugs,
  13. medications like calcium-based antacids,
  14. history of gastric bypass surgery, and
  15. taking medications for HIV infection treatment – the protease inhibitor indinavir.

In case of the severe pain in abdomen, not going away, immediately visit your doctor. The doctor might inject a solution to slow down your pain and will ask for your urine and blood sample for testing. He might perform following tests to screen and complete the diagnosis:

  1. urinalysis (UA): this test involves examining the urine sample for the presence of any infection or stone-forming substances;
  2. blood test: it is done to examine if any biochemical problems exist that are responsible for kidney stone formation;
  3. ultrasound: it is the most preferred test done for identifying if the stone is the reason of the pain as it provides complete details about hydronephrosis, if present;
  4. abdomen X-ray: this imaging test helps in identifying the location of the tone, wherein the radiation in small amount is used to generate the picture;
  5. computed tomography (CT) scan: it is the three-dimensional image, combination of X-ray and computer technology, which requires injection of special contrast medium dye to generate different pictures analyzed by a radiologist and the cause of stone formation might be interpreted apart from the location; and
  6. other tests: intravenous pyelogram (IVP), retrograde pyelogram, and magnetic resonance image (MRI) of kidneys and abdomen.

Location of Kidney Stones

You can consult the doctor at your place by just giving a missed call to Next Door Lab (NDL) on 0124-222-3197 or by registering on www.nextdoorlab.com. NDL provides you with the ability to choose from various different tests and provides the advantages of free home sample collection and medicines at your doorstep. Apart from the above tests, the doctor will ask you questions regarding your previous experience if any and your family history to conclude the result.

The treatment for kidney stones depends upon the stone size. It might include intravenous medications – depends upon the pain severity and duration. It includes undergoing following therapies in case of a larger stone or blocking the urine path and causing intolerably great pain:

  1. ureteroscopy,
  2. percutaneous nephrolithotomy (tunnel surgery),
  3. parathyroid gland surgery,
  4. expulsion therapy, and
  5. shock wave lithotripsy.

In order to prevent the stones formation in the kidney, following points can help a lot:

  1. drinking 2–3 liters of water a day,
  2. take dairy products for calcium and not calcium supplements,
  3. medications:
    1. diuretics,
    2. allopurinols,
    3. phosphorus solutions,
    4. mercaptopropionyl glycine,
    5. potassium citrate, and
    6. antibiotics (bacteria-fighting medications and acetohydroxamic acid),
  4. herbal medicines have also promoted the prevention of kidney stones,
  5. limit animal protein rich diet (eggs, fish and meats),
  6. reduce sodium,
  7. put down some weight, and
  8. reduce oxalate-rich food (rhubarb, wheat bran, spinach, and nuts).

Lifestyle changes and dietary measures affect a lot. However, the prevention of not developing kidney stone/s is not sure shot, as people who already have stone are likely to develop another one. In addition, the kidney stone increases the risk of developing chronic kidney disease (CKD). If making any changes to your diet, do not forget to consult your doctor.

 

 

 

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