CONDITIONS
Kidney Stones
Kidney stones are hard deposits formed inside the kidneys, made of minerals and salts. They may have different names such as renal calculi, nephrolithiasis, or urolithiasis.
Kidney stones are generally small and may be formed if the body has too many minerals and less of liquid.
Kidney stones have a prevalence of about 12% worldwide, with similar prevalence in India, although it is more common in the northern part (15%).
What are the symptoms of Kidney Stones?
Kidney stones may not have any symptoms and they may only start when the kidney stone is on the move within the kidneys or if it moves into the tube connecting the kidney to the bladder (ureters). Symptoms may be mild or strong, and pain, if present, the severity and frequency may vary as the stone moves through the tract. Following symptoms may occur in kidney stones:
- Intense pain at the side or back, below the ribs
- Radiating Pain in groin (junction between the torso area and the thigh) and in lower abdomen
- Difficulty in passing urine or burning sensation while urinating
- Increased frequency of going to bathroom
- Cloudy, pink, red, or brown appearance of urine or bad smelling of urine
- Feeling like the urge to pee all the time
- In case of infection, fever and chills may occur
- Nausea and vomiting
- Urinating small amounts
What are the causes and risk factors of Kidney Stones?
Kidney stones often occur when the amount of minerals that form crystals (calcium, oxalate, uric acid) are higher than the fluid required to lower their concentration. There are different types of kidney stones and knowing the types could affect the treatment received. They include:
- Calcium stones
- Cystine stones
- Struvite stones
- Uric acid stones
Some factors my increase the chances of kidney stones. These are:
- Family or personal history of kidney stones, or presence one or more kidney stones
- Dehydration – not drinking enough water or even people living in warm, dry climates, sweating a lot may be at higher risk.
- Certain diets such as a high protein, high salt (sodium) and sugar diet. Especially a high sodium diet increases the amount of calcium to be filtered by the kidneys and significantly increase the risk of kidney stones.
- Obesity and a large waist size and weight gain lead to increased risk of kidney stones.
- Digestive diseases and surgery.
- Certain other medical conditions such as hyperparathyroidism and repeated urinary tract infections may also increase the risk of kidney stones.
Certain supplements and medications, such as vitamin C, dietary supplements, laxatives (when used excessively)
How is Kidney Stones diagnosed?
Following physical examination, the doctor may suggest the following tests and imagine procedures:
- Blood tests: To assess the level of calcium or uric acid in the blood and understand the health of the kidneys.
- Urine test: One or two 24-hour samples may be collected, and these show the presence of stone-forming minerals in the urine or less of the other compounds that stop stones from forming.
- Imaging tests: X-ray of the belly or a computerized tomography (CT) scan may be conducted to check for images of the stones, its location. An X-ray can show larger stones, but the CT scan helps doctors find small ones.
- Analysis of passed stones: Urinating in a strainer may lead to expelling and catching any stones that are passed, which may further be tested in the lab to understand its material, identifying, and solving the cause.
An ultrasound rather than a CT scan is recommended in pregnant women since that is the time when babies are most at risk of a radiation injury. A low-dose CT scan is less dangerous in the second and third trimesters.
What are the treatment options for Kidney Stones?
Treatment of smaller stones with minimal symptoms:
Most small kidney stones do not require invasive treatment and may be able to pass from the kidney by:
Drinking water: Drinking as much as 1.8 to 3.6 liters a day keeps the urine diluted and prevents formation of stones. Drinking enough fluid, most ideally water, produces clear or nearly clear urine.
Pain relievers: In case of pain and related symptoms or if passing a small stone causes some pain or discomfort, the doctor may recommend pain relievers such as ibuprofen.
Medical therapy: A medication may be given to the doctor to help pass the kidney stone. This medication relaxes the muscles in the ureter and aids in passing the kidney stone more quickly and with less pain.
Large stones causing pain and other symptoms.
Kidney stones that are too large to pass on their own or cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment. Procedures may include:
- Extracorporeal shock wave lithotripsy (ESWL) – Using sound waves to create strong vibrations (shock waves) that breaks the stones into tiny pieces and is passed in the urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so anesthesia may be advised.
- Percutaneous nephrolithotomy is a surgical procedure to remove very large stones in the kidney.
- Ureteroscopy – to remove a smaller stone in your ureter or kidney.
Can Kidney Stones be prevented?
Kidney stones may be prevented by including a combination of lifestyle changes and medications.
Following tips may also reduce the risk of kidney stones:
- Drink water throughout the day.
- Eat fewer oxalate-rich foods (found in foods like rhubarb, spinach, beets, bran flakes, potato chips, and french fries)
- Cut back on sodium and salty foods.
- Choose a diet low in and animal protein in case a person already has one kidney stone.
- Continue eating calcium-rich foods but be careful while consuming calcium supplements as they may increase the risk of kidney stones.
References
- Singh S, Gupta S, Mishra T, Banerjee BD, Sharma T. Risk Factors of Incident Kidney Stones in Indian Adults: A Hospital-Based Cross-Sectional Study. 2023 Feb 27;15(2):e35558.
- Kidney Stones. Mayo Clinic. March 2024. https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759
- Kidney Stones. WebMD. https://www.webmd.com/kidney-stones/understanding-kidney-stones-symptoms
