Kidneys are bean-shaped organs that perform the filtration of the bodily wastes. The wastes are then combined with the urine stream and washed out of the body. Kidney stones also known as urinary stones, as the name suggests are the stone-like structure, which is made of hardened mineral deposits. These stones are found in the pelvic region of the human body, often obstructing the plumbing of the kidney to the bladder.
Kidney stones are made of several microscopic particles, which take a long time to combine and form the rock-like structures. This condition is medically termed as nephrolithiasis or renal stone disease. When the waste products filtered by the kidney do not dissolve and the kidney fails to flush them out, they take the form of renal stones or kidney crystals. While some stones are small, easy to pass out with urine, others may be big and may get stuck in the ureter (the tube carrying urine from the kidney to the bladder). The latter condition is concerning as the patient experiences severe pain starting from the lower back and moving towards the side or groin.
When kidney stones move in the ureter, the condition is even more painful. They can obstruct the flow of the urine, which can further create many health complications. The patient can also feel nausea along with vomiting. Other symptoms may include blood in the urine, backflow of urine, etc.
Types of Kidney Stones
There are different types of kidney stones, depending upon their composition:
- Calcium Stones: One of the most common types of kidney stones is calcium stones. When the calcium consumed by an individual is not completely utilized by the body, the buffer is flushed out with the urine. However, in certain cases, it might start depositing inside the body and create stones.
- Struvite Stones: When mineral magnesium and waste ammonia in the body combine and make hard structures, it is known as struvite stones. The condition primarily arises after an infection in the body.
- Uric Acid Stones: Excess of uric acid may start accumulating to form a stone. This happens when the urine becomes very acidic.
- Cystine Stones: Cystine is the primary component that contributes towards the development of muscles, nerves, and several other parts of the body. When in excess, it may get hardened and make stones. The Cystine stone disease runs in the family and is often a very rare condition.
Signs & Symptoms
Often small and smooth kidney stones do not create any panic and pass out of the body, through urine without showing any symptoms. They are also called “silent” stones”. However, large and stiff stones that get stuck in the ureter show visible symptoms as they block the urine flow which leads to spasm and thus produces pain. At times, even small stones can get stuck in the ureter, hence, there is no direct relationship between the size of the kidney stones and pain. Some of the other symptoms of kidney stones disease include:
- Blood in the urine.
- Increased frequency of urination.
- Nausea and vomiting.
- Pain and burning during urination.
- Fever, chills, loss of appetite.
- Urinary tract infection.
Diagnosis of Kidney Stones
The doctors conduct a physical exam and also ask questions about the patient’s medical history. Further, kidney stone diagnostic procedures include the following:
- Intravenous Pyelogram (IVP): A contrast dye intravenous injection is given to the patient, post which a series of x-ray examinations are performed for the kidney, ureters, and bladder. This helps in detecting tumors, abnormalities, kidney stones, or any other obstructions as well as assessing the renal blood flow.
- Urinalysis: A detailed urine analysis is performed to check the urine for cells and chemicals, and rule out any abnormalities.
- Blood Tests: To check for the presence of any substance in the blood that might promote the formation of renal stones.
- Renal Ultrasound: A transducer is scrolled over the kidney. The transducer emits ultrasounds which reflect a picture in a monitor, offering an inside view of any structure.
Treatment of Kidney Stones
- Extracorporeal shock wave Lithotripsy (ESWL): In Extracorporeal shock wave Lithotripsy (ESWL) highly focused electromagnetic waves are used to crush the kidney stones inside the body. The crushed parts of the stones are then flushed out or the system with urine. In the case of large-sized stones, more than one session of ESWL is required. The procedure is successful for all age groups except for pregnant women.
- Percutaneous Nephrostolithotomy (PCNL): Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure. Local anesthesia percutaneous is given to the patient and the stones are removed surgically. A Small cut is made through which the doctor inserts a mechanical lithotripter and breaks down the stone into small pieces. The pieces are then flushed out of the system.
- Ureteroscopic Lithotripsy with Holmium Laser: A full-fledged surgical procedure, Ureteroscopic Lithotripsy is used when the stones are in the middle and the lower ureter region. An epidural and spinal anesthesia is given to the patient after which a fiber-optic instrument (ureter scope) is inserted into the ureter. A laser is used to fragment the stones. The fragments then are flushed out with the urine.
Preventing Kidney Stones
There are possible ways to prevent kidney stones. Some of the preventive measures include:
- Drink plenty of liquids, a minimum of 10 cups of water a day.
- Eat healthy and well-balanced diet.
- To avoid recurrence the doctor may recommend some dietary changes, including avoiding sodium, animal protein, and foods with a high amount of oxalate, etc.
- Regulate the amount of calcium, however, not stop it completely.
- Certain medicines like thiazide diuretics, allopurinol, sodium or potassium citrate, calcium, or magnesium might be recommended to avoid reoccurrence.