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Kidney Stone: types, causes, symptoms, diagnosis, treatment

Kidney Stone: types, causes, symptoms, diagnosis, treatment

 
kidney stone-renal stone


What is Kidney Stone?

  • Usually, the work of the kidneys is to filter the waste materials in the body, but sometimes the salts and other minerals present in the urine stick together and form a solid stone called kidney stone.
  • The size of this stone can be sugar grains to golf balls.
  • Kidney stone is not detected until its becomes large, but when it becomes large (from 5mm to 10mm), it blocks the ureter and also causes unbearable pain.
  • Kidney stones are also known as Renal Stone, Renal Calculus and Nephrolith.

    Types of Kidney Stone

    There are four types of Kidney Stone :

    1. Calcium Stone - Calcium stones are the most common type of stone found in people. It is made of calcium oxalate, calcium phosphate or calcium maleate.
    2. Uric Acid Stone - This type of stones mostly found in men rather than women. Uric acid stone is formed when the amount of uric acid in the body is high. It is more likely to occur in people with diabetes, prolonged diarrhea, and those who eat more non-vegetarian protein foods like meat or fish. (Purine present in non-vegetarian protein rich food increases the amount of uric acid in our body)
    3. Struvite Stone - This type of stone is mostly found in those women who have urinary tract infection. These stones can become big in a short time, which can lead to kidney infection later.
    4. Cystine Stone - Cystine stone is found in very few people. This stone is formed from a genetic disease called Cystinuria. This genetic disease is caused by an overdose of an amino acid named cysteine.

    Causes & Risk factors of Kidney Stone

    Risk Factors 

    • Family history - You have more chances to get kidney stones If someone in your family has kidney stones before. 
    • Dehydration - Drinking less water than required amount each day can increase the risk of kidney stones. People who live in hot, dry climatics area and sweat a lot may be more at risk than others.
    • Diet - Eating foods high in non-vegetarian protein (animal protein), sodium (salt) and sugar can increase the risk of kidney stones.
    • Obesity - Those peopel who have a lot of body weight can also have an increased risk of stones.
    • Gastric Bypass Surgery - This type of surgery impairs digestion, which increases the absorption of calcium and other substances. Excess of calcium in the body can cause stones.
    • Other medical conditionsDiseases like renal tubular acidosis, cystinuria, hyperthyroidism and urinary tract infection can also increase the risk of stones.
    • Medicines - Diuretics and high calcium-rich antacids increase the amount of calcium in the urine, as well as high amounts of vitamin-A and vitamin-D can increase the risk of stones.

    Sign & Symptoms of Kidney Stone

    Symptoms of kidney stones are not seen in the early stage. When the stone becomes large, it starts to block the ureter, which causes severe pain as well as the following symptoms :
    • Severe pain in lower back and side.
    • Pain under the ribs.
    • Pain in the lower abdomen.
    • Groin pain.
    • Pain experienced while urinating.
    • Pain can be felt in spurts or waves.
    Other Symptoms
    • Urine discolouration to red,pink or sometimes brown.
    • Foul-smelling urine.
    • Cloudiness in urine.
    • Passing small amounts of urine but after a short while.
    • Nausea and Vomiting
    • Fever with chill.

     Diagnosis of Renal Stone

    • History collection & Physical examination In order to diagnose kidney stone, the doctor or nurse asks you about your previous medical information. This helps in detecting possible causes and other conditions of the disease.
    Some other diagnostic tests are also conduct to detect kidney stones :
    • Blood Test - The results of this test help in determining the amount of calcium and uric acid in the blood. With this, the doctor can know other medical conditions.
    • Urine Test - In this test, urine samples are taken from the patient. Many different samples are taken from the urine done by the patient in the entire 24 hours. From this test, the amount of minerals that form stones in urin and the amount of substances that prevent stone formation are determined.
    • Imaging Test - In this test photographs are taken inside the body, which helps in the identifying stone. This includes X-rays, CT scans, ultrasound, intravenous pyelograms (this involves injecting dye into intravenous line of the arm and then taking pictures inside the body with the help of X-rays).
    • Analysis of passed stones - In this test, patient may be asked to urinate through a strainer to catch stones that he/she pass. Lab analysis will determine the type of your kidney stones. Doctor uses this information to determine what is the cause of your kidney stones and to form a plan to prevent further kidney stones.

    Treatment / Management of Renal Stone

    Pharmacological Management

    • Diuretics
    • Allopurinol - to reduce the pain caused by uric acid stone
    • Phosphorus solution - to reduce the pain caused by calcium stone
    • Sodium bicarbonate - to reduce the acidity of urine
    • Ibuprofen - to reduce the pain
    • Tamsulosin - it's a type of alpha-blocker drug that relax the muscles of the ureter to passing the stones easily through the path of urin.

    Non surgical Management 

    • Lithotripsy - Extracorporeal shock wave lithotripsy (ESWL) uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passes through your urine. The procedure lasts approximately 45 to 60 minutes and may cause moderate pain, so you may have to do sedation or under mild anesthesia to relax.

    Surgical Management 

    • Ureteroscopy It consists of a tube-like device with camera and surgical equipment. Which is transported through the urethra to the ureter where the stone is. Later the stone is taken out with the help of surgical instruments. 
    • Percutaneous nephrolithotomy It involves making a small incision in the back and inserting a tube-like device with surgical equipment inside the body, with the help of surgical equipment the stone is removed. But this is done when :
             1. Stones can cause an infection.
             2. The stones are so large that they cannot be taken out of Urinary tract.
             3. The pain caused by stones cannot be reduced.

    Prevention of Kidney Stone

    • Taking calcium as needed - The stones formed in most people are made of calcium oxalate. That's why many people think that calcium should be eaten less. But actually eating less calcium increases the amount of oxalate in the body, which can increase the risk of stones. That's why calcium should be eaten according to the age of each person.
    • Stay hydrated - Drink 8 glass of water which is equally about 2 liter. Due to this, the urine will not accumulate for a long time and the urinary tract remains also be clean.
    • Eat less sodium - Eating more salt (sodium) increases the amount of calcium in the urine because more sodium does not bring calcium back to the blood from the urine. This increases the amount of calcium in the urine and increases the risk of calcium stone formation.
    • Eat less oxalate rich foods - Some kidney stones are made of oxalate, therefore, foods which contain oxalate should be consumed less. Spinach, peanuts, coffee, soy products, sweet potatoes are high in oxalate.
    • Eat less Non-veg protein - The purine present in non-vegetarian protein rich food (chicken, beef, egg) increases the amount of uric acid in our body, which increases the possibility of uric acid stone (a type of Renal stone). 

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