Kidney stone

Kidney stones :

Small kidney stones may not initially cause any problems. Kidney stones, however, have the potential to enlarge and potentially occupy the kidney’s internal hollow structures. Certain kidney stones remain there and damage kidneys. Sometimes kidney stones which are small in size can pass in to the ureter. (The tube that connects the kidney and bladder is called the ureter.) The stone may be expelled from the body through urine if it makes it to your bladder. Urine flow from that kidney is blocked if the stone lodges in the ureter.

What are the Symptoms of Kidney Stones?

Sharp, cramping pain in the side and back is a common sign of kidney stones. This sensation frequently shifts to the groin or lower abdomen. Usually, the pain comes on suddenly and in waves. As the body works to remove the stone, it may come and go. Additional indications of kidney stones include:
A strong urge to urinate.
More frequent urination or a burning sensation during urination.
Dark or red urine caused by blood. (Occasionally, there are very trace levels of red blood cells in urine that are invisible to the human eye.)
Vomiting and nausea.
Men who have pain at the tip of their penis.

What are Kidney Stones Made of?

Kidney stones come in many types and colors. The way your kidney stones will be treated depends on the type of stone you have. The path to prevent new stones from forming will also depend on your stone type.

calcium stones (80% of stones)

Calcium stones are the most common type. There are two types of calcium stones: calcium oxalate and calcium phosphate. Calcium oxalate is more common. Some people have too much calcium in their urine, raising their risk.

Uric acid stones (5–10% of stones)

Uric acid is a waste product that comes from chemical changes in the body. Uric acid crystals do not dissolve well in acidic urine.

Instead it will form a uric acid stone. Acidic urine may come from:

• Being overweight

• Chronic diarrhea

• Type 2 diabetes (high blood sugar)

• Gout

Struvite/infection stones (10% of stones)

Struvite stones are not a common type of stone.

These stones are related to chronic urinary tract infections

Cystine stones (less than 1% of stones)

Cystine is an amino acid that is in certain foods. It is one of the

building blocks of protein. Cystinuria (too much cystine in the

urine) is a rare, inherited metabolic disorder.

What Causes Kidney Stones?

Low volume of urine One of the main risk factors for kidney stones is consistently having low urine volume. Low urine volume can result from dehydration (loss of bodily fluids) brought on by strenuous exercise, hot environments at work or home, or inadequate fluid intake. Urine is concentrated and dark in color when the amount is small. Less fluid is needed to keep salts dissolved in concentrated urine. The salts in your urine will be diluted by increasing your fluid intake. You may reduce your chance of developing stones by doing this.

Adults who develop kidney stones should consume enough water each day to produce at least 2.5 liters of urine. In general, the best liquid to consume to avoid stones is water.

Nutrition

When it comes to your chance of developing kidney stones, what you eat counts. Elevated calcium levels in the urine are one of the more frequent causes of calcium kidney stones. The way your body processes calcium may be the cause of elevated urine calcium levels, but keep in mind that eating a lot of calcium isn’t necessarily the cause. The formation of stones is rarely prevented by reducing the quantity of calcium in your diet. Limiting dietary calcium has been linked to poor bone health and an increased risk of kidney stones, according to studies. In order to lower urine calcium, doctors frequently advise against restricting dietary calcium intake. However, your calcium intake shouldn’t be excessively high. Your doctor might attempt to lower your urine calcium level by lowering your salt intake rather than by lowering your dietary calcium intake. One risk factor for calcium stones is eating an excessive amount of salt. This occurs as a result of excessive salt entering the urine, which prevents calcium from being reabsorbed into the blood. Urine calcium decreases when dietary salt is reduced. You will be less likely to produce stones as a result.

Eating foods high in oxalate can increase your chance of developing kidney stones because it is a component of calcium oxalate, the most common type of kidney stone. Urine and body acid levels can rise as a result of eating a lot of animal protein, such as beef, fish, poultry, and pork. The formation of uric acid and calcium oxalate stones is facilitated by elevated acid levels. Kidney stone formation is also increased by the breakdown of meat into uric acid. Conditions of the bowel The chance of developing calcium oxalate kidney stones can be increased by some intestinal surgeries (such as gastric bypass surgery) or bowel disorders that result in diarrhea (such as Crohn’s disease or ulcerative colitis). Urine volume may decrease as a result of significant fluid loss from diarrhea.

How are Kidney Stones Diagnosed?

An X-ray and ultrasound abdomen and pelvis is frequently used to detect “silent” kidney stones, or those that don’t show any symptoms. Other persons who experience sudden discomfort during the passage of their stones and may require medical assistance have their stones diagnosed. Tests may be prescribed in cases of hematuria (blood in the urine) or abrupt side or stomach pain. A CT scan or ultrasound can unmistakably identify a stone. The size and location of the stone are revealed to the healthcare professional by these imaging examinations. The ER frequently uses a CT scan. It is employed due to its ability to provide a prompt and precise diagnostic.

Blood and urine tests:

To determine if you have a kidney infection or not, a urinalysis is also performed. Other imaging tests could be utilized if your kidney stone or stones are in an awkward place. Tests for blood and urine Your healthcare professional may collect blood and urine samples for testing following a thorough history and physical examination. Blood testing can assist in determining whether your stones are the result of a medical condition. To determine whether you have a urinary tract infection or crystals that are typical of certain stone kinds, your urine can be examined.

Urine can be collected for 24 hours if you are at a high risk of developing stones in the future. Your urine’s concentrations of various stone-forming substances will be determined by this test. Your doctor can use the test results to prescribe medicine and a healthy diet to help you avoid stones in the future.

Imaging examinations

A medical professional may request to view recent X-rays or order a new one when they see you for the first time and you have previously had stones. This is what they’ll perform to check for urinary tract stones. To monitor potential stone growth, imaging examinations may be conducted repeatedly throughout time. If you are experiencing pain, hematuria (blood in your urine), or recurrent infections, you could also require this test.

CT SCAN SHOWING LEFT KIDNEY STONE

Analysis of stones

Your doctor might wish to test it if you pass a stone or if a stone is surgically removed. The sort of stone will be identified by testing. Your healthcare professional uses this information to determine the best course of action for preventing stones in the future.

Get treated

Treatment of kidney stones depends on the following:

• The type of stone you have

• Location of the stone

• How bad it is

• Length of time you have had symptoms

There are different treatment choices.

It is of great value to talk to your health care provider about what is best for you

MEDICATION

It has been demonstrated that several drugs aid in the passage of stones.

Tamsulosin is the most often prescribed medication. By relaxing the ureter, tamsulosin facilitates the stone’s passage. While you wait, you could also require pain and nausea medication.

Operation

If the stone does not pass, surgery may be required to remove it from the kidney or ureter.

• The stone is interfering with kidney function; the discomfort is too severe to wait for the stone to go away. If there is no discomfort or infection from little kidney stones, they may be ignored. Some decide to get their little stones taken out. They act in this way out of fear that the stone may suddenly begin to pass and hurt. If kidney stones are obstructing the kidney’s ability to produce urine or are causing recurrent infections in the urine, they should be surgically removed. These days, surgery frequently entails few or no cuts, little discomfort, and little time away from work. The following procedures are used to remove kidney or ureter stones:

Shock Wave Lithotripsy (SWL)

Kidney and ureter stones can be treated with Shock Wave Lithotripsy (SWL). To locate the stone, X-rays or ultrasound are utilized to focus shock waves on it. The stone typically breaks into tiny fragments when shock waves are fired at it repeatedly.Over a few weeks, these tiny stone fragments dissolve in the urine. Some kind of anesthetic is frequently required since the shock waves will probably cause discomfort and because respiratory control is required during the treatment. Ask your doctor about the best course of action for your stone because not all stone types respond well to SWL.

URS (Flexible ureteroscopy)# LASER SURGERY:

Kidney and ureter stones are treated using ureteroscopy (URS). A tiny telescope known as a ureteroscope is sent into the bladder, up the ureter, and into the kidney during URS. For stones in the lower portion of the ureter close to the bladder, rigid telescopes are utilized. Kidney and upper ureter stones are treated with flexible telescopes. The urologist can view the stone with the ureteroscope without creating a cut. You remain calm throughout the URS surgery thanks to general anesthesia. Smaller stones are caught and removed by a tiny, basket-like device as soon as the urologist uses the ureteroscope to view the stone. A laser or other stone-breaking equipment can be used to shatter huge stones into smaller pieces if they cannot be removed in one piece. Your doctor might insert a temporary stent in the ureter after the stone has been removed, either completely or in sections. A small, stiff plastic tube called a stent aids in keeping the ureter open, allowing urine to flow from the kidney into the bladder. This tube is internal to the body and does not require a bag to collect urine, in contrast to a kidney drainage tube or bladder catheter. You can start your regular activities in two to three days after returning home on the same day as the URS. Four to ten days after the stent is implanted, your urologist will remove it. To enable self-removal, a string is occasionally left on the end of the stent. Taking your doctor’s advise regarding when to remove the stent is very important. Long-term stent implantation can result in infection and renal dysfunction.

RIRS in Laser Surgery

PCNL, or percutaneous nephrolithotomy :

For big kidney stones, percutaneous nephrolithotomy (PCNL) is the most effective treatment. To perform a PCNL, general anesthesia is required. PCNL entails creating a half-inch incision (cut) in the side or back of the kidney that is just big enough to insert a rigid telescope (nephroscope) into the kidney’s hollow center, where the stone is placed. The stone is broken apart and the fragments are sucked out by a tool that is passed through the nephroscope. PCNL is the greatest option for treating big stones because it can suction fragments. A catheter that drains urine into an external bag may be left in the kidney following the PCNL. This will prevent any bleeding and let urine to drain. The tube is left in for a few days or overnight. Following this surgery, you might need to spend the night in the hospital.

Other Surgery Other kidney surgery is rarely used to remove stones. Open, laparoscopic surgery or robotic surgery may be used only if all other less invasive procedures fail.

PCNL

FREQUENTLY ASKED QUESTIONS

A staghorn stone: what is it?

The shape that these stones adopt as they develop inside the kidney gives them their name. Recurrent urinary tract infections (UTIs) caused by certain bacteria frequently result in the formation of staghorn stones. You might not even be aware that you have them, despite the fact that they can get rather big. They are not too painful. Poor kidney function can result from a staghorn stone even if the urine flow is unobstructed. Staghorn-shaped stones are typically of the struvite/infection variety.

Will kidney stones affect my kids?

People who have a family member with them are more likely to get kidney stones. Stones can result from some hereditary diseases. However, kidney stones might occasionally develop as a result of our family’s eating habits. Kidney stones can occur in family members who have similar lives and behaviors.

Can my kidneys be harmed by kidney stones?

Yes, but not very often. If kidney stones result in severe or recurring infections, they may cause harm. Or, if a blockage persists for a long period, they may harm the kidneys. The kidney may stop functioning if certain stones are not addressed.

How can I treat my kidney stone in addition to my other medical conditions, such diabetes and/or heart disease?

Stones can also be avoided by making dietary adjustments for cardiac problems. Avoiding stones and other diseases can be achieved by eating a diet rich in fresh fruits and vegetables and low in animal protein and salt. Your dietician or healthcare professional can supply you with more information. Additionally, maintaining a healthy weight can help prevent diabetes and kidney stones.

My stone is still there. Do I require surgery?

A ureter stone may need to be removed surgically if it does not pass in a reasonable amount of time or if it is causing pain or infection.

If I continue to build stones, what will happen?

Even if you’ve undergone surgery, made dietary changes, or are taking medication, you could still get another stone. You may have a lower chance of developing stones again if you follow the proper diet and receive medical care.

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