Kidney Stones

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What it is?

Kidney stones (renal lithiasis) are small, hard deposits that form inside your kidneys. The stones are made of mineral and acid salts.
Stones can affect any part of your urinary tract — from your kidneys to your bladder.


Symptoms

A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. 

Following symptoms may occur:

  • Severe pain in the side and back, below the ribs
  • Pain that spreads to the lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent urge to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present

You need an appointment with a doctor if you have these symptoms.

What to ask the doctors?

For kidney stones, some basic questions include:

  • Do I have a kidney stone?
  • What size is my kidney stone?
  • Where is my kidney stone located?
  • What type of kidney stone do I have?
  • Will I need medication to treat my kidney stone?
  • Will I need surgery or another procedure to treat my kidney stone?
  • What’s the chance that I’ll develop another kidney stone?
  • How can I prevent kidney stones in the future?
  • I have these other health conditions. How can I best manage them together?
  • Do I need to follow any restriction?
  • Do I need a follow-up visit?

Don’t hesitate to ask questions during your appointment when you don’t understand something.

Test And Diagnosis

If your doctor suspects you have a kidney stone, you may have diagnostic tests and procedures, such as:

Blood Test

Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys.

Imaging Test
  • The aim is to look for site and size of the stone along with the function of the kidneys.
  • The best option is CT Scan. USG and X- ray has limited help.

Treatment

 

Treatment is only done if the stone is causing pain, infection or decrease in kidney function. asymptomatic stones in few conditions do not merit treatment.Treatment for kidney stones varies depending on the site of the stone and size of the stone.

Stone in the kidney

Picture5  Percutaneous Nephrolithotomy (PCNL) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back. You’ll receive general anesthesia during the surgery and be in the hospital for one to two days while you recover.
It has an advantage of being a one time procedure in most of the cases.




Stones in ureter

Picture6 For stones less then 1.5 cm with advantage of being done without anaesthesia and without surgery. The disadvantage is that may merit multiple sessions or ancillary procedures.







Uretroscopy

Picture4 To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.



Preventions

Lifestyle changes-You may reduce your risk of kidney stones if you:

Drink water throughout the day.

For people with a history of kidney stones, doctors usually recommend passing about 2.6 quarts (2.5 liters) of urine a day. Your doctor may ask that you measure your urine output to make sure that you’re drinking enough water. If you live in a hot, dry climate or you exercise frequently, you may need to drink even more water to produce enough urine. If your urine is light and clear, you’re likely drinking enough water.

Eat fewer oxalate-rich foods. 

If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate and soy products.

Choose a diet low in salt and animal protein. 

Reduce the amount of salt you eat and choose nonanimal protein sources, such as legumes.

Continue eating calcium-rich foods, but use caution with calcium supplements.

Calcium in food doesn’t have an effect on your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise. Ask your doctor before taking calcium supplements, as these have been linked to increased risk of kidney stones. You may reduce the risk by taking supplements with meals.