• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

KIDNEY STONES: CAUSES, SYMPTOMS, AND TREATMENT

Our kidneys function effectively to convert the waste and fluid from the blood to urine. However, when this natural process is hampered because of too much waste and lesser fluids to dissolve the waste, these particles tend to accumulate in the kidneys forming clumps known as kidney stones. A kidney stone is formed when these excessive minerals build up in the urine because of lack of hydration. Therefore, kidney stones are hard deposits of minerals and salts inside the kidneys; these deposits can be the size of a kernel, corn or a grain of salt but in cases where they tend to show symptoms, kidney stones no matter the size can be extremely painful. Sometimes, these stones are very tiny and pass unnoticed through the urinary tract, unlike cases of acute pain or larger stones where there may be a need for medical intervention to allow the stone to pass or break the stone to remove it from causing further problems. These stones are brown or yellow in colour with a smooth or rough texture.

Types of Kidney Stones

Calcium Stones: Most kidney stones are calcium stones and are formed of calcium oxalate which is naturally found in many food items and is also produced by the liver daily.

Struvite Stones: These kidney stones are formed because of an infection such as urinary tract infection. These stones have a tendency to grow big very fast with or without symptoms.

Uric Acid Stones: These stones are formed in people who do not drink enough water or sweat enough or eat high-protein diet and have gout.

Cystine Stones: These kidney stones are formed in people with a hereditary disorder, where the body excretes excessive amino acids (cystinuria).

Causes of Kidney Stones

Kidney stones can be caused due to multiple factors but they are created when the levels of minerals such as calcium, oxalate and uric acid are very high in the urine and they tend to accumulate overtime due to lack of fluids to dissolve them properly. That said, some of the factors that cause kidney stones or increase the risk of kidney stones are:

  • Insufficient intake of water
  • Diet rich in protein, sugar or sodium
  • Overweight or obesity
  • History of kidney stones
  • Family history of kidney stones
  • Gastric bypass or intestinal surgery
  • Kidney disease such as polycystic or cystic
  • Irritation in bowel or joints
  • Excessive diarrhoea
  • Digestive diseases
  • Medications including calcium-based antacids or diuretics
  • Medical conditions such as renal tubular acidosis, cystinuria, hyperparathyroidism, UTIs, etc.

Symptoms of Kidney Stones

Kidney stones may not show any symptoms until they move around in the kidney or move from the kidney into the ureter. A lot of kidney stones are so small that you might not even know that they exist in the body. However, sometimes the stones cause a lot of pain when they stir or pass through, which is also one of the biggest symptoms of kidney stones. Some other symptoms include:

  • Acute pain back, belly or the side, below the ribs
  • Pain flowing to the lower abdomen and groin
  • Flowing pain and varying intensity
  • Problem while urinating
  • Consistent urge to urinate
  • Urinating more than usual
  • Urinating in small or insufficient quantity
  • Pain or burning sensation while urinating
  • Pus in the urine
  • Cloudy or foul-smelling urine
  • Blood in urine
  • Discoloured urine – pink, red or brown
  • Vomiting and nausea
  • Fever and chills (caused by infection)

That said, one must call for immediate medical help in case these symptoms intensify to include:

  • Severe pain in standing still or even finding a comfortable position
  • Acute pain along with nausea and vomiting
  • Acute pain along with fever
  • Blood in urine
  • Urge to pee but no urination for more than 14 hours
  • Excessive burning or problem in urinating

Treatment for Kidney Stones

The treatment for kidney stones depends on factors – the size of stone, the composition of stone, and whether or not it is causing pain or blocking the urinary tract. To know the accurate answer to these questions, the doctor will ask you to get some tests including urine test, blood test, CT scan or X-ray. Once, the tests results are clear, the doctor will suggest any of the following options as a course of treatment:

  • If the stone is small and has negligible symptoms, the doctor will ask you to wait for a period of at least 2-4 weeks for the kidney stone to pass on its own by drinking excess water.
  • The doctor might suggest pain killers and would ask you to allow the stone to pass through on its own.
  • The last resort is surgery, provided the intensity of the pain is too much and there seems to be possible infection due to the kidney stones. That said, the doctor might recommend any of the following procedures:
    • Shock wave lithotripsy (SWL): In this treatment, high-energy sound waves are used to break the stones into small particles to enable the kidney stones to pass through easily on their own.
    • Ureteroscopy: In this course, a thin, flexible tube is inserted though the urethra, bladder and into the ureter to reach the stone and break it through laser (if it is too big) or remove the stone (if it is small or medium in size).
    • Percutaneous Nephrolithotomy orPercutaneous Nephrolithotripsy: This course of treatment is opted when the other treatments fail to break the stone. In this surgery, a thin tube is inserted through the skin to reach the stone, which is then removed or broken.
    • Open Surgery: The last resort of treatment, if the kidney stone is overtly big or cannot be removed through any other course. In this method, the doctor will make an incision on your side to reach the kidney stone and take it out through the opening.

The course of treatment varies as per the case. Hence, it is very critical to identify symptoms and consult your doctor well before opting for a treatment method. Moreover, it is vital to know precautions to avoid recurrence of the kidney stones in future.

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