Overview of Kidney Stones Symptoms, Treatments, and Prevention

Overview of Kidney Stones: Symptoms, Treatments, and Prevention [2024]

As stones are formed in nature from the natural minerals of the earth, stones can be formed in some parts of our body with the elements and minerals of the human body. For example: gall bladder, kidney, pancreas stones can occur. Kidney and bladder stones are often seen in our country.

Why are kidney stones?

Many studies have been and are ongoing to find out what causes kidney stones. A recent theory is that stone particles or crystals form when the urine becomes too concentrated. This condition occurs if the body constantly loses water (dehydration).

Dehydration is the main cause of stone formation. People who work in hot weather and don't drink enough water are more prone to stone formation due to dehydration. So in the deserts, in the hot countries of the Middle East and even in some parts of our subcontinent, there are a lot of kidney stone patients. Apart from this, repeated urinary tract infections can also lead to stones. Some minerals in the body, which prevent the formation of stones (urinary stone inhibitors) are reduced in the urine, but there is a risk of kidney stones. For example: If the amount of citrate, magnesium, zinc in the urine decreases.

Again, there are some substances in the body, the amount of which increases in the urine can lead to the formation of kidney stones. Eg: Excessive excretion of calcium and uric acid in urine. There is a risk of stone formation if the flow of urine is obstructed for any reason and if there is any congenital problem in the urinary system. Various metabolic factors such as overactive parathyroid glands or tumors increase calcium in blood and urine. And in this case, many stones are formed in both kidneys. Congenital metabolic factors such as cystinuria and xanthineuria in children are causes of kidney stones. Stones usually form in the kidneys and pass down the ureters and bladder.

Varieties of kidney stones

Not all kidney stones are the same. Several types of stones can be obtained by chemical analysis.

* Calcium oxalate: Most common, found in about 60-80 percent of cases. It was detected by X-ray.

* Mixed: Mixture of calcium oxalate and phosphate.

* Triple phosphate (ammonium-magnesium-calcium phosphate): A-type stones usually occur in alkaline (alkaline) urine when the infection occurs.

* Uric acid stones: usually not seen on X-ray. Patients with gout or arthritis may have these stones.

Symptoms of kidney stones

In many cases, kidney stones may have no symptoms at all. Many cases are caught during routine checkups for back pain. Pain due to kidney stones can be mild pain in the right or left side of the upper abdomen or lower back.

Red urine or light blood in the urine is another symptom. If the stone descends into the urinary tract, there is severe pain from the upper abdomen to the groin, accompanied by vomiting, fever, etc. When stones get stuck in the urethra or ureter, the kidney swells. Sometimes urosepsis or serious infection can be life threatening. In these cases, stones should be removed urgently with the advice of a urologist, and antibiotics should be taken intravenously.

Tests to detect kidney and urinary stones

Urinalysis in patients with urinary tract stones may reveal red blood cells, pass-cells, or stone crystals. Abdominal X-rays show about 90 percent of stones. However, a CT scan is needed to detect very small kidney stones or ureteral stones. Even after ultrasonogram, kidney and bladder stones were detected.

Treatment of kidney and urinary stones

If a kidney stone is 4 millimeters or smaller, there is a 90 percent chance that it will pass itself in the urine. In this case we ask patients to drink more water. If necessary, I give pain medication. And after a few weeks X-ray or CT scan to see how much the stone has come down or passed out with urine or not.

Urinating into the strainer can often lead to stones or patients may notice that something like clotted blood comes out with the urine or collects under the commode water. But if the stone gets stuck in any part of the urethra or ureter and goes down, obstructing the flow of urine and causing an infection, even if the stone is small, it should be removed to remove the obstruction. If the kidney stone is 1/2 to 2 cm in size and there is a convenient space, it is possible to pulverize the stone with a shock wave from outside the body. Later the powder comes out with urine. Another minimally invasive procedure to remove small kidney stones is RIRS (Retrograde Intrarenal Surgery). In this procedure, the stone is crushed by a laser and removed through the urinary tract with a flexible ureteroscope reaching the kidney.

However, the most effective method (gold standard) for kidney stone removal is PCNL. In this method it is possible to break stones of any size and nature through a small hole in the back side and extract 100%. Kidney stones are removed by these methods in our country like developed countries. Kidney stone surgery is no longer done by abdominal incision. Therefore, the patient does not need to be completely sedated and can go home in two days. There is not much pain in these procedures. If a kidney stone is lodged in the ureter, it is removed through the urinary tract through a ureteroscope. Bladder stones are also removed through the urinary tract with the help of an instrument without cutting the abdomen.

Ways to prevent kidney stones

Some dietary changes and drinking enough water are important parts of kidney stone prevention. Even if kidney stones are removed, there is a risk of recurrence. So for those who have had stones once, some advice should be followed.

* The most important advice is to drink enough water so that the body does not become dehydrated. How much water is enough for you depends on your type of work, location and climate. Those who work outside in the fields definitely need more water than people who stay inside AC at home. Similarly, water requirement will be more in hot regions or summer, cold region or winter. For people who have had stones before, we usually say to drink enough water and fluids so that the urine is 2 liters per 24 hours or the urine is not dark colored. It looks like water. You may need to drink 2-4 liters depending on your position.

* Obstructed urine flow due to any disease or infection should be treated.

* Reduce the amount of salt in food.

* After removing stones from urinary system or kidney we do chemical test of stones. In the case of calcium oxalate stones, foods that are high in oxalate should be eaten less. For example, spinach, strawberries, butter, chocolate, dairy foods. Potassium citrate can be given if urine citrate is low. It reduces acidosis in urine. Diuretics such as thiazides may be given if urinary calcium is elevated for unknown reasons. Cut down on red meat if you have stones from uric acid; Allopurinol medication can be given in many cases.

* Stones should be treated for metabolic problems. An overactive parathyroid gland or a tumor may require surgery.

* Avoid consuming excessive amounts of vitamin C (which turns into oxalates in the body) and vitamin D (increases the amount of calcium in the body). But adequate amount of vitamins is good for the body.

Finally

Many patients ask for medication that will dissolve the stones. There is no truly effective medicine. So once the stone is there, it can pass itself when it is small, otherwise it has to be removed. If the stone is inside the kidney, it will damage the kidney. It is important to take measures to prevent stones from forming in the kidney.