Kidney stones are a disease caused by various types of hard minerals that clump together. They usually occur in the kidneys, but can also occur throughout the urinary system. Stones can vary in type and size. If the stone is large enough to block and create a wound in the ureter, the patient may feel severe pain and may urinate blood.
There are many factors that can cause kidney stones, such as poor water intake, eating a diet high in salt, sugar, and protein, underlying diseases, and taking certain medications. These factors can cause the urine to become so concentrated that minerals can precipitate and form into stones. Proper treatment can help prevent complications such as kidney infections and kidney failure.
Symptoms of kidney stones
Very small stones may pass out with urination without causing any symptoms or pain . Symptoms of kidney stones often don’t appear until the stone starts to move around the kidney or into the ureter, the tube connecting the kidney to the bladder. As a result, people with kidney stones may experience these symptoms:
- Pain in the backor lower abdomen on one side, which may radiate down to the groin area.
- There is intermittent squeezing pain and intermittent severe pain in the area.
- Frequent urination, which may include less urination, cloudyor strong-smelling urine , blood in the urine , or red, pink, or brown urine.
- Pain during urination
- Nausea, vomiting
- Chills, fever
Causes of kidney stones
Kidney stones can be formed when the amount of salts, minerals and substances such as calcium , oxalic acid and uric acid in the urine changes, becoming too much for the urine fluid to dissolve or reduce concentration, eventually leading to the formation of stones.
The formation of kidney stones may also be caused by certain eating habits, such as salt, sugar, and high-protein foods, not drinking enough water each day, or as a result of other existing diseases, such as urinary tract infections, metabolic diseases, as well as the use of certain medications, such as gout , hyperthyroidism, diabetes , obesity, high blood pressure, and taking too much vitamin D supplements.
The causes of kidney stones can also be divided into four main types of stones, as follows:
- Calcium is the most common cause, and most often calcium stones are combined with oxalate. People who have had kidney stones or have genetic disorders may not be able to remove oxalate from their bodies as well as they should. Other types of stones that are combined with calcium may include phosphate or malic acid.
- Uric acid stones are a type of stone that is more common in men than in women, or in patients with gout or patients undergoing chemotherapy. Uricacid stones occur only when the urine is too acidic.
- Struvite stones are most commonly found in women with urinary tractThey are caused by kidney infections and can be so large that they obstruct urination.
- Cystine: This type of stone is uncommon and can occur in both men and women who have a genetic disorder of cystine, an acid that naturally occurs in the body and leaks from the kidneys into the urine.
Diagnosis of kidney stones
Diagnosis of kidney stones requires the patient’s medical history and physical examination results, such as:
Blood test
Blood test results can indicate the health of a patient’s kidneys and help doctors diagnose various diseases, including measuring the levels of substances that can cause stones. Patients with kidney stones may be found to have high levels of calcium or uric acid in their blood.
Urine test
This method is to check if the body is excreting too much minerals that form stones or too little substances that prevent stones from forming, as well as to check for infection. It can be done by collecting all the patient’s urine over a 24-hour period. For example, if starting from 8:00 a.m., at this time the patient must urinate first, then collect every subsequent time until 8:00 a.m. of the next day, then collect for the last time.
Examination by looking at kidney images
This method allows the doctor to see the stones that form in the urinary tract. There are many different methods of kidney imaging that can be used, such as X-rays of the abdomen, which may not see small kidney stones or some types of stones, and kidney ultrasound. In addition to these two methods, the doctor may consider using a computerized tomography ( CT ) scan, which may show small stones.
Intravenous Perfusion (IVP) (renal and urinary tract examination)
This is done by injecting dye into a large vein in the arm and taking X-rays to show the obstruction while the kidneys filter the dye out of the blood and excrete it in the urine. The patient is then asked to pass urine through a filter to catch the stones that are passed out and analyze them to determine the cause of the stones. This can help the doctor plan to prevent more stones from forming in the future.
Kidney Stone Treatment
Kidney stones are a treatable condition, with a variety of treatments available depending on the type of stone and its cause.
Treatment of small kidney stones
Treatment for small kidney stones with a diameter of no more than 5 millimeters may involve drinking plenty of fluids to help flush the stones out with urine. Drink enough fluids to dilute the urine and stop it from being yellow or brown. The stones may pass into the kidneys as kidney stones. However, if a patient with this type of kidney stone has symptoms, the doctor may consider surgically removing the stones.
Small stones can also be painful, although not severe. Your doctor may prescribe medications to relieve the pain, such as ibuprofen , paracetamol , and naproxen.
In addition, using medication to help expel kidney stones is another treatment method. The doctor may prescribe alpha-blockers, which are drugs that help expel kidney stones through the urine. They work by relaxing the muscles, allowing kidney stones to be expelled more quickly and with less pain.
Treatment of large kidney stones
Kidney stones larger than 5 mm can cause bleeding, ureteral ulcers or urinary tract infections, which may not pass on their own. Other treatments may be needed, as follows:
Using sound waves to break up kidney stones
This method is suitable for stones no larger than 2 centimeters in size. It is treated with Extracorporeal Shock Wave Lithotripsy (ESWL), which uses sound wave vibrations to break the stones into small pieces that can be passed through the urination system. This method is a surgical procedure without incisions , but it may cause moderate pain to the patient. The doctor may administer sedation to calm the patient or give shallow anesthesia. The treatment process takes about 45–60 minutes.
The time it takes for all the stone fragments to pass is uncertain. Some cases require repeated stone lithotripsy, and treatment results cannot be guaranteed for all cases. The chance of a complete cure is about 75%. This method takes about 3 months to treat and may cause some side effects, such as blood in the urine, bruising in the back of the abdomen, bleeding around the kidneys and nearby organs, and pain when fragments of the stone move through the urinary tract.
Percutaneous Nephrolithotomy
This treatment is suitable for stones up to 3 cm in size. It may be used after electrosurgical lithotripsy (ESWL) is ineffective. The doctor may choose to perform a stone removal surgery using a small telescope and instruments inserted into the patient’s back. The patient needs to stay in the hospital for 1–2 days and has an efficacy rate of 72–99%.
Endoscopy
This method is used to treat cases where the stone is no larger than 3 centimeters. The doctor may use a ureteroscope to shine a narrow beam of light through the urethra and bladder, and then use a special tool to capture or break the stone into small pieces that can be expelled through the urinary tract. To reduce swelling after surgery and help heal faster, a small tube may be used to hold it in place in the urethra.
This endoscopic procedure has been found to be 94% effective in treating staghorn stones with more than 2 branches or stones larger than 3 centimeters. Doctors usually consider open surgery as appropriate.
In addition to the above methods, doctors treat kidney stones in other ways, such as thyroid surgery. If a patient has hyperthyroidism , a condition in which the body produces an abnormal amount of parathyroid hormone, surgical removal of the tumor can help reduce the occurrence of kidney stones.
Complications of kidney stones
When a kidney stone that is too large moves from the kidney into the small and fragile ureter, it causes complications such as spasms and irritation of the kidney. The patient may also have blood in the urine. In addition, the kidney stone may block the flow of urine, causing ureteral obstruction and leading to infection and injury to the kidney, leading to kidney failure .
Kidney Stone Prevention
Kidney stones can be prevented by changing your health habits. An easy way to do this is to drink enough water each day to prevent dehydration and help reduce the concentration of urine that is conducive to kidney stone formation. You can drink fruit juice, tea, and coffee, but since caffeinated drinks make you urinate more frequently , drinking plain water is the best choice.
The concentration of urine at risk of kidney stones can be observed from the color of urine, which is dark. However, except after waking up, our urine is usually dark yellow because of the waste that the body produces throughout the night. Therefore, there is no need to worry.
Diet is also a part that may help prevent kidney stones. Doctors and nutritionists will advise on the right diet for patients. Patients can eat foods that contain calcium as usual because it has no effect on the formation of stones. However, they should be careful about consuming calcium supplements and always consult their doctor before consuming them. The doctor may recommend consuming calcium supplements with meals to reduce the risk of kidney stones.
