Kidney stones

published on: 10th august, 2021

Stones can form when your urine contains high levels of minerals and salts as many can be found in urine. Kidney stones may start out small but increase in size over time, eventually filling the kidney's inner hollow structures. Some stones remain in the kidney and are not harmful.

The urinary tract includes your kidneys, ureters, and bladder. The urinary tract is responsible for producing, transporting, and storing urine in the body. Urine is made by the kidneys from water and waste in the body. The urine then passes through the ureters and into the bladder, where it is collected. Urine exits the body through the urethra.

Some kidney stones pass through the ureter and end up in the bladder. The ureters are tubular structures that connect the kidneys to the bladder. A ureteral stone is one that passes through the kidney and becomes lodged in the ureter.

What are the factors that put you at risk?

Having less than 1 liter of urine a day is the biggest risk factor for kidney stones. Kidney stones are frequent in premature infants with kidney problems because of this.

Urine is condensed and dark in color when the amount of urine is minimal. There is less fluid in concentrated urine to hold salts dissolved. The salts in your urine will be diluted if you drink more water. You will reduce your risk of stones forming by doing so.

Kidney stones can be caused by a number of factors, including:

  • Genetic
  • Less water intake
  • Certain diets, with high levels of protein, salt, or glucose
  • Obesity
  • Digestive diseases and surgery
  • Hyperparathyroid condition
  • Sedentary life
  • Bowel condition

What are the symptoms?

Kidney stones are well-known for causing excruciating pain. It’s symptoms may not appear until the stone has moved down to ureters. Kidney stones can also cause the following symptoms:

  • Urine with blood (red, pink, or brown urine)
  • While urinating, you can experience pain or a burning feeling.
  • Pain in the side and back, just below the ribs, is severe and sharp.
  • Pain in the lower abdomen and groin that radiates

What are the types of kidney stones?

Knowing what kind of kidney stone you have will help you figure out what caused it and how to might your chances of having more. When you pass a kidney stone, save it as much as you can so you can bring it to your doctor for examination.

Calcium stones: The most popular form of stone is calcium. Calcium oxalate is commonly used (though they can consist of calcium phosphate or maleate). You will lower the risk of developing this form of stone by eating less oxalate-rich foods. Foods high in oxalate include: peanuts, potato chips, spinach, chocolate, beets, drinks with caffeine including coffee, tea, black soft drinks “Pepsi, cola.. Etc.”.

Even though calcium is found in some kidney stones, having enough calcium in your diet will help prevent them from forming.

Uric acid: Men are more likely than women to develop this form of kidney stone. They can happen to people who have gout or are undergoing chemotherapy.

People with diabetes or metabolic syndrome are more likely to develop uric acid stones if they lose too much fluid due to chronic diarrhea or malabsorption, follow a high-protein diet, or have diabetes or metabolic syndrome. These type of stones can also be caused by genetic factors.

Struvite: Women with urinary tract infections are more likely to develop this form of stone (UTIs). These stones can grow quickly and become quite large, obstructing the urinary tract. They grow as a result of a kidney infection. Strucvite stones may be prevented by treating an underlying infection.

Cystine: This type is extremely uncommon. Cystinuria is a genetic disease that affects both men and women. Cystine, a naturally occurring acid in the body, leaks from the kidneys into the urine in this type of stone.

How to diagnose kidney stones?

If your doctor thinks you have a kidney stone, you may undergo a series of tests and procedures, including:

  • Urine testing: The 24-hour urine collection test can reveal that you're excreting either too many or too few stone-forming minerals. Your doctor may ask you to collect two urine samples over the course of two days for this examination.
  • Imaging: Small stones can be detected using high-speed or dual-energy computerized tomography (CT). Simple abdominal X-rays aren't used as much as they once were because they can miss small kidney stones.
  • Blood testing: can show that you have an excessive amount of calcium or uric acid in your system. Your doctor can order additional tests based on the results of your blood tests to track the health of your kidneys.
  • Analysis of passed stones: To capture stones that you pass, you might be asked to urinate via a strainer. The composition of your kidney stones will be revealed by laboratory examination. Your doctor will use this knowledge to figure out what's triggering your kidney stones and devise a strategy to keep them from forming again.

Are kidney stones treatable?

Kidney stone treatment varies depending on the form of stone and its cause.

The majority of small kidney stones do not necessitate invasive treatment. You can pass a small stone by drinking water, pain relievers or medications.

Larger kidney stones, as well as those that cause leakage, kidney damage, or recurrent urinary tract infections, can necessitate more aggressive care such as:

  • Ureterscopy (URS): involves inserting a ureteroscope, a small telescope, into the bladder, up the ureter, and into the kidney. For stones in the lower part of the ureter near the bladder, rigid telescopes are used. Stones in the upper ureter and kidney are treated with flexible telescopes.
  • Shock wave lithotripsy: X-rays or ultrasound are used to locate the stone and direct shock waves at it. The stone will normally split into small pieces if shock waves are fired repeatedly on it. Over the course of a few weeks, these tiny stone fragments move into the urine.
  • Percutaneous nephrolithotomy (PCNL): which is the best treatment for large stones in the kidney.
  • Other surgeries: Rarely performed to remove stones in some cases. If all other less invasive techniques fail; open, laparoscopic, or robotic surgery may be used.

Tips to avoid having Kidney stones

  • Drink plenty of water.
  • Reduce your intake of oxalate-rich foods.
  • Choose a low-salt diet.
  • Eat plenty of fruits and vegetables
  • Eat less meat.

Note: * The information on this website is not meant to be used to diagnose health conditions or to replace legitimate medical advice. All treatments mentioned are available for patients at Burjeel Hospital. Abu Dhabi at the concerned department.

Prof. Dr. Hamdy AbdelMawla Aboutaleb

Consultant - Urology

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