By Dr Rajendra Prasad Ray, MS, DNB, MCh (Urology)
1. What is a kidney stone?
A kidney stone is a hard object that is made from chemicals in the urine. Urine has various wastes dissolved in it. When there is too much waste in too little liquid, crystals begin to form. The crystals attract other elements and join together to form a solid that will get larger unless it is passed out of the body with the urine.
After it is formed, the stone may stay in the kidney or travel down the urinary tract into the ureter. Sometimes, tiny stones move through the body in the urine without causing too much pain. But stones that don’t move may cause a back-up of urine in the kidney, ureter, the bladder or the urethra. This is what causes the pain.
2. What causes kidney stones to form?
Possible causes include drinking too little water, exercise (too much or too little), obesity, weight loss surgery or eating food with too much salt or sugar and metabolic disorder.
3. How common are kidney stones?
The peak age for stones is between 20 years and 50 years. Other diseases like high blood pressure, hyperuricemia/gout, diabetes, obesity, osteoporosis, chronic diarrhea, or kidney cysts might increase the risk of stones. Diabetes increases the risk of developing kidney stones, especially in younger women.
4. What are the symptoms of a kidney stone?
The symptoms could be one or more of the following:
- severe pain on either side of your lower back
- vague pain or stomach ache that doesn’t go away
- blood in the urine
- nausea or vomiting
- fever and chills
5. Are there any long term consequences of having a kidney stone?
Kidney stones increase the risk of developing chronic kidney disease. If anybody have had one stone, they are at increased risk of having another stone. Those who have developed one stone are at approximately 50% risk for developing another within 5 to 7 years.
6. Do children get kidney stones?
Kidney stones are found in children as young as 5 years. The two most important reasons are not drinking enough fluids, eating foods that are high in salt and metabolic disorder. Kids should eat less salty potato chips and French fries. There are other salty foods: sandwich meats; canned soups; packaged meals; and even sports drinks. Sodas can also increase risk of stones due to the high sucrose content (a kind of sugar).
7. How are kidney stones treated?
Fortunately, majority stones are small & may pass spontaneously. In some situations, medications may be needed for expulsion of stone. Most kidney stones can pass through the urinary system with plenty of water – 2 to 3 quarts a day – to help move the stone along. Often, the patient can stay home during this process, drinking fluids and taking pain medication as needed. Some important steps are to be followed for the treatment of kidney stone. They are:
- Should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period.
- People who form calcium stones need to avoid dairy products and other foods with high calcium content.
- Need to avoid food with added vitamin D and certain types of antacids that have a calcium base.
- Need to eat less meat, fish, and poultry. These foods increase the amount of acid in the urine. etc.
In recent era, medical technologies revolutionize the Endoscopic Stone management. Miniaturization of Instruments & laser make it minimally invasive procedure & significantly reduce the risk. LASER, URSL, RIRS & mini PCNL largely change the current management of Urinary Stones from open to endoscopic to minimally invasive procedure.
Surgery is indicated in following situation:
- Large stone
- Stone causing hydronephrosis
Following steps to be followed during medical management of stone (Medical expulsion therapies)
- Should try to drink enough water throughout the day to produce at least 2-2.5 ltr of urine in 24 hrs.
- Avoid certain foods with high calcium & oxalate, protein rich diet.
- Lemon juice increases urinary citrate that helps in prevention of recurrence.
- Alpha blocker once daily for 2 weeks increases success rate of stone expulsion.
- Reduce salt intake.