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Kidney Stones

Overview

Also called nephrolithiasis, kidney stones are hard deposits of salts and minerals that form inside the kidneys and may eventually travel to the urinary tract – from the kidneys to the bladder. It is a common and short-term condition that resolves within days to weeks. Kidney stones usually do not cause any permanent damage.

The most common kidney stone symptoms include:

  • Pain during urination
  • Severe pain below the ribs, side and back
  • Pain with fluctuating intensity
  • Brown, pink or red urine
  • Foul smelling or cloudy urine
  • Vomiting and nausea
  • Frequent urination
  • Chills and fever because of an infection
  • Inability to empty the bladder completely

As the stone(s) moves through the urinary tract, the location of the pain may also change. Scheduling an appointment with a doctor is advised when the pain becomes so severe that the person is not able to sit still in a comfortable position. Also, vomiting, nausea, fever and chills often accompany the pain.

 

There is no definite cause for kidney stones; however, there are several factors that may increase the risk. Kidney stones primarily form when the urine becomes rich in crystal-forming substances like oxalate, uric acid and calcium. Also, when the urine lacks substances that prevent these crystals from sticking together; it creates the right environment for the formation of kidney stones. Family or personal history, dehydration, obesity, unhealthy diet, gastric bypass surgery and digestive diseases are some of the significant risk factors for kidney stones.

 

Diagnosing and testing for kidney stones requires a complete health history of the patient along with a physical exam. The doctor may perform the following tests:

  • Blood test for electrolytes, phosphorous, calcium and uric acid
  • Creatinine and BUN (blood urea nitrogen) to asses the functioning of the kidney
  • Urinalysis to check for white cells, bacteria, crystals and blood
  • An examination of stones passed through urine to determine their type
  • Abdominal CT scan and X-ray
  • IVP (intravenous pyelogram)
  • Kidney ultrasound
  • MRI scan of the kidneys and abdomen
  • Retrograde pyelogram

The contrast dye used in IVP and CT scan can affect the functioning of kidneys in those who have an existing kidney condition. However, on the other hand, for those with normal kidney function, the dye is not a concern.

 

In most cases, kidney stones do not require invasive surgery. However, if the stones are big enough to cause disruptions in daily life, they may require invasive treatment.

 

  • Drinking Water – Doctors recommend drinking as much water as possible to flush the stones out of the urinary system. 2 to 2.8 litres of water a day is enough to flush out small stones.
  • Pain Relievers – Though it is easy to pass small kidney stones with enough fluid consumption, it can cause slight discomfort or even pain. To relieve pain, the doctor might recommend certain pain relievers.
  • Medical Therapy – Medicines known as alpha blockers are prescribed to help pass the kidney stones more quickly and with less pain.
 

Those stones that cannot be passed naturally by consuming plenty of fluids require more extensive kidney stone treatment.

  • Sound Waves – Extracorporeal Shock Wave Lithotripsy (ESWL) is recommended when the size of the stone is too large to pass naturally. ESWL breaks the stones using strong vibrations (shock waves) into tiny pieces so they can pass easily through urine.
  • Surgery – Surgical removal of kidney stones is done through a procedure known as percutaneous nephrolithotomy. It is a minimally invasive surgery and is usually performed when ESWL does not work on some patients.

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