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Kidney Stones (nephrolithiasis) : Symptoms, Causes, Diagnosis and Treatment

What is Kidney Stones?

Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.

Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones. Kidney stones can affect any part of your urinary tract ? from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances ? for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications ? surgery may be needed.

Your doctor may recommend preventive treatment to reduce your risk of recurrent kidney stones if you're at increased risk of developing them again.

Types of kidney stones

Not all kidney stones are made up of the same crystals. The different types of kidney stones include:

Calcium

Calcium stones are the most common. They?re often made of calcium oxalate (though they can consist of calcium phosphate or maleate). Eating fewer oxalate-rich foods can reduce your risk of developing this type of stone. High-oxalate foods include:

  • potato chips
  • peanuts
  • chocolate
  • beets
  • spinach

However, even though some kidney stones are made of calcium, getting enough calcium in your diet can prevent stones from forming.

Uric acid

This type of kidney stone is more common in men than in women. They can occur in people with gout or those going through chemotherapy.

This type of stone develops when urine is too acidic. A diet rich in purines can increase urine?s acidic level. Purine is a colorless substance in animal proteins, such as fish, shellfish, and meats.

Struvite

This type of stone is found mostly in women with urinary tract infections (UTIs). These stones can be large and cause urinary obstruction. They result from a kidney infection. Treating an underlying infection can prevent the development of struvite stones.

Cystine

Cystine stones are rare. They occur in both men and women who have the genetic disorder cystinuria. With this type of stone, cystine ? an acid that occurs naturally in the body ? leaks from the kidneys into the urine.

Kidney Stones is also known as nephrolithiasis. Kidney Stones belongs under the category of Kidney Disease. Calcium stone, Uric acid stone, Struvite stone and Cystine stone are some common types of Kidney Stones. Generally Male, Female, Child are the victim of the Kidney Stones. Seriousness of this disease is Low.

Symptoms of Kidney Stones are :

  • Pain that comes in waves and fluctuates in intensity
  • Dark color urine
  • Pain or burning urination
  • Blood in urine or semen
  • Frequent urination
  • abdominal pain
  • Abdominal pain has many potential causes. The most common causes ? such as gas pains, indigestion or a pulled muscle ? usually aren't serious. Other conditions may require more-urgent medical attention.

    While the location and pattern of abdominal pain can provide important clues, its time course is particularly useful when determining its cause.

    Acute abdominal pain develops, and often resolves, over a few hours to a few days. Chronic abdominal pain may be intermittent, or episodic, meaning it may come and go. This type of pain may be present for weeks to months, or even years. Some conditions cause progressive pain, which steadily gets worse over time.

  • Vomiting
  • Vomiting, or throwing up, is a forceful discharge of stomach contents. It can be a one-time event linked to something that doesn?t settle right in the stomach. Recurrent vomiting may be caused by underlying medical conditions.

    Frequent vomiting may also lead to dehydration, which can be life-threatening if left untreated.

  • Nausea
  • Nausea and vomiting are common signs and symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis ? often mistakenly called stomach flu ? or the morning sickness of early pregnancy.

    Many medications can cause nausea and vomiting, as can general anesthesia for surgery. Rarely, nausea and vomiting may indicate a serious or even life-threatening problem.

  • Medium Fever
  • A fever is a higher-than-normal body temperature. It?s a sign of your body's natural fight against infection.

    • For adults, a fever is when your temperature is higher than 100.4F.
    • For kids, a fever is when their temperature is higher than 100.4F (measured rectally); 99.5F (measured orally); or 99F (measured under the arm).

    The average normal body temperature is 98.6 Fahrenheit (or 37 Celsius). When you or your child?s temperature rises a few degrees above normal, it?s a sign that the body is healthy and fighting infection. In most cases, that?s a good thing.

    But when a fever rises above 102F it should be treated at home and, if necessary, by your healthcare provider if the fever doesn?t go down after a few days.

    Causes

    Kidney Stones can be caused due to:

    The leading cause of kidney stones is a lack of water in the body.

    Stones are more commonly found in individuals who drink less than the recommended eight to ten glasses of water a day.

    When there is not enough water to dilute the uric acid, a component of urine, the urine becomes more acidic.

    An excessively acidic environment in urine can lead to the formation of kidney stones.

    Medical conditions such as Crohn?s disease, urinary tract infections, renal tubular acidosis, hyperparathyroidism, medullary sponge kidney, and Dent?s disease increase the risk of kidney stones.

    What kind of precaution should be taken in Kidney Stones?

    Proper hydration is a key preventive measure. The Mayo Clinic recommends drinking enough water to pass about 2.6 quarts of urine each day. Increasing the amount of urine you pass helps flush the kidneys.

    You can substitute ginger ale, lemon-lime soda, and fruit juice for water to help you increase your fluid intake. If the stones are related to low citrate levels, citrate juices could help prevent the formation of stones.

    Eating oxalate-rich foods in moderation and reducing your intake of salt and animal proteins can also lower your risk of kidney stones.

    Your doctor may prescribe medications to help prevent the formation of calcium and uric acid stones. If you?ve had a kidney stone or you?re at risk for a kidney stone, speak with your doctor and discuss the best methods of prevention.

    Treatment for the Kidney Stones

    Diagnosis:

    Diagnosis of kidney stones requires a complete health history assessment and a physical exam. Other tests include:

    • blood tests for calcium, phosphorus, uric acid, and electrolytes
    • blood urea nitrogen (BUN) and creatinine to assess kidney functioning
    • urinalysis to check for crystals, bacteria, blood, and white cells
    • examination of passed stones to determine their type

    The following tests can rule out obstruction:

    • abdominal X-rays
    • intravenous pyelogram (IVP)
    • retrograde pyelogram
    • ultrasound of the kidney (the preferred test)
    • MRI scan of the abdomen and kidneys
    • abdominal CT scan

    The contrast dye used in the CT scan and the IVP can affect kidney function. However, in people with normal kidney function, this isn?t a concern.

    Treatment:

    Treatment for kidney stones varies, depending on the type of stone and the cause.

    Small stones with minimal symptoms

    Most small kidney stones won't require invasive treatment. You may be able to pass a small stone by:

    • Drinking water. Drinking as much as 2 to 3 quarts (1.8 to 3.6 liters) a day will keep your urine dilute and may prevent stones from forming. Unless your doctor tells you otherwise, drink enough fluid ? ideally mostly water ? to produce clear or nearly clear urine.
    • Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
    • Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain. Examples of alpha blockers include tamsulosin (Flomax) and the drug combination dutasteride and tamsulosin (Jalyn).

    Large stones and those that cause symptoms

    Kidney stones that are too large to pass on their own or cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment. Procedures may include:

    • Using sound waves to break up stones. For certain kidney stones ? depending on size and location ? your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).

      ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.

      ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

    • Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back.

      You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL is unsuccessful.

    • Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.

      Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.

    • Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result.

      Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that's causing your parathyroid gland to overproduce the hormone.

    Possible complication with Kidney Stones

    Kidney stones that remain inside the body can also lead to many complications, including blockage of the the tube connecting the kidney to the bladder, which obstructs the path that urine uses to leave the body.

    According to research, people with kidney stones have a significantly higher risk of developing chronic kidney disease.

    References:

    1 https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755 2 https://www.kidneyfund.org/kidney-disease/kidney-problems/kidney-stones/#treatments-for-kidney-stones 3 https://www.healthline.com/health/kidney-stones#complications 4 https://www.medicalnewstoday.com/articles/154193#diagnosis 5 https://www.urologyhealth.org/urologic-conditions/kidney-stones#Diagnosis 6 https://www.kidney.org/atoz/content/kidneystones 7 https://www.medicinenet.com/kidney_stones/article.htm#kidney_stone_facts 8 https://www.webmd.com/kidney-stones/do-i-have-kidney-stones#1

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