What are kidney stones?
A kidney stone is a hard, crystal-like mineral substance formed within the kidney or urinary tract. In medical terms, it is known as nephrolithiasis. They are also called as renal calculi.
Kidney stones can block the stream of urine and can result in urinary infection, kidney damage, and even kidney failure. Kidney stones can vary in size and location.
The risk of occurrence of kidney stones is approximately 1 in 10 for males and 1 in 35 for females.
Kidney stones progress when minerals separate from the urine and get collected within the renal pelvis, papilla, or ureter. Newly invented techniques can help remove kidney stones without getting surgery. Drinking plenty of water and fruit juices is good for the health of the kidneys and may help stop the formation of kidney stones.
Once you have one kidney stone, the chance of getting a second stone is between 5 and 10 percent each year. Up to half of the patients with a first kidney stone will have a second stone within 4-5 years. After five years, the risk of getting another kidney stone declines. Conversely, some people keep getting kidney stones their entire lives.
What are the signs and symptoms of kidney stones?
Kidney stones are rock-like structures formed in the urinary tract or kidneys. These stones may appear brown or white in color. The stones are generally made up of acidic salts or minerals in the urine. These substances mostly include oxalates and phosphates. When the kidney filters excess substances from the blood, they dissolve in the urine and are excreted. However, in cases where these materials are in excess or when there is not enough urine to dissolve them, they concentrate in the urinary system and solidify forming kidney stones.
Kidney stones do not stay in the kidney every time. They may pass from the kidney and into the ureters over a period of time. The ureters are small and delicate structures, and thus, may not allow the stones to pass smoothly into the bladder. In such cases, the passage of kidney stones down the ureter can cause spasms and may irritate the ureters while passing. This will cause blood to appear in the urine.
Sometimes, kidney stones may block the flow of urine. It is called as urinary obstruction. Urinary obstructions can lead to kidney infection (pyelonephritis) and kidney damage. Kidney stones are formed when there is a reduction in the volume of urine and/or an excess presence of stone-forming substances like minerals and acidic salts in the urine.
Kidney stones are rarely diagnosed before they begin showing symptoms. Furthermore, they do not always cause symptoms. When they are small, they can be passed without pain. You will only feel pain when the stones become large enough to block the urine flow. Most people do not realize it unless they experience pain. The pain may be severe enough to send patients to the Emergency Room. When a patient complains of excruciating pain, doctors suggest a variety of tests to identify the stones. Tests may include a CT scan, X-ray, urinalysis, or ultrasound. Blood tests are also performed to help look for high levels of minerals, which may be the cause for kidney stones.
What are the causes of kidney stones?
Kidney stones are formed when elements such as oxalate, calcium, cystine, or uric acid are at high levels in the urine. However, sometimes, kidney stones are formed even if these chemical substances are at normal levels.
Medicines used for the treatment of other medical conditions such as kidney diseases, AIDS, or cancer can also increase the risk of having kidney stones. A small number of people can get kidney stones because of some medical circumstances, which can lead to excessive levels of oxalate, calcium, cystine, or uric acid in the body.
Types of kidney stones
- Struvite stones - These stones are mostly found in women. It results from urinary tract infections.
- Calcium oxalate stones - They are very common for both genders. The condition is brought by high amounts of phosphates and oxalates.
- Uric acid stones - These stones result from excess acidic salts and high amounts of purines in the body.
- Cystine stones - They are related to genetic disorders. They occur as a result of high amounts of cystine in the body.
Kidney stones are more common in men than women. In every 100 people, 20 of them suffer from this condition at one point in their lives. When the stones form in the beginning, it is quite difficult to identify what is happening.
When do the symptoms appear?
- When the stones are big enough to get stuck in the kidney.
- When the stones start to cause other infections.
- When they start moving down the ureter.
Main symptoms of kidney stones
- Pain is the main and the first symptom experienced by a person with kidney stones. The patient will experience pain on the lower back and the side of their back.
- Pain that radiates slowly down to the abdomen and the groin. This pain lasts for a long time, especially when the condition worsens.
- Men may experience pain in their scrotum and testicles.
- Pain that lasts for more than 50-60 minutes.
- Production of smelly and cloudy urine.
- Urge to urinate even when there is no urine to pass.
- Change of urine color from yellow to pink, brown, or red.
- Pain when urinating, especially in the urethra.
- Problems when lying down, especially on the sides.
- The patient feels uncomfortable and cannot sit properly.
- Passing small amounts of urine.
- Renal colic (abdominal pain due to kidney stones)
- Hematuria (presence of blood in urine)
It is said that pain due to kidney stones usually begins either late at night or early in the morning. The reason is that people generally urinate less frequently at night and early in the morning. Moreover, the ureter is usually constricted in the morning.
It must be noted that in the case of a small kidney stone, the patient may not have any pain or symptoms as the stone passes through the urinary tract. However, once the stone passes through the urinary tract, the pain can be excruciating and a doctor’s visit is advised.
Diagnosing kidney stones
Several kidney stones are revealed by chance during examinations for other conditions or diseases. Urine tests and blood tests can be helpful in finding out the cause of kidney stones.
Additional tests may include:
- CT scans
- X-ray - including an intravenous pyelogram (IVP), where a dye is injected into the arteries before the X-ray is done.
If you pass a stone through normal urination, collect it and show it to your doctor for analysis. Examination of a stone is very useful to find out the reasons behind the specific type of stone.
Kidney stone complications
Kidney stones can range in various sizes from a grain of sand to that of a pearl or larger. They can be smooth or rough and are frequently yellow or brown in color. A large stone can get stuck in the urinary system and may cause permanent kidney damage. Kidney stones also increase the risk of urinary tract infections and kidney infections, which can let germs enter the bloodstream, leading to life-threatening conditions.
Different kinds of surgeries may involve certain complications, which the surgeon may further explain to the patient. Potential complications are based on the type of surgery being opted to remove the kidney stones. Complications include:
- Sepsis – It is a type of infection that spreads through the bloodstream resulting in life-threatening complications.
- Steinstrasse – This is a medical term used for blockages, which is caused by fragments of stones in the tube that connects each kidney to the bladder (ureter).
- An injury or damage to the ureter.
- Some people may go through excessive bleeding during the surgical removal of kidney stones.
- It is estimated that around 5-9 percent of patients experience complications after a ureterorenoscopy.
Treatment for kidney stones
A kidney stone treatment depends on the type and size of the stone. Most people with small kidney stones can easily pass the stones through the urine and do not need any type of surgery. Small kidney stones may still cause pain until the time the stone is passed through the urine.
If you are experiencing extreme pain, the doctor may give you a painkiller. A second dose can be given after half an hour if the pain still persists. Some medicines can be intravenously given if symptoms such as nausea and vomiting are present. They are called as antiemetics.
Doctors may also prescribe oral painkillers and antiemetics.
If you pass the stone through the urine, you should take it to your physician for further examination. It will help the physician plan your treatment depending on the results of the examination.
Drink a lot of water to help your body frequently pass urine. If you notice that the color of your urine is dark yellow or brown, it means you are not drinking an adequate amount of water.
Large kidney stones
If a kidney stone is too big and cannot be passed through the urine naturally, you may have to opt for an alternative treatment to get the large stones removed.
Other treatments include:
- Extracorporeal shock wave lithotripsy (ESWL) – It is the most common way to treat large kidney stones. It involves an X-ray or ultrasound to find out the exact location of the kidney stone.
- Ureteroscopy – It is also known as retrograde intrarenal surgery. It is done by passing a long, thin telescope (ureteroscope) through the urethra and into the bladder.
- Percutaneous nephrolithotomy (PCNL) - It is an alternative procedure that may be used for larger stones. It involves using a thin telescopic instrument (nephroscope). An incision that leads to the kidney is made on your back. The nephroscope is passed through the incision and into the kidney. The stone is either towed out or cracked into smaller pieces using a laser or ESWL.
The bottom line
The effects of kidney stones can increase over time. Other more dangerous symptoms are also identified in the presence of kidney stones. A blocked ureter accumulates bacteria, causing kidney infections. Related symptoms include chills, diarrhea, tiredness, and high fever more than 38°C. These symptoms should be identified early for immediate treatment and to prevent more dangerous complications to happen.