Kidney stones are also known as renal calculi. The occurrence of kidney stones is known as nephrolithiasis. Kidney stones in the urinary tract lead to a condition known as ureterolithiasis. Kidney stones are seen as a common occurrence in the medical world. One in twenty people tend to suffer from kidney stones at least once in their lifetime.
Kidney stones are formed when there is reduction in the volume of urine and/or an excess of stone-forming substances present in urine. Kidney stones often result in blood in the urine, and could lead to intense pain in the abdominal region or groin. There are many causes that can lead to formations of kidney stones, and they can affect any part in the urinary tract – right from the kidneys to the bladder. One of the main risk factors for formation of kidney stones in individuals is dehydration. Apart from people who are dehydrated, those who are suffering from certain medical conditions like gout or are on certain medications are also at risk of getting kidney stones.
Symptoms of kidney stones are flank pain which in certain cases can be very severe, and blood in the urine. In most cases, kidney stones pass from the ureter to the bladder on their own within a period of time. The process of passing kidney stones can be very painful depending upon the size of the kidney stone. But the stones very rarely cause any permanent damage. Kidney stones can be diagnosed by the following methods: ultrasound, CT scan and intravenous pyleography (IVP)
In many cases, the patient might not need specific treatment, but they may just need pain relief medications and drink plenty of water to enable passing of the stone. In certain cases where the kidney stones get blocked in the urinary tract, there may be a need for a surgery. For some patients who are at a higher risk of getting recurrent kidney stones, the doctor may suggest some preventive measures to avoid the risk of developing any stones in the future.
What are the main causes of kidney stones?
Although kidney stones are very common, there are no specific reasons as to why these kidney stones occur. However, there are some factors often associated with the occurrence of kidney stones, such as:
- Dehydration: Drinking less water in a day than recommended can increase the risk of getting kidney stones. People who live in warm climatic conditions, who work out, are very active, and sweat more but do not drink the required amount of water to make up for the loss of water in their body are at a higher risk than those who live in cool climatic conditions and those who are less active.
- Hereditary factors: There are some people who fall in the risk category of suffering from kidney stones. Hereditary factors are often known to play an important role in the formation of kidney stones. Most kidney stones are a result of calcium deposits which can happen due to multiple reasons.
- Hypercalciuria is another factor that could cause kidney stones. The tendency to have high levels of calcium traces in the urine could be passed on in generations. Sometimes certain rare diseases that are hereditary could also put one at a risk of kidney stones.
- Residing area: The geographical location of where one lives can also put one at a high risk of kidney stones. There are certain regions known as the stone belts where people could be at a high risk of stones in the body. Places like the southern United States could fall in such a category. The hot temperatures coupled with poor intake of fluids can cause dehydration in people which in turn results in higher concentrated urine. This causes a closer contact between certain chemicals to the nidus which starts the beginning of stone formation.
- Food habits: Diet is not considered as an issue by itself. However, if there are other factors that put you at the risk of acquiring stones, then certain foods that are rich is animal proteins and salt may need to be avoided to reduce the risks. If one is not predisposed to the risk of stones, then diet alone cannot make the alteration. But it is advisable to avoid food that is high in sodium. Excessive sodium in the diet increases the amount of calcium the kidney has to filter and therefore increases the risk of getting kidney stones.
- Medicines: People who are consuming medications like diuretics or antacids that have a higher content of calcium could be at risk of stones. This is simply because these forms of medications increase the calcium composition in your urine.
- Other medical conditions: There are a few chronic medical conditions that could lead to the formation of stones. Diseases like cystic fibrosis, renal tubular acidosis, and more could increase your chances of acquiring kidney stones.
What are the symptoms of kidney stones?
Kidney stones do not always cause any symptoms until they move within the kidney or passes to the ureter which is the tube that connects the kidney and the bladder.
Only when it moves to the ureter, a person may experience the following symptoms:
- Severe pain in the side and back area below the ribs
- Pain that keeps spreading to the lower abdomen and groin
- Pain that keeps coming on and off and the severity of the pain will vary
- Pain while urinating
- Red, pink, or brown urine
- Foul smelling urine
- Cloudy urine
- Nausea and/or vomiting
- Continuous need to urinate
- Urinating more frequently
- Urinating less amount of urine
- Fever and chills in case of an infection
When should you consult a doctor?
Speak with your doctor if you experience any of the signs and symptoms that are mentioned above.
You must seek immediate medical care in the following cases:
- Severe pain making it difficult to sit in a still or comfortable position
- Pain along with a nausea and vomiting
- Pain along with fever and chills
- Blood in the urine
- Difficulty to pass urine
- Stop producing urine
- History of kidney removal
- Severe fatigue
What are the tests and diagnosis options for kidney stones?
In cases where the doctor suspects that the signs and symptoms are caused due to kidney stones, he/she may ask the patient to take certain tests to confirm the cause of the problem.
- Blood test – Blood testing will help the doctor analyze the amount of calcium or uric acid in the blood. Blood tests will also be useful in studying the health of the kidneys of the patient.
- Urine test – The doctor may suggest a 24 hour urine test in which the patient will have to give two samples of the urine in two consecutive days. This test will help to determine if the patient is excreting too much stone formation minerals.
- Imaging test – This will help to show the presence of kidney stones in the urinary tract. Some imaging test options available are abdominal X-rays and high speed computerized tomography (CT). In the former there is a possibility of missing the small kidney stones but in the later the small stones are visible.
- Analysis of the stones passed – The patient may be asked to urinate through a strainer to get a sample of the kidney stones and this is further send for lab analysis. This will reveal the details of the type of kidney stone and the doctor will be able to determine what is causing the kidney stone and help the patient take preventive measures to prevent the kidney stone formation in the future.
The doctor will be in a position to determine the size of the kidney stone with the help of the imaging test. If the kidney stone is very large or the patient is having any signs of an infection, then passing the stone through urine will not be a safe option.
In such a case, the doctor may recommend Lithotripsy which is a procedure where shock waves are used to break the stones to smaller pieces. This will make it possible for the stones to pass easily. If the location of the stone is where the lithotripsy method will not be effective, the doctor will opt for more invasive methods. Then, a scope known as a ureteroscope is inserted into the urethra. The doctor will advance it further up till the stone is accessed. The other option is referred to as percutaneous nephrolithotomy, in which a small incision is made on the back to access the kidney stone and remove it.
Are kidney stones serious?
Kidney stones can be extremely painful, but apart from the pain, they could also cause some serious permanent damage to the kidneys. Though such a deep impact is rare, in some cases where the stones occur for a long time, there could be permanent damage to the kidneys due to the stones.
The good news is that before the actual damage occurs, there are enough signs to watch out for to have the condition treated. Kidney stones can damage the kidneys in two main ways:
- A stone that is left untreated for long can result in a continuous blockage. Such stones, instead of passing through like normal stones, can result in damaging the kidney as they cause dilation and thinning of the kidneys, reducing their functioning. Since most kidney stones have extreme pain as a symptom, patients are able to recognize them before the permanent damage occurs. The kidney damage mainly occurs due to stones that do not show any symptoms of pain and silently cause damage to the kidneys. Some patients can go on for months or years with an undetected and untreated stone.
- Sometimes a few infections like the infection of the urinary tract can cause slower damage to the kidneys. When these infections occur along with kidney stones, they can cause damage to the kidneys by permanently scarring the tissue in the kidneys.
Can kidney stones be prevented?
Kidney stones are a nuisance that could interfere with your normal functioning due to the immense pain they cause. However, some steps can be taken to help you prevent the occurrence of kidney stones in your body.
- Avoid constant excessive sweating: While saunas, hot yoga and other forms of workouts are considered beneficial for health, they could have a downside as well if performed too often. Sweating leads to excess loss of water which could cause an impact on the production of urine. The more one sweats, the lesser one urinates, and that causes the stone to settle in the kidneys. In fact, it is more crucial to keep up with your body’s hydration requirements to keep the problem of kidney stones at bay. Drinking a lot of water helps in increasing your fluid intake, and that in turn helps in flushing out small stones if any through urine. It is extremely important to stay hydrated through exercise or any form of physical activities that could cause you to sweat a lot.
- Oxalate consumption should be moderate: Oxalate is a natural compound found in many types of foods like fruits, vegetables, nuts, seeds, and even tea. Some foods contain higher levels of oxalate compounds that could lead to the formation of calcium oxalate stones, which is just a type of kidney stone. Restricting intake of these kinds of foods can help in preventing kidney stones.
- Calcium is an essential requirement: Calcium normally ends up getting a bad name due to kidney stones, but it is also an important requirement of the body. Do not eliminate calcium from the diet, but try and eat it in moderation. Moreover, it is more crucial to keep sodium intake under check as that has more chances of causing kidney stones.
What are the medications for kidney stones?
Medications can help in a huge way to regulate the minerals and acid in the urine and could also be helpful in treating various kinds of stones that one may be suffering with. Several medications will be prescribed by the doctor in case you are suffering from kidney stones, but will largely depend upon your condition and what kind of stones you are suffering from. Some medications prescribed include:
Stones due to calcium deposits: To prevent the occurrence of calcium stones, certain diuretics or phosphate-containing medications could be prescribed by the treating doctor.
Stones due to uric acid: Medicines like allopurinol can help in controlling your uric acid content in the body that in turn can help in controlling the formation of uric acid stones. This medication in some cases is even helpful in dissolving the uric acid stones.
Struvite stones: These stones are primary caused due to bacterial infection in the urine. Antibiotics may be prescribed to keep the bacterial growth under check and prevent the occurrence of infection-causing bacteria. Sometimes the antibiotics advised may be for long-term consumption.
Cystine stones: This kind of kidney stones can sometimes get difficult to treat. For treating these types of stones, the doctor may ask you to increase your fluid consumption so that you can produce more urine. If that is not helpful, the doctor may suggest the medication that can help in reducing the amount of cystine found in your urine.