Kidney Stones: Causes, Symptoms, Risk Factors, Diagnosis and Treatment

Kidney stones are hard mineral and salt deposits that develop inside your kidneys. They may also be referred to as renal calculi, urolithiasis, or nephrolithiasis.

Kidney stones can be caused by a variety of factors, including diet, excess body weight, certain medical conditions, specific supplements, and drugs. Your kidneys, bladder, and other urinary tract organs can all be impacted by kidney stones. Concentrated urine contains minerals that have the capacity to crystallise, adhere to one another, and frequently form stones.

Even while passing kidney stones can be brutally painful, if they are caught early enough, they usually don't have a lasting negative impact. Depending on your circumstances, you might only need to take painkillers and drink a lot of water to remove a kidney stone.

 In some circumstances, such as when stones lead to problems that become lodged in the urinary tract or have contributed to an infection, surgery may be necessary. Your doctor could advise preventive therapy if you have a higher risk of developing kidney stones again.

Symptoms Of Kidney Stones

Symptoms usually don't appear until a kidney stone starts moving about in the kidney or gets into one of the ureters. Urine tubes, also referred to as ureters, connect the kidneys and bladder.

The restriction of urine flow, enlargement of the kidney, and spasms of the ureter that result from a kidney stone being caught in the ureters can all be quite painful. Following that, you might exhibit the following symptoms:

• Lower abdomen pain below the ribs that is extremely sharp and severe
• Different pain waves of varied intensity
• Burning or discomfort during urination.

The following additional symptoms and warning signs:

• Urine may be red, pink, or brown.
• Urine that is cloudy or smells bad
• A continuous urge to urinate, urinating in small amounts, or urinating more frequently than normal
• Vomiting and nauseous
• If an infection is present which leads to fever and chills
• As the stone passes through your urinary tract, the pain from a kidney stone may alter, such as moving to a different spot or becoming more intense.

Causes Of Kidney Stones

While there is often no cause for kidney stones, there are a few things that could make you more likely to get them.

Kidney stones can develop when your urine contains more crystal-forming chemicals than the fluid in your urine can dissolve, such as calcium, oxalate, and uric acid. If the molecules in your urine that prevent crystals from sticking to one another are lacking, kidney stones are more likely to form.

Types Of Kidney Stones

Knowing what kind of kidney stone you have can assist in pinpointing its cause and may provide information on how to lower your risk of developing additional kidney stones. If you pass a kidney stone, try to save it as much as you can so you may bring it to your doctor for evaluation.

Among the several kidney stone types are:

• Calcium stones. In the form of calcium oxalate, kidney stones are most frequently composed of calcium. Each day, your liver produces oxalate, which is also ingested through food. A high oxalate level can be found in some fruits, vegetables, nuts, and even chocolate.
• The concentration of calcium or oxalate in urine can be raised by dietary variables, excessive vitamin D dosages, intestinal bypass surgery, and a number of metabolic conditions.
• Calcium phosphate stones are another type of calcium stone that could develop. In metabolic disorders such as renal tubular acidosis, this specific form of stone is more prevalent. It might also be related to the drug topiramate, which treats migraines and seizures.
• Stones made of struvite. Urinary tract infections can cause struvite stones to form. These stones can grow swiftly and are very large, sometimes with no notice or warning.
• Crystals of urate. Those who consume a high protein diet, those who have diabetes or metabolic syndrome, those who lose too much fluid, and those who have chronic diarrhoea or malabsorption are all at risk of developing uric acid stones. Your risk of getting uric acid stones may also increase due to certain causes.
• Cystine stones. People with cystinuria, a hereditary condition where the kidneys excrete an excessive amount of a certain amino acid, are more likely to develop these stones.

Risk Factors Of Kidney Stones

Your risk of having kidney stones is affected by the following factors:

• Personal or family history. You're more likely to get kidney stones if someone in your family has had them. You have a higher chance of getting kidney stones again if you've already had one or more.
• Dehydration. If you don't consume enough water each day, your chance of kidney stones may rise. Greater danger may apply to those who perspire frequently and reside in warm, dry climates.
• Certain diets. You can be more prone to kidney stones if you eat a diet high in sodium (salt), sugar, and protein. When consuming a lot of sodium, this is especially true. Your risk of kidney stones greatly increases when you consume too much salt, which increases the quantity of calcium your kidneys must filter.
• Obesity. A higher incidence of kidney stones has been associated with a high body mass index (BMI), a large waist circumference, and weight gain.
• Surgery and digestive disorders. Changes in the digestive system that impact calcium and water absorption can result from gastric bypass surgery, inflammatory bowel disease, or persistent diarrhoea, which raises the levels of stone-forming chemicals in your urine.
• Kidney stones can also be more likely to develop if you have other medical disorders such as renal tubular acidosis, cystinuria, hyperparathyroidism, or recurrent UTIs.
• Your risk of kidney stones can be raised by using certain vitamins, minerals, laxatives, calcium-based antacids, and medications for migraines or depression, as well as vitamin C, dietary supplements, and other drugs (when used excessively).

Diagnosis Of Kidney Stones

Your doctor may suspect you of having a kidney stone and recommend diagnostic procedures like:

• Blood testing. Blood tests could indicate that you have too much calcium or uric acid. Your doctor can monitor the health of your kidneys and look for additional medical conditions using the results of a blood test.
• Urine tests. The 24-hour urine collection test may reveal that you excrete too many stone-forming minerals or not enough stone-preventing compounds. In order to prepare for this test, your doctor may instruct you to perform two urine samples over the course of two consecutive days.
• Computerised tomography (CT) with high-speed or dual energy may be able to detect even microscopic stones.
• Simple abdominal X-rays are less commonly utilised since they have a higher chance of missing tiny kidney stones.
• Ultrasound is a quick and easy noninvasive exam that is another imaging modality for the diagnosis of kidney stones.
• Inspection of already-passed stones. You might have to urinate through a strainer in order to catch any stones you pass. An investigation in the lab will reveal the makeup of your kidney stones. Your doctor will use this information to determine what is causing your kidney stones and to create a strategy to prevent further stone formation.

Treatment Of Kidney Stones

There are numerous therapies for kidney stones, depending on the kind of stone and where it came from.

Smaller Stones with Few Symptoms

The majority of small kidney stones won't need invasive treatment. A little stone might be passable:

• Water consumption. Drinking up to 2 to 3 quarts (1.8 to 3.6 litres) of liquid each day will keep your urine diluted and may stop the development of stones. Drink enough liquid, ideally largely water, to result in clean or nearly clear urine, unless your doctor instructs you otherwise.
• Medicines that reduce pain. A little stone might be uncomfortable to pass. To manage minor discomfort, your doctor may advise ibuprofen or naproxen sodium,
• Medical treatment. Your doctor might suggest a medication to help with the passage of your kidney stone. An alpha blocker, a type of drug, helps kidney stones pass through the ureter more rapidly and painlessly by relaxing the ureter's muscles. Alpha-blockers include the drugs tamsulosin and the combination of dutasteride and tamsulosin.

Larger Stone Treatment

More severe care may be required for larger kidney stones that can't pass normally or that cause bleeding, kidney damage, or recurring UTIs. Procedures could consist of:

• Stones can be broken up using sound waves. Depending on the size and location of the stone, your doctor might advise extracorporeal shock wave lithotripsy (ESWL) for some kidney stones.
• In the ESWL method, sound waves are used to create strong shock waves that break the stones into little pieces that can be removed by urine. You may be given sedation or light anaesthesia to make you more comfortable throughout the 45 to 60-minute procedure, which can be uncomfortable and cause moderate pain.
• Blood in the urine, bruises on the back or abdomen, bleeding around the kidney and other nearby organs, and pain when the stone is present are all potential side effects of ESWL. 
• Surgery to remove kidney stones, particularly large ones. Percutaneous nephrolithotomy) is a treatment where a kidney stone is surgically removed using small telescopes and tools placed through a tiny incision in your back.
• A general anaesthetic will be used to put you to sleep throughout the procedure, and you'll stay in the hospital for one to two days to recover. If ESWL is unsuccessful, your doctor could advise that you have this procedure.
• The removal of stones using a scope. A thin, illuminated tube called a ureteroscope with a camera may be sent through your urethra and bladder to your ureter in order to remove a tiny stone from your ureter or kidney.
• Once the stone has been found, specialised equipment can either snare it or break it into bits that will pass in your urine. To reduce swelling and encourage healing, your doctor may then insert a tiny tube (a stent) into the ureter. During this treatment, you can require either general or local anaesthesia.
• Surgery on the parathyroid gland. Some calcium phosphate stones are brought on by overactive parathyroid glands, which are found on your thyroid gland's four corners, just below your Adam's apple.

Hyperparathyroidism, in which these glands produce too much parathyroid hormone, can cause your calcium levels to rise excessively, which can cause kidney stones to form.

You may suffer hyperparathyroidism if a tiny, benign tumour forms in one of your parathyroid glands or if you contract a disease that causes these glands to overproduce parathyroid hormone. By eliminating the growth from the gland, kidney stone growth can be halted. 

Alternatively, your doctor might suggest treating the condition that is making your parathyroid gland overproduce the hormone.

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