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A Guide to Diagnosing & Treating Kidney Stones

Kidney stones are concrete masses that are made of many tiny crystals. They are like lumps and may develop in one kidney or both at the same time. They are normally small but solid deposits and are medically termed as nephritis, calculi, or renal lithiasis. They are made up of minerals and salty acid. The development of a kidney stone might be because of a number of causes and it affects the urinary tract part from the kidneys to the bladder. More often, stones are formed when the urine becomes undiluted and allows minerals to make crystals and stick them together. Though the passing of a kidney stone is extremely torturing, it does not usually cause any damage. Kidney stones treatment can reduce the severity of pain in the flanks or lower back.

What are Kidney Stones Made of?

There are many types and colors of kidney stones. The way you treat them and prevent new stones from forming is determined by the type of stone you have.

Calcium stones (80% of stones)

Calcium stones come in two forms: calcium oxalate and calcium phosphate. The most common calcium stone is calcium oxalate. A high level of calcium in the urine can increase the risk of calcium stones in some people. Calcium stones can form even with normal amounts of calcium in the urine.

Uric acid stones (5-10% of stones)

An acid called uric acid results from chemical changes in the body. In acidic urine, uric acid crystals do not dissolve and instead form a stone. Acidic urine may be caused by:

* Gout

* Type 2 diabetes (high blood sugar)

* A diet containing a lot of animal protein and a few fruits and vegetables

* Being overweight

* Chronic diarrhea

Struvite/infection stones (10% of stones)

Struvite is a rare type of stone. Chronic urinary tract infections (UTIs) are related to these stones. The bacteria can make the urine more basic or alkaline by reducing its acidity. In alkaline urine, magnesium ammonium phosphate (struvite) stones are formed. Stones of this type are often large, have branches, and are very fast-growing.

Patients with chronic urinary tract infections, such as those with tubing in their kidneys or bladders, or those with impaired bladder emptying due to neurological disorders (paralysis, multiple sclerosis, and spina bifida), are more likely to develop these stones.

Cystine stones (less than 1% of stones)

Cystine is an amino acid that appears in certain foods. Its main role is to build proteins. The metabolic disorder cystinuria (excess cystine in the urine) is rare. It occurs when the kidneys do not reabsorb cystine from the urine. High levels of cystine in the urine can cause stones to form. The formation of cystine stones usually begins in childhood.

What causes kidney stones?

If someone is going through the condition, he might need nothing more than a pain killer or plenty of water to excrete stones. Somehow there is not a single reason behind the development of these stones but there may be several factors. Stone formation takes place due to calcium, oxalate crystals, and uric acid in the urine.

Most of the foods contain calcium oxalate at high levels such as chocolate, some fruits, or nuts while the liver itself makes oxalate in the body, intake of vitamin D in high value, diets, surgeries that may increase the risk of oxalate in the urine. The other form of calcium is phosphate. Uric acid stones are formed due to insufficient intake of liquid fluids or by those who perspire a lot and take rich protein meals and some genetic factors also cause to form uric acid stones.

Some calculus is formed by a genetic disorder that causes the kidney to discharge much amount of amino acids. A stone can not show its symptoms until it moves over the kidney or urinary tract which is a long tube that connects the kidneys to the bladder. At this stage, the following signs and indications can occur: extreme pain at the backside and near the ribs, pain sensation that starts spreading in the lower abdominal area and groin, discomfort and pain which is felt in waves that fluctuate in intensiveness, irritation, and intense pain during urination, change the color of urine such as pink, brown or red, or bubbly smelling urine, feeling urine repeatedly, fever or nausea or infection. All these are symptoms of kidney stones.

Diagnosis

In a health exam, X-rays can identify silent kidney stones, those without symptoms. Others have their stones diagnosed when sudden pain occurs while the stone is passing, and they should seek medical attention.

People who have blood in their urine (hematuria) or sudden abdominal or side pain may need an ultrasound or CT scan to determine if they have a stone. Using these imaging tests, the health care provider can determine the size and location of the stone.

When a stone is suspected, a CT scan is often performed in the emergency room. The reason it is used is that it can provide a quick, exact diagnosis.

Treatment

Depending on the type of stone, how bad it is, and how long you’ve had symptoms, the treatment will vary. There are different treatments available. It is important to speak with your physician about the treatment options available.

Medication

Tamsulosin is the most common medication prescribed for this purpose. The ureter is relaxed with Tamsulosin (Flomax), making it easier for the stone to pass. As you wait to pass the stone, you may also need pain and nausea medication.

Surgery

A stone in the ureter or kidney may require surgery if:

* The stone does not pass.

* Waiting for the stone to pass is too painful.

* Kidney function has been affected by the stone. Usually, kidney stones that don’t cause pain or infection can be left alone. Occasionally, people choose to have their small stones removed. They do this because they are afraid the stone will suddenly start passing and cause pain.

Surgical removal of kidney stones is necessary if they cause repeated infections in the urine or if they block the flow of urine from the kidney. Nowadays, surgery usually involves small or no incisions (cuts), minimal pain, and little time off work.

Surgery to remove stones from the kidneys or ureters includes:

*Shock wave lithotripsy (SWL)

*Ureteroscopy (URS)

*Percutaneous nephrolithotomy (PCNL)

Surgical procedures other than those listed above

Other kidney surgeries are rarely used to remove stones. All other less invasive procedures should be tried first before attempting open, laparoscopic, or robotic surgery.

Consult the best nephrology doctors in the city for more information.