Wednesday, 11 January 2017

Kidney stones Or Renal lithiasis

What are Kidney Stones?
Kidney stones (clinically known as Renal Lithiasis or Nephrolithiasis) are hard, solid deposits made of minerals and acid salts that form inside your kidneys.

They typically form when your urine becomes highly concentrated, allowing minerals to rapidly crystallize and stick together. While passing them can be incredibly painful, they usually cause no permanent damage if they are diagnosed and treated early.

Symptoms

A kidney stone usually will not cause any symptoms until it moves around within the kidney or passes into your ureters (the tubes connecting the kidneys and the bladder). When it gets stuck, it blocks the flow of urine, causing the kidney to swell and the ureter to spasm. Symptoms include:

  • Severe Pain: Sharp, debilitating pain in the side and back, just below the ribs.
  • Radiating Pain: Pain that spreads to the lower abdomen and groin area.
  • Fluctuating Pain: Pain that comes in intense waves and fluctuates in severity.
  • Urinary Issues: A persistent need to urinate, burning pain while urinating, or urinating in small amounts.
  • Discoloration: Pink, red, or brown urine (indicating blood in the urinary tract).
  • Nausea and Vomiting: Often triggered by the sheer intensity of the pain.
⚠️ WHEN TO SEEK EMERGENCY CARE
Kidney stones can lead to severe infections if a blockage is left untreated. Seek immediate emergency medical attention if you experience:
  • Pain so severe that you physically cannot sit still or find a comfortable position.
  • Pain accompanied by a fever and chills (a strong sign of a dangerous kidney infection).
  • Visible blood in your urine.
  • Difficulty passing any urine at all.

Types & Causes

Determining the exact type of kidney stone you have is the key to figuring out what caused it and how to prevent it from coming back.

1. Calcium Stones (Most Common)

About 80% of all kidney stones fall into this category, usually forming as Calcium Oxalate. Oxalate is a naturally occurring substance made daily by your liver or absorbed from your diet (found in high amounts in spinach, nuts, and chocolate). High doses of Vitamin D, intestinal bypass surgery, and certain metabolic disorders can heavily increase the concentration of calcium or oxalate in your urine.

2. Struvite Stones

These form almost exclusively in response to a urinary tract infection (UTI). Struvite stones can grow very quickly and become quite large, sometimes with very few symptoms or little warning.

3. Uric Acid Stones

These typically form in people who lose too much fluid because of chronic diarrhea or malabsorption, those who eat a high-protein diet, and those with diabetes or metabolic syndrome. Certain genetic factors also increase your risk.

4. Cystine Stones

These are rare and form in people with a hereditary disorder called cystinuria, which causes the kidneys to excrete too much of a specific amino acid.

Complications

If ignored or left untreated, kidney stones can lead to serious, lasting health issues:

  • Blockage (Hydronephrosis): A stone completely blocks the ureter, causing urine to back up. The kidney swells under the pressure, causing intense pain.
  • Severe Infection: A blocked urinary tract is a perfect breeding ground for bacteria, rapidly leading to severe kidney infections (Pyelonephritis) or life-threatening sepsis.
  • Kidney Damage: Long-term obstruction or constantly recurring stones can lead to scarring and a permanent loss of kidney function.

Diagnosis

If your doctor suspects a kidney stone, you may have diagnostic tests and procedures, such as:

  • Blood Tests: To reveal if you have too much calcium or uric acid circulating in your blood.
  • Urine Tests: A 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances.
  • Imaging (CT Scan): Computerized Tomography (CT) scans are the gold standard. They can quickly and accurately reveal even tiny stones that simple abdominal X-rays frequently miss.

Treatment

Treatment varies widely depending on the type of stone and how large it is.

1. Small Stones (Minimal Symptoms)

Most small stones won't require invasive treatment and can be passed naturally.

  • Aggressive Hydration: Drinking 2 to 3 quarts (1.8 to 3.6 liters) of water a day will help flush out your urinary system.
  • Pain Relievers: Over-the-counter medications like Ibuprofen (Advil, Motrin IB) or Naproxen sodium (Aleve).
  • Medical Therapy: Your doctor may prescribe an alpha-blocker (like Tamsulosin). This medication relaxes the muscles in your ureter, helping you pass the kidney stone much faster and with less pain.

2. Large Stones (Surgical Procedures)

Medical diagram of a ureteroscopy procedure being performed to remove a large kidney stone
Ureteroscopy

If the stone is too large to pass naturally, or if it is actively causing bleeding, kidney damage, or continuous UTIs, more extensive procedures are necessary:

  • Lithotripsy (SWL): Extracorporeal Shock Wave Lithotripsy uses targeted sound waves to create strong vibrations that physically break the stones into tiny, passable pieces.
  • Percutaneous Nephrolithotomy: Surgically removing a very large kidney stone using small telescopes and instruments inserted through a tiny incision in your back.
  • Ureteroscopy: A thin, lighted tube equipped with a camera is gently passed through the urethra and bladder into the ureter. Once the stone is located, special tools can snare it or break it apart with a laser.

Frequently Asked Questions (FAQs)

Should I stop eating dairy to prevent calcium stones?

No, this is a very common myth. Dietary calcium actually helps prevent stones. When you eat calcium-rich foods, the calcium binds with oxalates in your stomach and intestines before they ever reach your kidneys. However, you should avoid taking calcium supplements unless directed by a doctor, as those can increase your stone risk.

Does cranberry juice help with kidney stones?

While unsweetened cranberry juice is often recommended to help prevent urinary tract infections (UTIs), it is generally not recommended for kidney stones. Cranberry juice contains high amounts of oxalates, which can actually increase your risk of forming calcium oxalate stones.

References

  • National Kidney Foundation (NKF)
  • Mayo Clinic - Kidney Stones Symptoms and Causes
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Disclaimer: This content is for informational purposes only and does not constitute medical advice. No doctor-patient relationship is established. Always consult a qualified healthcare professional.
Author: Tariq
Reviewed & Sources: WHO, CDC, medical textbooks
Last Updated:

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