Kidney Stone - Kidney Stone Symptoms and Preventive Methods

About Kidney Stones

Every year, more than one million Americans develop kidney stones.  They occur in one out of every 250 people, with the average adult having a 10% chance of developing a kidney stone in his or her lifetime.  While it can be a daunting experience, learning about kidney stone treatments and preventive methods is a first step.

The kidneys are located on either side of the spine, near the rear of the abdomen.  While they serve a number of physiological purposes, their main function is to help regulate the levels of certain chemicals and minerals in the body.  They filter out the waste products and extra water that build up in the blood and remove them in the form of urine, which travel through tubes called ureters into the bladder, where they are stored until emptied by the individual.  

Typically, urine is composed of a balanced mix of water, salts, acids, and metabolites. But sometimes, this delicate balance is upset.  When this happens, certain chemicals can accumulate to form crystals which can lead to kidney stones, also known as renal calculi or renal lithiasis.  Usually, these crystals can be flushed out of the body through the urinary tract; but occasionally, they can form larger deposits that develop into a more noticeable problem-kidney stones.

Kidney Stones Types

There are several different types of kidney stones.  The most common ones are made of calcium, and can include calcium oxalate stones and calcium phosphate stones.  The former is often attributed to a high concentration of calcium or oxalate in the urine, which can be caused by a variety of factors including dietary intake and metabolic disorders like Dent’s Disease and hyperoxaluria.  Calcium phosphate stones are less common than their oxalate counterparts and can be caused by disorders like hyperparathyroidism or renal tubular acidosis (RTA), a hereditary disease.

Other types of kidney stones include struvite stones, which are generally associated with urinary tract infections, and uric acid stones, which are found more often in those who have extremely high-protein diets.  Uric acid stones can also be caused by gout or certain metabolic diseases.

The rarest form of kidney stone is a cystine stone, which is found only in those with a hereditary disorder in which the kidneys produce too much of the chemical cystine which they then filter into urine.
Incidentally, those who have had kidney stones in the past are more likely to develop them again in the future. Those with a family history of kidney stone occurrence are also more likely to develop kidney stones.  

Kidney Stones Symptoms

Symptoms can include a sharp pain that starts near the side or rear of the abdomen, and can traverse to the lower abdomen or groin.  This pain comes in waves, and can last as long as an hour.   Other signs include reduced urinary flow, bloody urine, or urine that is cloudy, discolored, or foul.  One may also have to urinate frequently, or may feel a burning sensation during urination, although the latter is often the sign of an infection.  Some may also experience nausea and vomiting, sometimes accompanied by fever and chills.

Kidney Stones Treatment

Luckily, the treatment for kidney stones is very well characterized and is standard procedure for many medical facilities.  Small stones (4mm or less) usually pass out of the body without any kind of intervention, and just require proper dietary and fluidic intake.  It’s recommended that patients drink up to 3 quarts of water a day and limit their consumption of caffeine-containing fluids, which can make water flush out of the body too quickly.  Various medications can also be prescribed to help ease the pain until the stone passes naturally.

It’s important to save the stone to show to a physician.  It can be analyzed to provide valuable information on exactly what type of stone a patient has.

If a stone remains in the urinary system for too long, is causing too much pain, or is simply too large to pass, surgical techniques may be employed.

Extracorporeal Shockwave Lithotripsy (ESWL)

A common therapy is extracorporeal shockwave lithotripsy (ESWL), in which a shock wave is applied externally on the skin’s surface.  The waves hit the stone, breaking it apart into smaller pieces, which can then be passed naturally.  The procedure is performed under anesthesia, but recovery time is relatively short, with the patient usually going home the same day.

Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy is also used, especially in cases where the stone is very large, or cannot be reached adequately using ESWL.  A small incision is made in the patient’s back, giving access to the kidney.  The surgeon then uses a nephroscope (special device that is used to look inside the kidney) to locate and remove the stone.  Larger stones may require the use of laser, ultrasonic, or electrohydraulic probes to break them up before they can be removed.  

Ureteroscopic Laser Lithotripsy

Ureteroscopic laser lithotripsy is another common procedure that is used when a stone is entrapped in the ureter, causing blockage. In this situation, a ureteroscope is passed through the bladder into the ureter under anesthesia.  Once the stone is reached, it is broken down into small fragments and then extracted using special baskets.

Ureteral Stent

Another treatment option is the use of a ureteral stent, a spaghetti-like tube that’s inserted between the bladder and the inside lumen of the kidney.  While this doesn’t directly remove the blockage, it does allow urine to be drained while the actual stone is broken down by other methods.

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