Kidney Stones

The kidneys are bean shaped organs. They are two in number, located in the back side of the lower abdomen. Their main function is to eliminate waste products and excess fluids from the body, in the form of urine. Urine is carried from the kidneys to the urinary bladder (Organ that stores the urine) with help of a tube like connection known as the ureter. Waste products include mainly salts like urea, sodium, potassium, etc.” When the amount of water in urine decreases or the salts in urine increases, they tend to clump to become hard small masses known as stones or calculus. When such stones forms and stay either in the kidneys, the ureters, or the bladder, they are known as kidney stones “.

ureteric and kidney stones

Causes of Kidney stones

There are different type of stones. Out of those the most common are calcium oxalate (a type of salt responsible for bone and teeth formation) stones and uric acid (it’s an acid present in urine, which is a result of protein breakdown) stones. Less common are cystine (it’s something present in proteins) stones and stones formed due to urinary infection.

Inadequate fluids

The most common cause is of course drinking less water. Excess sweating can be an aggravating factor.

  • Diet

    There are many foods that are rich in oxalate. Intake of such foods may cause increased concentration in blood leading to stones. People who take a high protein diet like red meat, egg, protein shakes, etc. have a high amount of uric acid in urine. High uric acid will increase the acidity in urine. Acidic urine is again a cause of stone formation.

  • Cystinuria

    There is a condition in which a certain type of amino acids known as cystine gets deposited in the kidneys and urinary bladder. Hence high amount of cystine in urine will lead to cystine stones.

Symptoms of Kidney Stones

Most of the people who have kidney stones usually do not show any symptoms. When the stones travels out of the kidney and gets trapped in the ureter, one or more of the following symptoms may occur:

  • It will cause severe abdominal pain.
  • Will be associated with vomiting in severe cases.
  • One may even get blood in urine because of the stone causing the damage.
  • One may have the feeling to urinate again and again. This is because, when the stone move, it irritates the bladder giving the sensation.
  • If infection sets in , one may also have fever.

Diagnosing Kidney stones

Blood test

a blood test should be done to rule out presence of high calcium or uric acid in blood.

X-ray

A normal x-ray would show large stones , but small stones would be missed.

CT scan

Hence a CT (Computed Tomography) scan would be preferred. This is reliable to find out even small stones.

Filter collection of stone

While passing urine, one will be told to pass through a filter. This is to trap the stones passed in urine. This stone will be then investigated on what it is made of. this would be helpful in preventing further episodes of kidney stones.

Treatments for Kidney Stones

When the symptoms doesn’t gets controlled with medication and gets severe as time passes. You might need advanced techniques to remove the stones.
There are different ways available to get rid of the stone:

  • The exact location of the stone is identified with the help of an ultrasound. Then shockwaves are sent , this would break down the stones in smaller fragments. The smaller fragments would be passed in urine. but this would need more than one sitting. This procedure is known as Extracorporeal Shock Wave Lithotripsy (ESWL).
  •  In case of larger stone , a small incision is made in the lower back. A cable containing camera in end, known as nephroscope, is inserted through the incision. This approaches the kidneys and locates the stone. Then it is broken with the help of laser and is pulled out. This type of treatment is known as percutaneous nephrolithotomy (PCNL).
  •  If the stone present is causing any obstruction in flow of urine. It may even damage the kidney , hence for temporary drainage a tube like structure is kept with one end in the kidney and the other in the urinary bladder. This helps in draining the urine, until the stones are treated or removed. This is known as JJ stenting or Double J or DJ stenting.

Prevention of kidney stones

  • First and foremost, one should drink lots and lots of water. Especially in summer. That is more than 8 to 10 glasses per day.
  • Increase the amount of fluids if one works out, sweat a lot, or exerts in anyway.
  • Lower the amount of foods like peanuts, spinach, beets, chocolate and sweet potatoes. This contains high amount of oxalate.
  • Drinks like lemonades and cranberry juice are good to eliminate kidney stones.

Kidney stone Specialists

Dr. Ilamparuthi Chennakrishnan

GENITO- URINARY SURGEON
M.B.B.S., M.S. (General surgery), M.Ch. (Urology), D.N.B. (GUS), F.I.C.S.