Kidney stones

Ever heard about one Wazir Muhammand? He holds a record in Guinness World Records. The reason? He had a massive stone weighing 620 g in his right kidney! Later the stone was removed but don’t you think it was too much of a weight for the kidney to bear, itself being 150 g. Kidney stones are quite common, but if left untreated may lead to complications.

Kidneys and its function

Kidneys are bean shaped organs in our bellies that are important to sustain life.

  • Kidneys are efficient filters and processors of the blood and the organs that produce urine. Complex processes of filtration, secretion, and reabsorption are involved in the formation of urine. This is essentially to remove the waste products, drugs, unwanted harmful substances, and excess fluids from the body.
  • Kidneys maintain a delicate balance of water and electrolytes in the body.
  • Kidneys contribute to regulate the production of red blood cells that carry oxygen in the blood.
  • Kidneys are the sites of production of active forms of vitamin D, an essential vitamin for bone health.
  • Kidneys also produce hormones that regulate our blood pressure.

About kidney stones

A kidney stone is a hard solid mass that can be several millimeters to few centimeters in size. It is formed when crystals and grime separate, aggregate and precipitate in urine.

Surgical procedures

If medical therapy fails, you may need to undergo Extracorporeal shock wave lithotripsy (ESWL). Shock waves are delivered through the skin and body tissues to hit the stones and break them into smaller pieces. These are then easily expelled in the urine.

Percutaneous nephrolithotomy may be done in some cases. The surgeon may make a cut on the skin and pass an endoscope to see and remove the stone.

Ureteroscopic kidney stone removal may be done where then endoscope is passed up through the urinary tract and the stone is removed. No incisions are required in this case.

Preventing another kidney stone

Kidney stones can recur but taking some precautions can help to keep them away. The key to prevention of kidney stones is intake of copious amounts of fluids, especially water. It works miracles! You may need dietary modifications to avoid the oxalate rich foods.

You may need some medicines to prevent any further stone formation. The thiazide diuretics, AHA, allopurinol make be required depending upon type of stone. Potassium citrate may help to control the urine acidity.

Stones may grow over months or years before they cause symptoms.

You may get to know that you have stones because you may experience one or more attacks of pain. This pain is severe and incapacitating, and can leave you doubled up in bed.

The pain is usually felt in the side of the back and then moves to the groin, the junction of the legs with the lower abdomen, the inner thighs, or the genital area.

The pain is referred to as ‘colic’ as it is severe and may be accompanied by vomiting, sweating, and restlessness. You may develop fever and chills. There will be a rapid heart rate.

A few symptoms of kidney stones are:

  • Fever
  • Chills
  • Frequent urination
  • Severe pain
  • Sweating
  • Restlessness
  • Blood in urine

As the stone travels down in the urinary pipes, it can cause varying degrees of obstruction depending upon its size, and can cause distention of the abdomen.

Kidney stones can be caused by various factors. The prime reason for kidney stones is dehydration. Deficit of fluids leads the minerals and other substances to aggregate and sediment. Excess intake of vitamin D and foods rich in oxalate such as rhubarb, spinach, chocolate, peanuts, wheat germ, etc can lead to stone formation in some.

Common stone forming minerals are calcium oxalate, calcium phosphate, and struvite. Urine is normally acidic in nature. Stones can form when there is an imbalance of acids in urine. They may also form when there is a deficiency of certain chemicals like citrate, magnesium, and pyrophosphate in urine. These are required to break down the debris and wastes.

Stones can form when there is a persistent or recurrent urinary tract infections (UTIs) that disturbs the internal milieu of the urinary tract. Struvite stones form when there are urinary infections.

Uric acid is one of the normal constituents of urine. When production exceeds the rate of excretion, uric acid precipitates in the urinary tract to form small crystals. Uric acid may build up in obesity, disorders of intestine, and diet rich in meats. Stone that are made of uric acid are common in gout, a chronic painful disease of joints. Stones can also develop in course of treatment of gout as the balance of uric acid is disturbed in the body.

Kidney stones are also seen in people who have been too obese and have undergone surgical resection of part of bowel for obesity.

Kidney stones also form when there are defects in the filtering units and tubules of the kidneys that disrupt the processes of filtration, excretion, or reabsorption.

Kidney stones may run in your family and you may inherit the tendency to form stones.

Kidney stone treatment includes the following points:

You may initially be asked to drink plenty of fluids, so that the small stone can pass out in urine. Drink 8-10 glasses of water in a day.

If you intermittently have pain, you may take some medicines for pain, like the NSAIDs. If you are taking any other medicines for other medical conditions, discuss with your doctor.

The doctor may ask you to catch a stone that is expelled in the urine and preserve it for analysis. Depending upon the type of stone, you may be prescribed other medicines.

  • You may be prescribed medicines to regulate the acidity of the urine as this can check the process of crystallization. One such medicine is allopurinol which is given to patients with uric acid and calcium stones.
  • To regulate the amount of calcium that appears in urine, you may be prescribed a class of medicines called the thiazide diuretics. These increase urine formation and prevent calcium leaking in urine.
  • If you have any underlying disorders that are believed to be causing stones, you may be required to undergo treatment for the same. If you have repeated UTIs, you should take antibiotics to eliminate the infection.
  • In struvite stones, a medicine called acetohydroxamic acid (AHA) is helpful when taken with antibiotics.