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Kidney stones (renal lithiasis) are small, hard deposits that form inside your kidneys. They are made of mineral and acid salts and have many causes. In one common scenario, kidney stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

 

Most kidney stones contain crystals of more than one type. Types of kidney stones include:

Calcium stones. 

The most common kidney stones are made of calcium oxalate or calcium phosphate.

Struvite stones.

Struvite stones can result from an infection, such as a urinary tract infection. Struvite stones can grow quickly and become quite large.

Uric acid stones.

Uric acid stones can form in people who are dehydrated, those who eat a high-protein diet and those with gout. Certain genetic factors and disorders of the blood-producing tissues also may predispose you to uric acid stones.

Cystine stones.

Only a small percentage of kidney stones are of this type. They form in people with a hereditary disorder that causes the kidneys to excrete excessive amounts of certain amino acids (cystinuria).

Other stones.

Other, rarer types of kidney stones can occur.

Knowing your type of kidney stone helps to understand what might have caused the stone to form and may give clues as to what you can do to reduce your risk of getting additional kidney stones.

 

Passing kidney stones can be painful. The pain of a kidney stone typically starts in your side or back, just below your ribs, and moves to your lower abdomen and groin. The pain may change as the kidney stone moves through your urinary tract.

 

A kidney stone may or may not cause signs and symptoms until it has moved into the ureter — the tube connecting the kidney and bladder. At that point, these signs and symptoms may occur:

Severe pain in the side and back, below the ribs

Pain that spreads to the lower abdomen and groin

Pain on urination

Pink, red or brown urine

Nausea and vomiting

Persistent urge to urinate

Fever and chills if an infection is present

 

 

Make an appointment with your doctor if you have any signs and symptoms that worry you.  Seek immediate medical attention if you experience:

Pain so severe that you can't sit still or find a comfortable position

Pain accompanied by nausea and vomiting

Pain accompanied by fever and chills

 

Kidney stones often have no definite, single cause. They form when the components of urine — fluid and various minerals and acids — are out of balance. When this happens, your urine contains more crystal-forming substances, such as calcium, oxalate and uric acid, than the available fluid can dilute. At the same time, your urine may be short of substances that keep crystals from sticking together and becoming stones. This creates an environment in which kidney stones are more likely to form.

 

Factors that increase your risk of developing kidney stones include:

Family or personal history of kidney stones.

If someone in your family has kidney stones, you're more likely to develop stones, too. And if you've already had one or more kidney stones, you're at increased risk of developing another.

Being an adult.

Kidney stones are most common in adults age 40 and older, though kidney stones may occur at any age.

Being a man.

Certain diets.

Eating a diet that's high-protein, high-sodium and high-sugar may increase your risk of some types of kidney stones.

Being obese.

High body mass index (BMI), increased waist size and weight gain have been linked to an increased risk of kidney stones.

Digestive diseases and surgery.

Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and increase the levels of stone-forming substances in your urine.

Dehydration.

Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may need to drink more water than others.

Other medical conditions.

Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism and certain urinary tract infections.

  

If your doctor suspects you have a kidney stone, you may undergo tests and procedures to diagnose your condition, such as: 

Blood tests.

Blood tests may reveal excess calcium or uric acid in your blood. Blood tests allow your doctor to check for other medical conditions and to monitor the health of your kidneys.

Urine tests.

Tests of your urine, such as the 24-hour urine collection, may show that you're excreting too many stone-forming minerals or too few stone-inhibiting substances.

Imaging tests.

Imaging tests may show kidney stones in your urinary tract. Imaging tests may include computerized tomography (CT) or, less commonly, X-ray.

Analysis of passed stones. 

You may be asked to urinate through a strainer designed to catch any stones you pass. That way, any stones can be collected for laboratory testing. A laboratory analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to formulate a plan to prevent future kidney stones.

 

Treatment for kidney stones varies, depending on the type of stone and the cause. Kidney stones usually cause no permanent damage. Apart from pain medication and drinking lots of water, treatment is often unnecessary. However, treatment may help prevent recurrent kidney stones in people with increased risk.

 

Treatment for small stones with minimal symptoms
Most kidney stones won't require invasive treatment. You may be able to pass a small stone by:

Drinking water.

Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system

Pain relievers.

Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve).

 

Treatment for larger stones and those that cause symptoms

Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more invasive treatment. Procedures include:

Using sound waves to break up stones.

A procedure called extracorporeal shock wave lithotripsy uses sound waves to create strong vibrations called shock waves that break the stones into tiny pieces that are then passed in your urine. The procedure creates a loud noise and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable. The specifics of your procedure may vary depending on the type of equipment your doctor uses.

Extracorporeal shock wave lithotripsy can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

Surgery to remove very large stones in the kidney.

A procedure called percutaneous nephrolithotomy involves surgically removing a kidney stone through a small incision in your back. This surgery may be recommended if extracorporeal shock wave lithotripsy has been unsuccessful or if your stone is very large.

Using a scope to remove stones.

To remove a stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter. Your doctor maneuvers the ureteroscope to the stone. Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine.

Parathyroid gland surgery.

Some calcium stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone, your body's level of calcium can become too high, resulting in excessive excretion of calcium in your urine. This is sometimes caused by a small benign tumor in one of your four parathyroid glands. A surgeon can remove the tumor or the parathyroid glands.

 

 
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