Nowadays kidney stones have become very common in every age group. It is of different sizes and causes acute and severe pain on the backside and radiates to the lower abdomen and groin while walking or sitting. When we jump on kidney stones it is better to know the basic anatomy and physiology of the urinary system.
The urinary system consists of two kidneys, ureters, urethra, and bladder. I think we all have studied the basic few points about our urinary system but if not so don’t worry before giving knowledge about kidney stones we will gonna provide you guys an overview of the urinary system. In this article, you will get all relevant information about kidney stones, types of kidney stones, sizes of kidney stones, symptoms, causes, etc.
Our kidney filters the blood and removes the waste products so the waste products passed out through a liquid form called urine.
The urine passes from the kidney through the ureters to the bladder. Urine stores in the bladder till you are ready to pass it. So here is the basic overview of the kidneys.
What are kidney stones?
Kidney stones, or renal calculi, are solid masses made of minerals salts. Kidney stones normally form in your kidneys. However, they can develop wherever in your urinary tract. Stones develop when the urine becomes concentrated, enabling crystals to crystallize and attach together.
Stones can be formed from different sources like diet, obesity, supplements, medications, and specific medical conditions.
Symptoms of kidney stones
Kidney stones initially will not cause any symptoms until it goes around your kidney or reaches into the ureter. When kidney stones stick into the ureter it may obstruct the flow of urine and cause the kidney to swell and spasm of the ureter.
Pain caused by kidney stones shifting to different positions as the stone moves through your urinary tract. You may suffer the following signs and symptoms includes;
- Burning sensation while urinating
- Severe pain below ribs
- Pink, red, or brown urine
- Cloudy or foul-smelling urine
- Urinating in small amounts
- Nausea and vomiting
- Fever and chills
There is no particular or specific cause of kidney stones. Kidney stones caused by several different causes. Kidney stones develop when your urine holds more major crystal-forming substances such as calcium, oxalate, and uric acid.
Anyone can get a kidney stone, but few persons are more prone than others to have them. Men get kidney stones more often as compared to women. Some known causes of kidney stones include;
1.Low urine flow
constant low urine volume is the major risk for the kidney. When urine volume is low the urine becomes concentrated and dark in color. Concentrated urine actually means that there is more limited urine to keep salts dissolved. So you should improve water intake that will break down salts in urine.
Diet may also enhance the chances of kidney stones. A high level of calcium in the urine is the most common cause of kidney stones. It is not due to how much calcium you consume. All you need to lower your calcium consumption in your diet or maybe your health care provider may limit or decrease your salt intake to lower your calcium level in your urine.
Too much salt enhances the risk of increased calcium in the urine and causes kidney stones. Diet rich in animal protein raises the acid level in the urine.
The breakdown of meat into uric acid also increases the risks of forming calcium and uric acid stones in the kidney.
3. Bowel conditions
Certain bowel conditions that cause diarrhea may raise the risk of calcium oxalate kidney stones. Diarrhea is the condition in which loose or watery stools. It usually lasts a few days and frequently fades outwardly any treatment. Diarrhea can be acute or chronic.
The body may absorb a large amount of oxalate from the intestines that cause more oxalate in your urine as well which develops different sizes of kidney stones.
Some other causes are below:
- Previous history of kidney stones
- History of family have had kidney stones
- Don’t drink enough water.
- Polycystic kidney disease
- High levels of cystine, oxalate, uric acid or, calcium in urine
- Diuretics (water pills) or calcium-based antacids.
Types of kidney stones
Not all stones are made of the same minerals. There are different reasons and types as we mentioned above for kidney stones. Knowing the types of kidney stones is very important as it will give you a hint about the treatment and precautions that should be taken that save your kidney. Types of stones include:
1. Calcium Stones
Most kidney stones are calcium stones, that’s why it is called the most common type of kidney stone. They are present in the formation of calcium oxalate. Oxalate is a substance made every day by your liver or ingested from your diet.
Consuming less oxalate-rich foods can lower your risk of producing this type of stone. High-oxalate foods are chocolate, peanuts, potato chips, nuts, and beets.
Calcium stones may also take place in the form of calcium phosphate. This type of kidney stone is more popular in metabolic conditions, such as renal tubular acidosis.
2. Struvite Stones
Struvite stones can occur when you have specific kinds of urinary tract infections in which bacteria make ammonia that grows up in your urine.
Struvite stones are made of magnesium, phosphate, and ammonia. Struvite stones can develop fastly and grow quite big, seldom with few symptoms. People with paralysis, Spina Bifida, and multiple sclerosis are at the highest risk of causing these stones. These stones can be big and create a urinary obstruction.
3. Uric Acid Stones
Uric acid stones can occur in people who drop too much liquid because of chronic diarrhea or malabsorption, a high-protein diet, diabetes, or metabolic syndrome. They form when your urine is frequently too acidic. Uric acid can make stones by itself or with calcium. Food rich in purines can elevate urine’s acidic level
4. Cystine Stone
This type of stone is seen mostly in women with urinary tract infections (UTIs). These stones can be big and produce urinary obstruction. Cystine stones are quite unique and usually only seen in people with a genetic condition named cystinuria.
Diagnosis of kidney stones
When your doctor observes symptoms and signs of kidney stones then he will recommend to you some diagnostic test that provides you specific results about the stones like where it is? The size of the stone etc. the following test are as follows;
1. Blood testing
Blood analyses may disclose too much calcium or uric acid in your blood. Blood test outcomes assist observe the health of your kidneys and may direct your doctor to examine for other diseases.
2. Urine testing
For this test, your physician may ask you to perform two urine samples over two consecutive days. The 24-hour urine collection test may reveal that you’re eliminating too numerous stone-forming minerals.
Imaging tests may reveal kidney stones in your urinary tract. High-speed or dual energy computerized tomography (CT) may also reveal little stones. Simple abdominal X-rays are used less usually because this kind of imaging analysis can miss tiny kidney stones. The contrast stain used in the CT scan and the IVP can influence kidney function.
3 Sizes of kidney stones
Kidney stones occur in different forms and sizes. They can be as little as a grain of dirt to several measures in diameter. The size and location of the stone determine how it affects you. Sizes are;
1. Less than 5mm
the kidney stones less than 5mm can easily pass through the ureter without any pain and issues. Even it never shows any symptoms while passing out. This size of kidney stone doesn’t require any treatment and dissolves naturally by passing through urine. This takes an average of 45 days to dissolve completely.
2. Stone 5mm to 6mm
Kidney stones that are greater than 5 mm are often too large to pass through the ureter spontaneously. It requires some sort of treatment to completely dissolve the stones but 60% passes naturally. The complete duration to dissolve the stones is 45 days or more.
3. Greater than 6mm-9mm
This size of stones is very painful. It is never passing out through urine. The larger the stones, the greater time required to treat. Large stones are difficult to pass as it is like a popcorn type but the only treatment for this size of stones is surgical. It rarely passes without a surgical procedure.
Treatment for kidney stones
Treatment can be determined according to the size and type of stones. Drinking enough water can save you from the dehydration and risk of kidney stones. People having nausea and vomitings often require intravenous fluids. Treatments include;
If the infection is present it requires antibiotics for the treatment of kidney stones. Medications are:
For pain; Ibuprofen (Advil), acetaminophen (Tylenol), naproxen sodium (Aleve) medication are given.
- allopurinol (Zyloprim) for uric acid stones
- thiazide diuretics to inhibit calcium stones
- sodium bicarbonate or sodium citrate for the making of the low amount of acidic urine
- phosphorus solutions to stop calcium stones from forming.
Sometimes stones are small enough to split the body during urination without a person discerning. Large stones, though, can cause pain and prevent the flow of urine. If stones do not pass, they can harm the kidneys and urinary tract. When medications do not support so moving towards the lithotripsy procedure can crush the stones broken into small parts so they can pass out in the urine. Sometimes, in very big stones, this needs to be done more than once. This treatment can be very efficient.
3. Percutaneous nephrolithotomy
If another treatment fails and does not affect positively so the last option will be surgery. In this surgery, the kidney stone is obtained by an incision in the patient’s back. Here are the following steps require while performing this surgical procedure:
Step 1: Patient positioning
After giving general anesthesia the patient is in the prone position, a circular packet is set below the pelvic bone and another under the upper abdomen and chest region to provide enough stretching throughout the flank region. The side to be operated should be taken at the side of the operating table.
Step 2: marking of the sites
Mark the sites according to the posterior axillary line as the lateral limit, the upper edge of the iliac top as a lower limit, the oblique edge of paraspinous muscle as the medial limit, the 11th and 12th rib margin as the upper limit.
Step 3: Site of percutaneous puncture
The specific site of the hole depends primarily on the cause of hydronephrosis (HDN) including anatomic sites. Better envisioned space of dilated renal pelvis (in mild HDN) and both renal pelvis and calyx (in mild to firm HDN) is chosen and marked. The electronic dotted puncture position focused up that space and directed into the chosen calyx/pelvis.
Step 4: Incision
The incision is given 1 cm to the flank area of the patient. A small incision is made with no. 11 surgical scalpels.
Step 5: Guidewire insertion
Guidewire (0.038-inch diameter) is entered within the needle under fluoroscopy guidance, trying to adjust it into the ureter. When the dorsolumbar fascia is incised and the tract then is expanded up to 14 F by using a single step fascial dilator.
Step 6: Nephrostomy insertion
A small ureteral stent may be left draining the kidney to the bladder in addition to a nephrostomy tube removing the kidney to an external drainage pack at the end of the surgery. The duration of the surgery is generally 3-5 hours.
Prevention against kidney stones
- If you have a history of kidney stones so your doctor recommends you to drink as much water as you can and pass about 2.1 quarts (2 liters) of urine a day. If your urine is bright and clear, you’re likely sipping sufficient water intake.
- If you had calcium oxalate stones or were willing to form in your kidney. Your doctor immediately stops the foods that are rich in calcium oxalate to reduce the risk of making calcium oxalate stones. Food includes; rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate, black pepper, and soy products.
- Reduce your salt and sugar intake as well as animal protein. It is good to take vegetables as compared to the above-mentioned food.
- If you are taking enough calcium through foods or calcium supplements. First, ask your doctor whether it’s safe to have this in your diet or not. You might reduce the risk by taking supplements with the meals. Your physician may prescribe medications to inhibit the formation of calcium and uric acid stones.
Why are kidney stones a problem?
Stones do not always remain in the kidney. Small stones move out through the ureter without any sign but large stones do too easily pass through the ureter to the bladder. The stones cause urine obstruction that causes severe infection.
What are the risks that you may control?
Drinking too little water is the most common reason for kidney stones. First of all, if you develop the symptoms and back pain do first consult your doctor. Drink enough water, do not eat high animal protein. Control the diet and taking a sufficient amount of water can save you from kidney stones.
What are the risks that you can’t control?
Certain medical conditions can raise the risk of kidney stones. If you have a family history of kidney stones you may not control the risk to form kidney stones in your kidney as well.
Kidney stones are very common and the most common cause of kidney stones is lack of drinking water. If you do not control your diet and take enough salts may cause kidney stones of different sizes. It is very painful and sometimes causes urine obstruction and ureter spasms.
Some stones can easily pass out without any sign and large stones need medications or surgery. You can only prevent it by drinking enough water and controlling your diet.