Stones that are composed of minerals and salts and have a solid texture develop in the kidneys, known as kidney stones. This issue arises from an excess of materials that form crystals in urine, such as calcium oxalate, uric acid, struvite, cystine, xanthine, and phosphate. The urinary tract is susceptible to kidney stones at all stages, from the kidneys to the bladder. Indications of kidney stones involve intense, cutting pain on the side or back that typically transitions to the stomach or groin, queasiness, vomiting, high temperature, and blood in urine.
When the stones get stuck in the urinary system, it can result in blockages that cause the kidney to enlarge and the ureter to contract, leading to extreme agony. When the stones lead to complications or infection, surgery may be necessary for their removal. Despite the excruciating pain accompanying the passage of kidney stones, proper and prompt treatment can usually prevent permanent damage.
In various scenarios, a patient may only require pain relievers and ample hydration to successfully pass a kidney stone. Modifying their diet and consuming more fluids can also be useful in preventing future kidney stones. Nonetheless, it is crucial to identify the type of kidney stone one has, as it can pinpoint its origin and provide insight into methods to deter future occurrences. Kidney stones fall under four classifications: calcium oxalate, uric acid, struvite, and cystine. Hence, if there are any worrisome indications or potential risk factors, it is crucial to seek medical attention.
Types of Kidney Stones
Kidney stones are mineral and salt deposits that solidify in the kidneys. There are four categories of kidney stones, namely calcium, uric acid, struvite, and cystine, and specific information about each type is listed below.
Calcium Stones:
The majority of kidney stones, making up around 80% of cases, are referred to as calcium stones. These stones are primarily made up of a substance called calcium oxalate, though they may comprise calcium phosphate as well. Calcium stones are more likely to form in individuals who consume a diet that is high in oxalate, found in foods such as spinach, beets, nuts, and chocolate, while also having a low calcium intake. Additionally, some medical conditions and medications can increase the likelihood of developing calcium stones.
Uric Acid Stones:
In the kidneys, the buildup of uric acid can result in the formation of stones. This is more frequently observed in individuals with gout, a type of arthritic condition characterized by elevated levels of uric acid in the bloodstream. Consuming a diet that is rich in animal protein, such as meat, fish, poultry, and shellfish, can heighten the likelihood of developing uric acid stones.
Struvite Stones:
The development of these stones occurs as a reaction to an infection in the urinary tract. They are more frequently observed in females than males and have the potential to expand rapidly, resulting in significant harm to the kidneys.
Cystine Stones:
The stones are uncommon, as they only occur in under 1% of cases. They develop in individuals with cystinuria, an inherited condition that causes excessive excretion of specific amino acids through the kidneys. Managing cystine stones can be challenging, and surgery may be necessary.
Identifying the kind of kidney stone you possess can aid in uncovering its origin and potentially uncover strategies to prevent future stones from developing. It is advisable to seek advice from a healthcare expert to receive appropriate diagnosis and therapy.
Causes
Minerals and salts can combine to create hard deposits known as kidney stones that develop within the kidneys. These stones can impact any section of the urinary system, from the kidneys to the bladder. Below are the identified causes of kidney stones, backed by verifiable information.
- Urinary tract infections (UTIs) can lead to the development of struvite stones. These stones form in the urine due to the presence of certain bacteria that increase the alkalinity of urine by reducing acidity levels. This condition is more common in people who have had kidney or bladder tubes for a long time or in those who have poor bladder emptying due to neurological issues.
- Eating certain substances in large amounts, such as calcium oxalate, phosphorus, and uric acid, can increase the risk of developing kidney stones. Some foods, including those containing high levels of oxalate (such as nuts, spinach, rhubarb, and chocolate), those containing high amounts of animal protein and low levels of fruits and vegetables, have been associated with a higher likelihood of kidney stone formation.
- Genetics play a role in the formation of kidney stones, as individuals with the inherited metabolic disorder cystinuria may experience an excess of cystine in their urine, leading to stone formation.
- If you don’t consume an adequate amount of water, your urine may become concentrated, leading to a higher likelihood of kidney stones.
- Medical issues like Crohn’s disease, gout, and hyperparathyroidism have the potential to cause an increase in calcium and uric acid in the bloodstream and urine resulting in an increased probability of developing kidney stones.
Multiple factors can be responsible for the formation of kidney stones. A person’s chances of developing them can be increased by a combination of genetic, lifestyle, and dietary factors such as lack of hydration and pre-existing medical conditions. But by minimizing potential risks, one can reduce the possibility of developing kidney stones. Drinking abundant water and sticking to a healthy diet that contains less animal protein and more fruits and vegetables can prevent the formation of stones. When someone experiences ongoing pain, blood in their urine, or fever, it is crucial to seek medical help without delay.
Risk Factors
Kidney stones are hard deposits of minerals and acid salts that form in the kidneys. Multiple factors can increase the chances of developing them. One major cause is not drinking enough water, which leads to concentrated urine that contains materials promoting crystal creation. High intake of sodium, protein and sugar in one’s diet can raise the risk of specific types of kidney stones. Furthermore, diuretics and protease inhibitors given for HIV infection can also increase the probability of stone formation.
Several factors can increase the chances of developing kidney stones, including having a family or personal history of them, being overweight, and having weight loss surgery. Other conditions like chronic inflammatory bowel disease, cystic kidney disease, and hypercalciuria can also contribute to the risk. In addition, metabolic disorders like hyperoxaluria and hyperuricosuria can increase the likelihood of developing kidney stones even more.
Besides these factors, the amount of exercise one has can also impact the likelihood of developing kidney stones. Exercising either too much or too little could lead to stone formation. Individuals who have previously had gastrointestinal tract surgery or have a history of gout may have an increased risk. Being aware of the risk factors associated with kidney stones can help one take measures to prevent the painful condition, such as drinking more fluids, adjusting their diet, and seeking medical attention if needed.
Symptoms of Kidney Stones
If you are observing any of these warning signs, it is likely that you have formed hard lumps in your kidneys, known as kidney stones, which can cause intense discomfort.
- Renal stones often manifest with a distressing sensation commonly known as pain, which is predominantly felt in the back or flank region. The discomfort can be so unbearable that it becomes challenging to assume a comfortable position. Additionally, it may fluctuate in severity and occur in recurrent waves.
- Renal stones can lead to the presence of blood in your urine. If you observe that your urine has a pink, red, or brown tint, it is recommended that you seek medical attention without delay.
- Nausea and throwing up are prevalent indications of kidney stones in addition to the pain. These signs may be a result of intense discomfort or due to an obstruction of urine flow.
- Having a kidney stone and an infection can cause a rise in body temperature with accompanying shivering. This is a sign that demands urgent medical intervention.
- If you have kidney stones, your urine may have a strange odor or look hazy which can be attributed to the minerals and salts in it.
If you happen to be going through any of these symptoms, it is essential to consult a medical professional. The doctor can identify kidney stones and propose the most suitable remedy relying on the dimensions and position of the stone. In some circumstances, an operation may be needed. Keeping yourself hydrated with ample water can aid in thwarting the formation of kidney stones.
What does kidney stone pain feel like?
The pain caused by kidney stones can be very intense, and is frequently the main indicator of this ailment. It is usually explained as a cutting or squeezing feeling that takes place in the back and flank; it may also spread to the lower belly and groin. This uneasiness can be extremely severe and may change as the kidney stone progresses through the urinary system, coming and going in waves.
Kidney stones can lead to several signs, such as discomfort or aching while urinating, and urine that is either pink, red, or brown in color. The urine may also be unclear or possess a bad smell. There could also be a need to urinate frequently or trouble in passing urine in little quantities.
If you encounter severe discomfort that hinders your comfort level or if you have queasiness and heaving accompanied by acute pain, it is crucial to consult a doctor. Furthermore, if you experience bouts of fever and shivers accompanied by pain, it is also imperative to seek medical care. These warning signs could indicate the presence of other grave ailments, making it vital to contact a physician immediately.
Diagnosis
An essential diagnostic procedure for locating kidney stones is a urinalysis. Your urine sample will be examined by a medical professional to see if it contains excessive amounts of minerals that could lead to kidney stones.
Another method for evaluating whether someone has kidney stones is through blood tests. These tests can identify abnormal blood levels of particular minerals that may be a factor in the formation of kidney stones.
Kidney stones can be seen in the urinary tract using imaging techniques like dual-energy computerized tomography or high-speed computerized tomography. Simple abdomen X-rays, on the other hand, are rarely employed because of their limited capacity to find tiny kidney stones.
You can do a 24-hour urinalysis to determine whether you are excreting too many minerals that can cause stones or not enough compounds that can stop stones from forming.
The composition of kidney stones can be determined through laboratory analysis. The doctor can utilize this information to determine the underlying cause of the problem and create an efficient preventative strategy to stop the growth of new stones.
It is advisable that anyone who suspects they may have kidney stones undertake diagnostic tests right away rather than waiting until their symptoms get worse. For an appropriate diagnosis and course of therapy, seeking medical advice is essential.
Treatment Options
Kidney stones can be a painful condition to deal with, but there are various treatments available depending on the size and location of the stone. For small stones that do not cause blockages or other issues, patients may be advised to drink plenty of liquids and may be prescribed pain relief medication. Patients with larger or more severely symptomatic kidney stones may require more extensive treatment options such as extracorporeal shock wave lithotripsy (ESWL), uteroscopy, percutaneous nephrolithomy, or nephrolithotripsy. These procedures involve using tools such as sound waves or lasers to break up and remove the kidney stone. Patients may also require stents to support urine flow or to assist in passing the stones.
Extracorporeal shock wave lithotripsy (ESWL)
ESWL is a medical procedure that uses shock waves to break kidney stones into tiny pieces so they can easily pass through the body or be taken out. It doesn’t involve cutting into the body. This treatment is a popular option for people with kidney stones that doesn’t require surgery. It has been used since the 1980s.
When someone has a stone in their body, they can lay down on a table and a machine called a lithotripter will use shock waves to break up the stone. The machine uses X-rays or ultrasound to help aim the shock waves at the stone. The aim is to make the hard rock into tiny pieces so that they can come out of the body through pee. Sometimes, stones can get stuck in other parts of the body like the tubes that connect the liver and the intestine or the tube that connects the pancreas and the intestine. To remove these stones, doctors may use a special tool called an endoscope to break them up into smaller pieces.
ESWL can be affected by different things that can make it work better or worse. This means that the type, location, and size of the stone, along with any past infection problems, are important factors to consider. Some types of stones made of cystine or certain forms of calcium can be difficult to break apart using shock waves. Moreover, if the tubes are too small or if there are big rocks, it can cause big pieces that might be difficult to go through or take out.
ESWL is a medical procedure that is usually done outside of the hospital. During the procedure, you will be given a mild anesthesia to help reduce any pain in your kidney area. After finishing the procedure, the person usually gets to go back home on the same day. But sometimes, depending on how well the procedure went, the doctors might ask the person to stay at the hospital for one night to keep an eye on them. Doctors suggest that patients should drink plenty of water and use a strainer to collect any small pieces of stones that come out in their urine. They might also need medicine to help with pain and infection.
Uteroscopy
Ureteroscopy is a way that doctors can help get rid of kidney stones that a lot of people use. This is a medical procedure that doesn’t require staying in the hospital. It involves using a small telescope called a ureteroscope. The doctor puts it through the tube you pee from, your bladder, and up to where the stone is. The process usually lasts for one to three hours and is performed while the patient is asleep under general anesthesia. If the stone is tiny, a tool can be used to gather it up and remove it without difficulty. If the stone is too big or the tube it needs to go through is too small, doctors may need to use a special light to break it into smaller pieces before they can take it out.
Ureteroscopy is a medical procedure that is usually done without the patient needing to stay in the hospital. However, sometimes the procedure can take a long time or be difficult, and in those cases, the patient may need to spend the night in the hospital. Additionally, after the procedure, the tube that carries urine from the kidney to the bladder may become enlarged. To help the urine flow correctly, a small tube may be put in temporarily.
Ureteroscopy is a way to remove stones from the kidney or tube that carries urine from the kidney to the bladder. It works well even for stones that can’t be seen on X-rays. This is a safe way to help patients who can’t handle other treatments like ESWL or PERC. People who take medicine to make their blood thinner, women who are going to have a baby, and people who are very overweight are examples of patients who need special attention. It’s important to know that if someone has had surgery to fix their urinary tract, they shouldn’t choose to have a procedure called ureteroscopy.
Percutaneous nephrolithomy
The procedure of percutaneous nephrolithomy is frequently employed for patients who have kidney stones that are large or have an irregular shape, infections, or stones that have not been sufficiently broken down through other treatments. This method includes entering the kidney through a small cut in the back and using tools such as a nephroscope to see, break down, and extract the stone. This method is more successful in removing all stones in one session than other methods and reduces post-surgery discomfort, results in a shorter time spent in hospital, and enables a quicker return to work and daily routines compared to open surgery.
Although the procedure is minimally invasive, as with any surgical procedure there are risks and potential complications. Patients may experience some blood loss, the possibility of developing an infection, or injury to surrounding tissue or organs. There is also a chance that the stone may not be able to be removed completely, and additional treatment may be required. Despite these risks, the benefits of percutaneous nephrolithomy outweigh the potential complications, making it an accepted standard of care for patients with large or difficult-to-treat kidney stones.
Patients who undergo this procedure will require general anesthesia and a short hospital stay of 2-3 days. Recovery time varies but most patients are able to return to work within a week or so. While there is a small risk of long term complications including high blood pressure or reduced kidney function, patients should discuss these risks with their surgeon and determine if the procedure is right for them. By utilizing percutaneous nephrolithomy, patients can avoid the need for more invasive open surgery, making it an effective treatment option for those with kidney stones.
Nephrolithotripsy
Nephrolithotripsy is a medical intervention utilized to manage kidney stones that cannot pass through the urinary tract without assistance. This procedure is typically suggested for patients whose stones exceed 2 cm (roughly equivalent to the size of a marble), those who have contracted infections, misshapen stones, or those who have not responded to alternative treatment methods aimed at dissolving the stones.
The process requires making a small cut on the back to access the kidney, then using a small camera and other instruments to either eliminate or break down the stones. After breaking up the stone, a suction machine removes it. This surgery is not very intrusive and usually only requires general anesthesia, with patients staying in the hospital for 2-3 days and needing about a week of recovery time before going back to work.
An important benefit of this operation is that it has a high success rate in removing all stones from patients. Nevertheless, as with any procedure, there are potential hazards involved, such as infection, bleeding, and harm to neighboring organs like the bowel, liver, ureter or bladder. Patients should also be informed about the low possibility of developing high blood pressure or reduced kidney function after the kidney surgery, which they should discuss with their surgeon.
Painkillers that help with kidney stones pain
Pain relievers are known as analgesics, which function by interrupting the transmission of pain signals to the brain. Medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil) and naproxen (Aleve) are some of the commonly prescribed analgesics for alleviating kidney stone pain.
Alpha blockers are a type of medication that can help ease the passage of kidney stones by relaxing the smooth muscles in the ureter. Nifedipine, for instance, is a commonly prescribed alpha blocker used for this purpose.
Calcium channel blockers are medications that have a similar effect as alpha blockers. They work by relaxing the smooth muscles in the ureter, which helps to make the passing of kidney stones easier. One drug in this category is called Diltiazem, and it can be used to relieve pain caused by kidney stones.
For intense kidney stone pain, opioids like morphine or oxycodone may be recommended for temporary use since they provide stronger pain relief. Nevertheless, there is a greater likelihood of addiction with such drugs, hence they should be used with careful medical monitoring.
A mixture of pain medications may be recommended to provide better relief for kidney stone pain. Using a combination of ketorolac, a type of anti-inflammatory drug, and morphine can bring better pain relief than using either of them alone.
It is crucial to understand that every pain medication has the possibility of causing adverse effects. Therefore, before beginning any medication, patients should talk with their physician about potential side effects. It is known to experience stomach irritation and kidney harm with analgesics, and opioids could result in sleepiness, constipation, and respiratory depression.
Prevention
To avoid kidney stones, the most crucial thing one can do is consume an adequate amount of water. This is because water can dilute the substances in urine that result in stone formation. A person should aim to drink enough fluids to enable them to pass approximately 0.5+ gal (2+ liters) of urine per day. It is also recommended to consume citrus beverages such as lemonade or orange juice since the citrate found in these drinks can obstruct stone formation.
Furthermore, moderating the consumption of certain foods can be beneficial for those who develop calcium oxalate stones, which are the most prevalent type of kidney stones. These foods may consist of vegetables such as spinach, fruits like rhubarb, nuts, tea, beetroot, sweet potatoes, chocolate, and legumes. Eating these foods in small amounts can be advantageous for individuals looking to prevent kidney stones.
In addition, the human body requires calcium as a crucial mineral. It is often wrongly assumed that consuming a diet low in calcium reduces the chances of developing calcium oxalate kidney stones. However, this method is flawed when it comes to overall health.
The vast majority of kidney stones are formed when oxalate combines with calcium during urine production in the kidneys. Therefore, it is vital to consume foods and beverages high in both calcium and oxalate simultaneously during a meal. Reducing sodium intake and pairing calcium-dense foods with those abundant in oxalate can help prevent kidney stones.
In conclusion, closely following the guidance of medical experts is the most effective method of preventing kidney stones from recurring. Research has demonstrated that individuals who experience kidney stones often fail to take sufficient steps to prevent their recurrence, such as following prescribed medicine or modifying their diet.
Without proper medications and dietary changes, stones may return, and recurring kidney stones could suggest the presence of other health problems, such as chronic kidney disease.
