- 1 What are kidney stones?
What are kidney stones?
A renal calculus or kidney stones (renal lithiasis) is a concretation that appears in the kidney after the deposition of mineral crystals.
It is a very painful condition in case the stones are placed in the ureter, especially when urinating.
Consequences of kidney stones
Kidney stone is a very painful condition, especially when the stones are located in the ureter and the patients tries to urinate.
When the stones are too big, they can block the exit of the liquids that are stored in the kidney, causing swelling of the kidney. It is a condition known as hydronephrosis. Hydronephrosis requires a quick intervention by the doctor because it can seriously damage the health of the person who suffers from it.
If fever, chills, blood in the urine or problems with urination occur, the visit to the specialist is mandatory and as quickly as possible.
Symptoms of kidney stones
Me main simptoms are:
- Dripping when urinating
- Pain in the side, belly, or thigh.
- Pain that starts in the side and moves to the lower abdomen and groin.
- Back pain
- Pain that comes and goes
- Frequent desire to urinate
- Burning when urinating
- Abdominal spasms
- Pain in the vulva or testicles
- Shaking chills
- Blood in the urine.
- Reddish or brownish urine
Why do kidney stones form?
The kidneys are the filter where most fluids and waste products are collected from the blood. Healthy kidneys are able to purify the blood and eliminate waste through the urine without the toxins present in them could affect their health.
For the kidneys to be able to do this function, it is important that our body is well hydrated, so that impurities can be well dissolved and e expelled outside when we urinate.
However, sometimes there are changes in the composition of the blood or the urine is not abundant enough to dissolve the impurities. Thus, these are retained in the kidneys, forming by accumulation the famous kidney stones or stones.
Types of kidney stones
According to the composition of the material dissolved in the urine of the kidneys we have different types of stones in the kidneys:
- Calcium Crystals: They constitute the majority of kidney stones (80%) They are formed by the combination of calcium with phosphorus or oxalates. A diet plenty of milk products, proteins and oxalates may be the cause of these formations, but they are sometimes caused by physical illness.
- Crystals caused by urinary tract infections (Cálculos de estruvita) (Struvite calculi) 10% of these calculi is formed by deposits of struvite favoured by the alkalinization of the blood carried out by the bacteria causing the infections.
- Uric acid crystals: Formed by sedimentation of the excessive uric acid in the blood. Sometimes they are a symptom of other physical illnesses. Less frequent than those mentioned before, they affect 5% of cases.
- Amino acids crystals (Cystine calculi) they are the less frequent but the most painful. They only account for 2% of kidney stones
Causes that favor the appearance of kidney stones
In most cases, the cause of the stones is unknown or is the sum of various factors. The main causes of kidney stones are:
- Underdrinking: : A dehydrated organism does not have enough liquid to dissolve the grit of the kidneys, which gathers together to form a stone or stone. Too concentrated urine can also be produced, in addition to drinking insufficient water, dehydration, or excessive loss (sweat).
- Urinary tract infections: They can modify the pH of the urine. If the urine is very acidic, it favors the precipitation of substances (urinary tract infections, acidifying diet, …)
- Improper diet: Eating improperly favors the formation of kidney stones. Among the foods that promote the formation of kidney stones we have the following: foods with a lot of salt, foods with a lot of sugar, drinks rich in caffeine, foods rich in oxalates, foods rich in purines, a diet rich in dairy products, a diet that contains an excess of proteins (hyperproteic diets).
- Obesity: People with obesity have a tendency to develop more kidney stones.
- Certain metabolic diseases: There are some metabolic diseases that favor the appearance of kidney stones. Among them we have, for example, those that suppose an accumulation of calcium in the organism, such as hypercalcemia or those that accumulate cysteine in the organism, such as cystinuria. Hypercalcemia will cause, among other problems, calcium stones while cystinuria, amino acid crystals.
Gout is another metabolic disease that may be responsible for the same thing.
- Diseases and abnormalities of the urinary system: Some diseases such as urinary tract infections can produce struvite stones. While some abnormalities, such as narrowing of the urinary tract, lead to urine retention that will end up producing a kidney stone
- Other diseases: such as hyperparathyroidism, sick people who have been immobilized for a long time (due to bone decalcification), hyperthyroidism, or vaginal infections.
- Supplements for osteoporosis: An excessive intake of calcium (through supplements or the exaggerated consumption of dairy products) can produce calcium deposition in the kidneys, in a condition known as milk and alkaline syndrome. This can be aggravated by taking vitamin D supplements.
- Problems in the intestinal flora: The intestinal flora (microbiota) is capable of increasing or decreasing the absorption of oxalates. In some people there is a greater intestinal absorption of oxalates, which increases renal elimination and the formation of calcium oxalate crystals in the kidneys (hyperoxaluria)
Causes of kidney stones
Prevention of kidney stones
A proper diet and a number of hygiene considerations can help prevent kidney stones. (How to prevent kidney stones)
Diagnosis of kidney stones
Although most of the stones dissolve spontaneously, it is advisable to visit the doctor to diagnose what type of stone it is and what treatment or eating behavior should be taken to prevent its recurrence. If the patient suspects the presence of a kidney stone , one should urinate into a container from which the stone could be filtered, if it can be removed, to be analyzed.
The diagnosis supposes in the first place an interview in which the doctor asks about possible cases of kidney stones in the family, about the diet and habits of the patient. The doctor will also perform a physical examination to check by body pressure if there are areas of pain that presuppose the existence of a kidney stone.
If the doctor suspects the presence of a kidney stone, he will request specific tests such as:
- Blood test
- Urine analysis
- CT scans (computed tomography scans)
Kidney stone treatment
Since most kidney stones usually pass on their own, their official treatment is based on the administration of pain relievers to decrease pain until the stones are expelled.
There are some calculi that, due to their size, cannot be expelled, so other dissolution or extraction methods are required, including the following:
- Shock waves: What is known as extracorporeal lithotripsy. The waves break and crumble the stones that are expelled by the urine
- Uteroscopy: This involves the introduction of a camera probe (uteroscope) through the ureter or conduit that connects the kidneys with the bladder. With this you can find out where the stone is and be able to extract it or break it with the uteroscope. It is a test that is performed while the patient is asleep under general anesthesia.
- Surgery: Sometimes a surgical intervention is required to remove a large stone that could not be removed with the previous methods. These types of interventions are known as nephrostomy or nephrolithotomy. Percutaneous nephrostomy involves inserting a catheter through the skin into the kidneys to facilitate drainage of urine in the event of obstruction. In percutaneous nephrolithotomy, the doctor inserts a hollow needle through a cut made in the patient’s back. , through which the instruments that will allow removing or breaking the kidney stone are introduced.
More information about kidney stones
17 June, 2020