Kidney Stones: All You Need to Know

Kidney stones, though small in size, can bring about immense discomfort and pain. These crystalline formations, which develop within the kidney or urinary tract, can cause sharp, stabbing sensations during their passage through the urinary system. Beyond the immediate discomfort, kidney stones can lead to complications such as urinary tract infections and blockages, underscoring the importance of understanding their causes, symptoms, and treatments. In this article, we delve into the finer lines of kidney stones, exploring their formation, risk factors, and management strategies. Whether you're seeking preventive measures or coping mechanisms for current symptoms, gaining insight into kidney stones can empower you to navigate this common urological concern with confidence and clarity. Let’s begin with understanding the basics.

What are Kidney Stones?

Kidney stones are small, solid mineral deposits that form in the kidneys or urinary tract. These stones can vary in size and composition, ranging from tiny grains to larger, jagged structures. They are typically made up of substances such as calcium, oxalate, uric acid, or cystine, which can crystallise and accumulate over time. While small stones may pass on their own without causing significant symptoms, larger stones may require medical intervention to alleviate discomfort and prevent complications.

What are the Complications of Kidney Stones?

Kidney stones can lead to several complications, especially if left untreated or if they cause obstruction in the urinary tract. Potential complications of kidney stones include:

• Acute Pain: While passing kidney stones, some individuals may experience acute pain in the back, abdomen, or groin area, known as renal colic. This pain can be debilitating and affect the quality of life.
• Urinary Tract Infections (UTIs): Kidney stones can serve as a nidus for bacteria, leading to urinary tract infections (UTIs). UTIs can cause symptoms such as frequent urination, burning sensation during urination, and fever.
• Blockage of Urine Flow: Large kidney stones or stones that become lodged in the urinary tract can block the flow of urine, leading to severe pain, urinary retention, and potentially serious complications such as kidney damage or infection.
• Hydronephrosis: Hydronephrosis is a condition characterised by the swelling or enlargement of the kidneys due to the build-up of urine. It can occur as a result of obstruction caused by kidney stones, leading to back pain, urinary symptoms, and potential kidney damage if left untreated.
• Kidney damage: Prolonged obstruction or recurrent kidney stone formation can lead to kidney damage, affecting the function of the kidneys over time. Chronic kidney disease (CKD) or kidney failure may occur in severe cases.

• Sepsis: In rare cases, kidney stones can lead to a severe systemic infection known as sepsis. Sepsis is a life-threatening condition that requires immediate medical attention and treatment.

• Recurrent Kidney Stones: Individuals who have had kidney stones are at an increased risk of developing recurrent stones. Without proper management and preventive measures, recurrent kidney stones can lead to ongoing symptoms and complications.

It's essential to seek medical attention if you experience symptoms of kidney stones or complications associated with them. Early diagnosis and treatment can help prevent complications and improve outcomes for individuals with kidney stones.

What are the Treatment Options for Kidney Stones?

Treatment options for kidney stones can be broadly categorised into non-surgical management and surgical management, depending on the size, composition, and location of the stones.

Non-surgical management of kidney stones

• Watchful waiting: In some cases, small kidney stones may pass out of the body on their own without medical intervention. Patients may be advised to drink plenty of fluids and take pain medications to help facilitate stone passage.
• Pain management: Over-the-counter or prescription pain medications may be recommended to alleviate discomfort caused by kidney stones. Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are commonly used to manage pain during stone passage. One has check kidney function by blood test to make sure kidneys are working well before prescribing painkillers for longer periods
• Medications: Certain medications, such as alpha-blockers or calcium channel blockers, may be prescribed to relax the muscles of the ureter and facilitate stone passage. Additionally, medications to control underlying conditions that contribute to stone formation, such as hypercalciuria or hyperuricosuria, may be prescribed.

Surgical Management of Kidney Stones

• Extracorporeal Shock Wave Lithotripsy (ESWL): Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure that uses shock waves to break kidney stones into smaller fragments, which can then pass out of the body in the urine. It is typically used for small to medium-sized stones located in the kidney or upper urinary tract.
• Ureteroscopy (URS)/ RIRS: URS and RIRS involves the insertion of a thin, flexible scope through the urethra and bladder to reach the ureter and kidney. Small instruments, such as lasers or baskets, are used to fragment or remove stones located in the ureter or kidney.
• Percutaneous Nephrolithotomy (PCNL): Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large or complex kidney stones. A small keyhole is made in the back, and a nephroscope is inserted through the incision to access and remove the stones from the kidney.
• Open Surgery: In rare cases where other treatments are not feasible or effective, open surgery may be performed to remove large or complicated kidney stones. This involves making a larger incision in the back or abdomen to access the kidney and remove the stones.

Note: A comprehensive evaluation by a healthcare provider is essential to determine the most appropriate treatment approach for each individual case of kidney stones.

How to Prevent Kidney Stones?

Preventing kidney stones involves adopting lifestyle and dietary changes to reduce the risk of stone formation. Here are some strategies to help prevent kidney stones:

• Stay Hydrated: Drink plenty of water throughout the day to maintain urine volume and prevent the concentration of minerals that can lead to stone formation. Aim to drink at least 8-10 glasses of water daily, or enough to keep your urine colour pale yellow.

• Maintain a Healthy Diet: Follow a balanced diet that includes plenty of fruits, vegetables, and whole grains, and limits high-oxalate foods such as spinach, rhubarb, nuts, and chocolate. Limit salt intake and avoid excessive consumption of animal protein, which can increase the risk of kidney stones.
• Monitor calcium intake: While calcium is an essential mineral for bone health, excessive intake from supplements or high-dose calcium antacids may increase the risk of kidney stones. Aim to meet your calcium needs through dietary sources and discuss calcium supplements with your healthcare provider if necessary.
• Limit Oxalate-rich foods: Some foods are high in oxalates, which can contribute to the formation of calcium oxalate kidney stones. Limit consumption of foods such as spinach, beets, nuts, chocolate, and tea, and consider pairing oxalate-rich foods with calcium-rich foods to help reduce oxalate absorption.
• Reduce Sodium intake: High sodium intake can increase calcium excretion in the urine, leading to the formation of calcium-containing kidney stones. Limit your intake of processed and packaged foods, which are often high in sodium, and opt for fresh, whole foods instead.
• Monitor Medications: Some medications, such as diuretics, antacids, and certain prescription medications, can increase the risk of kidney stones. Discuss your medications with your healthcare provider and inquire about potential side effects related to kidney stone formation.
• Consider dietary supplements: Certain dietary supplements, such as citrate or magnesium supplements, may help prevent the formation of kidney stones by inhibiting stone formation or promoting urinary tract health. Consult with your healthcare provider before taking any supplements.

By incorporating these preventive measures into your lifestyle, the risk of kidney stones can be reduced. If someone has a history of kidney stones or is at increased risk, it is important for them to consult with their doctor for personalised recommendations and guidance.

Commonly Asked Questions about Kidney Stones

1. Do I need surgery for removal of stone?

This depends on the location, size of the stone and the damage it is causing to our kidneys. A small stone of size 6 mm or less, which is in the urinary tube (Ureter) not causing much swelling of the kidney, can be managed medically. You will not require surgery but you have to be under medical supervision. Also Read About Kidney Removal Surgery

Small kidney stones of size 5 mm (0.5 cm) also do not require surgery for removal, until and unless they come down and get stuck in the tube (Ureter). Larger stones than 5 mm (0.5 cm) in the ureter causing swelling of the kidney or infection require immediate removal by ureteroscopy and Holmium LASER.

As per the doctor, small obstructing stones in the kidney also require removal by either Shock waves (ESWL) i.e. crushing the stone from outside. Though this method is not so effective in stones of our region because they are hard calcium stones.

The other method is by going to the kidney through a ureter with a flexible scope and crushing the stones with Holmium LASER. This method is called Retrograde Intrarenal Surgery (RIRS). Large kidney stones can be removed by a small hole (approximately 5 mm) through the skin. This method is called Percutaneous Nephrolithotripsy (PCNL). Nowadays, it is extremely rare to do open surgery for kidney stones.

2. Will I get kidney stones again?

There is a high probability that one gets the stone again in their lifetime. Almost 40% of patients can develop a second stone in their lifetime. Therefore it is essential for stone formers to undergo a regular followup with the best urologist whether they require surgical or medical therapy for kidney stones treatment. Also check: How to dissolve kidney stones with apple cider vinegar.

3. Can I do something to prevent reformation of stones?

To reduce the recurrence rate of stone formation patients require certain blood, urine tests and stone analysis. Those patients who are identified to have certain metabolic defects can be treated medically to reduce the reformation of stones. Otherwise, the rest of the patients are advised to modify their diet and increase water intake.

4. Can kidney stones damage my kidneys?

Stones which block the kidney, whether they are in kidney or ureter and cause swelling of the kidney can gradually damage the kidney function. Stones can also cause recurrent infection in the urinary tract which can further damage the renal function. Therefore even asymptomatic stones should be kept in surveillance.

5. How do I know if my kidney stone requires surgery?

If a kidney stone is large, causing severe symptoms, or leading to complications like kidney damage or infection, surgery may be necessary. Additionally, if conservative measures fail to alleviate symptoms or facilitate stone passage, surgical intervention may be recommended. Ultimately, the decision is based on factors such as stone size, location, and associated symptoms, and is made in consultation with a healthcare provider.

6. What are the risks associated with kidney stone surgery?

While kidney stone removal surgery is considered a fairly safe procedure, just like any surgical intervention, it has certain risks. These may include infection, bleeding, damage to surrounding tissues or organs, pain, and potential complications from anaesthesia.

Wrap up

If you or someone you know has been experiencing symptoms of kidney stones, it's important to seek prompt medical attention. The specialists at Max Hospitals are highly experienced in.diagnosing and treating kidney stones using the latest techniques and technologies. With a focus on patient-centred care and personalised treatment plans, our team is dedicated to providing the highest quality of care to help you achieve optimal health and well-being. Book an appointment with one of our specialists for expert guidance and support.