Kidney stone

DESCRIPTION

Definition
 
A kidney stone is a solid, hard, crystalline material that can form in one or both kidneys or anywhere along the urinary tract, which includes the kidneys, ureters, bladder, and the urethra. They are also referred to as renal calculi and the medical condition is termed as nephrolithiasis.
 
Causes and Risk Factors
 
There are a number of reasons that predispose to kidney stone formation. Some of them are:
1. Family history
2. Dietary habits: Diet rich in meat, chicken and extra-salt.
3. Dehydration
4. Calcium supplements
5. Antacid preparations containing calcium
 
Signs and Symptoms
 
Signs and symptoms of kidney stone include:
1. Pain: A sudden sharp pain in your back, side, lower abdomen, or groin can indicate a kidney stone. This severe pain is called renal colic. This pain may come and go, but may be intense.
2. Blood in urine: Another symptom maybe passing of red, pink, or brown urine which indicates blood in the urine.
3. Other symptoms: Other symptoms maybe nausea, vomiting, or change in the frequency of passing urine. Fever and chills are present when there is an infection.
 
In case of a small stone that does not obstruct the urinary tract and easily passes through it, a person may not have any symptoms at all.
 
Investigations
 
The doctor will take a thorough medical history and perform a physical examination. To confirm the presence of kidney stone, the doctor will ask for certain tests such as:
1. X-ray of KUB (kidney & urinary bladder)
2. Ultrasound
3. CT scan
 
The following laboratory tests may also be asked for:
1. Urine analysis
2. Kidney function tests
3. Blood tests for calcium, phosphorous, uric acid.
 
Treatment
 
1. Most people with small kidney stones (less than 4 mm in size) are able to pass them on their own within 48 hours by drinking plenty of fluids.
2. Analgesics may help in relieving the pain. In case of severe nausea and vomiting or dehydration, intravenous fluids may be administered. The presence of infection requires treatment with antibiotics.
3. Medical management depends on the type of stones. For example, allopurinol may be prescribed for uric acid stones or potassium citrate for oxalate stones.
4. Stones which do not pass on their own may be removed by lithotripsy that uses sound waves to break up large stones or through a small incision in the skin by percutaneous nephrolithotomy.
 
Complications and When Should You See a Doctor
 
Kidney stones can block the flow of urine leading to a condition called urinary obstruction. This can lead to kidney infection also called pyelonephritis which may spread through the blood, leading to sepsis. The stone could damage the kidneys or injure the ureters while passing through it. Recurrent urinary tract infections could also occur.
 
Prognosis and Prevention
 
1. The best way to prevent kidney stones is by drinking at least 8 to 10 glasses of water per day.
2. Kidney stones can be prevented in the future by reducing salt-intake and animal protein consumption (red meat and poultry).
3. Oxalate-rich foods, such as spinach, beets, peanuts, quinoa should be consumed in moderation.
4. If a person has had a kidney stone in the past, he/she is at an increased risk of developing the stones in future and must consult a doctor.
 
Did You Know?
 
1. About one in 11 people develop kidney stones at some point in their life.
2. More than half of those who are diagnosed will have another within 5 to 10 years.
 

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