Diagnosed with Kidney Stone - What Next?

What Is a Kidney Stone?

Kidney stones are hard deposits formed inside the kidney and are made of minerals and salts. It is also called nephrolithiasis, renal calculi, and urolithiasis. Stones can form anywhere in the urinary tract, from the kidney to the urinary bladder. Many patients are found to have small 3 mm to 5 mm stones in the kidneys. They get worried and rush to the doctor. Some land up taking unnecessary, costly treatment.

What Are the Types of Kidney Stones?

The type of kidney stone helps in determining the cause for the formation. Therefore, collecting a stone that you have passed in urine will help identify the cause. The following are the types of kidney stones:

• Calcium stones.

• Uric acid stones.

• Struvite stones.

• Cystine stones.

What Are the Symptoms of Kidney Stones?

Pain is produced only when kidney stones move in the kidney or travel down the ureter. The ureter is the tube that connects the kidney with the urinary bladder. Pain associated with kidney stones exhibits shifting and a rise in intensity as the stone movies downwards through the urinary tract. In a few cases, the stones might get lodged between the ureter, leading to blockage of urine, swelling of kidneys, and ureter spasm. This produces a lot of pain and is characterized by the following symptoms:

• There is sharp and severe pain on the sides, back, and below the ribs.

• Radiating pain to the groin and lower stomach.

• Pain and burning sensation while urinating.

• Intermittent pain which shows a fluctuation in intensity.

In addition to this, the following symptoms may also occur:

• The color of urine becomes pink, brown, or red.

• Frequent urge to urinate.

• Increased urination.

• Passing only small amounts of urine.

• Nausea and vomiting.

• Cloudy urine.

• Foul-smelling urine.

• Fever.

• Chills.

What Causes Kidney Stones?

There is no particular cause for kidney stones. It is influenced by several risk factors. When there is an increased amount of crystal-forming substances like oxalate, uric acid, and calcium in urine or inadequate fluids to dilute the urine, kidney stones may form. Also, the lack of substances that prevent the crystals from sticking increases the risk of developing kidney stones.

What Increases the Risk of Developing Kidney Stones?

• Previous History or Family History of Kidney Stone: The risk of developing kidney stones is increased in individuals who have had a prior history of kidney stones or have family members with a history of kidney stones.

• Diet: Increased intake of foods rich in proteins, sodium, and salt raises the risk of developing kidney stones. Excessive salt consumption increases the amount of calcium that has to be filtered by the kidneys, thereby increasing the chance of causing kidney stones.

• Dehydration: Inadequate water intake increases the risk. The risk is even more increased in people who live in hot and humid climates and sweat a lot.

• Digestive Problems and Surgeries: Calcium and water absorption is reduced in inflammatory bowel disease and chronic diarrhea and after gastric bypass surgery. Thus the risk of kidney stones is increased in such patients.

• Obesity: The risk of developing kidney stones is increased in people who have increased BMI, raised waist circumference, and weight gain.

• Supplements and Medications: The chance of kidney stone formation is increased in people who take calcium-based antacids, laxatives, Vitamin C supplements, dietary supplements, and drugs that help treat migraines and depression.

• Medical Conditions: Kidney stone formation can occur in people with chronic medical conditions like recurrent urinary tract infections, cystinuria, hyperparathyroidism, and renal tubular acidosis.

How Is a Kidney Stone Diagnosed?

1. Blood Tests:

The calcium and uric acid level in the blood helps investigate renal health and diagnose other associated health conditions.

2. Urine Tests:

Urine tests are taken to detect the presence of crystal-forming substances in urine or substances which prevent stone formation. The urine sample is collected over 24 hours for two consecutive days.

3. Imaging:

High-speed or dual-energy computed tomography helps in diagnosing kidney stones that are even too small. Ultrasound also helps in the diagnosis. An abdominal X-ray is not frequently recommended to detect small stones.

4. Stone Analysis:

The passed stones are analyzed in the laboratory to determine the cause.

What Should I Do After I Have Been Diagnosed With a Kidney Stone?

The anatomy of the urinary system is such that urine formed in the kidney is transported to the urinary bladder by a narrow tube called the ureter.

Size is the limiting factor for the natural passage of kidney stones through this narrow path. The ureter can accommodate around 4 mm diameter stones. Multiple kidney stones of size 3 mm to 4 mm have an increased likelihood of spontaneously passing through the urinary tract. As the size progressively increases, the chance of the stone getting stuck increases. Then, it requires some procedures to clear kidney stones.

Regular high fluid intake and healthy physical activity in patients carrying multiple small stones may help in the spontaneous passage of stones. But, they need to remain alert to some of the following danger signs to seek urgent medical help.

• Fever, persistent pain, and swelling in the kidney due to a stone on ultrasound are red flag signs and need urgent treatment.

• Infection in an obstructed system manifesting as fever can cause life-threatening sepsis.

• Persistent swelling in the kidney may progressively damage kidney function if not relieved.

• Pain due to small stones passing through the ureter can be managed medically if no danger signs are present. But, never neglect surgery for stone disease if required as it may cost you the kidney.

Do not get worried if you were recently diagnosed with small kidney stones on ultrasound during a health checkup. The likelihood of spontaneously passing a stone less than 5 mm is 77 %, whereas, for stones greater than 5 mm, it is 46 %. The interval of the stone passage is highly variable and is dependent on the stone size and location. About 40 days are required for stones of size 2 mm to 6 mm to pass out the urinary tract.

In patients where the stone size is more significant, surgical options are needed, which include the following:

• Extracorporeal shock wave lithotripsy.

• Percutaneous nephrolithotomy.

• Removing stone with the help of a ureteroscope.

• Parathyroid gland surgery.

What Lifestyle Remedies Help in Preventing Kidney Stone Formation?

• Intake of adequate amount of water.

• Reduce the intake of oxalate-rich foods like tea, black pepper, chocolate, soy products, nuts, sweet potatoes, and swiss chard.

• Take a diet that contains less salt and animal proteins.

• Replace animal proteins with non-animal proteins like legumes.

• Be cautious while taking calcium supplements.

• Do take foods that contain calcium. Only reduce the intake of calcium when the doctor advises to do so.

Conclusion:

Do not be grieved about getting kidney stones. With proper treatment, kidney stones can be fully treated, and further occurrence can be prevented by taking appropriate preventive measures. Do take an adequate amount of water and reduce the intake of salt.